This is the presentation by Dr. Padmal De Silva - Head of the Research Unit, National Institute of Health Sciences, Sri Lanka done on the inauguration of Medical Research Consortium. http://learnent.net/research-symposium-dgh-hambantota/
The document provides an overview of key concepts in health research methodology. It discusses identifying research topics and prioritizing them based on relevance, feasibility, and other criteria. The document also covers analyzing problems, formulating clear problem statements, conducting literature reviews, and developing research objectives. The overall aim is to guide researchers in designing and planning rigorous, ethical health research studies.
This document discusses various topics related to health research including:
- Definitions of research and health research.
- Key attributes of good research include planning, accurate data collection, and proper unbiased interpretation.
- Health research serves to identify health challenges and provide solutions to improve health systems.
- Both quantitative and qualitative research methods are useful for understanding health issues.
This document summarizes a journal club presentation on a study about premarital sexual behavior among male college students in Kathmandu, Nepal. The presentation includes a critical appraisal of the selected research article addressing its study design, methods, results, and conclusions. It provides an overview of the article authors, journal, methods used in the study, key findings on premarital sexual experiences and awareness among participants, and strengths of addressing an important public health issue.
This document provides an overview of research methodology in medical research. It discusses what research is, types of research including conventional and unconventional, and the objectives of research. The basis of research methodology in medical research is explained, noting that medicine is inherently experimental. The steps in medical research are outlined, including identifying the problem, formulating research questions, study design and methodology, data collection and analysis. Common research study designs like case reports, case series, cohort studies, randomized clinical trials and meta-analyses are described.
This document outlines the table of contents for a textbook on public health and community medicine. It includes 11 sections that cover topics such as introduction and general concepts in public health, epidemiology, health policy, environmental health, nutrition, family health, communicable diseases, non-communicable diseases, occupational health, and more. Each section addresses important qualitative and quantitative issues within its respective topic area. The textbook aims to provide comprehensive coverage of concepts, principles, and practices for public health and community medicine.
This document provides an overview of evidence-informed decision making and critical appraisal for nursing practice. It defines evidence-informed decision making and its importance for nursing. It also outlines the steps of evidence-informed decision making including formulating a focused, answerable question using PICO/PICOT, searching for and collecting the best evidence, and critically appraising the literature. Criteria for critically appraising different study designs are discussed, including intervention studies. The importance of critical appraisal for nursing practice, policy, and research is emphasized.
The document provides an overview of key concepts in health research methodology. It discusses identifying research topics and prioritizing them based on relevance, feasibility, and other criteria. The document also covers analyzing problems, formulating clear problem statements, conducting literature reviews, and developing research objectives. The overall aim is to guide researchers in designing and planning rigorous, ethical health research studies.
This document discusses various topics related to health research including:
- Definitions of research and health research.
- Key attributes of good research include planning, accurate data collection, and proper unbiased interpretation.
- Health research serves to identify health challenges and provide solutions to improve health systems.
- Both quantitative and qualitative research methods are useful for understanding health issues.
This document summarizes a journal club presentation on a study about premarital sexual behavior among male college students in Kathmandu, Nepal. The presentation includes a critical appraisal of the selected research article addressing its study design, methods, results, and conclusions. It provides an overview of the article authors, journal, methods used in the study, key findings on premarital sexual experiences and awareness among participants, and strengths of addressing an important public health issue.
This document provides an overview of research methodology in medical research. It discusses what research is, types of research including conventional and unconventional, and the objectives of research. The basis of research methodology in medical research is explained, noting that medicine is inherently experimental. The steps in medical research are outlined, including identifying the problem, formulating research questions, study design and methodology, data collection and analysis. Common research study designs like case reports, case series, cohort studies, randomized clinical trials and meta-analyses are described.
This document outlines the table of contents for a textbook on public health and community medicine. It includes 11 sections that cover topics such as introduction and general concepts in public health, epidemiology, health policy, environmental health, nutrition, family health, communicable diseases, non-communicable diseases, occupational health, and more. Each section addresses important qualitative and quantitative issues within its respective topic area. The textbook aims to provide comprehensive coverage of concepts, principles, and practices for public health and community medicine.
This document provides an overview of evidence-informed decision making and critical appraisal for nursing practice. It defines evidence-informed decision making and its importance for nursing. It also outlines the steps of evidence-informed decision making including formulating a focused, answerable question using PICO/PICOT, searching for and collecting the best evidence, and critically appraising the literature. Criteria for critically appraising different study designs are discussed, including intervention studies. The importance of critical appraisal for nursing practice, policy, and research is emphasized.
A systematic review is a rigorous analysis of published research on a focused question that collects and summarizes the evidence. It contrasts with an overview, which may include non-research articles and be influenced by other evidence. Meta-analysis uses statistical methods to combine results from multiple studies. To ensure validity, meta-analyses must have a well-defined methodology, including comprehensive searches and duplicate screening and data extraction to reduce bias. Important factors include assessing whether all relevant studies were found and the sources searched, as well as controlling for biases such as from selective data extraction or funding influences.
This document describes different types of epidemiological study designs, including observational studies like cross-sectional, case-control, cohort, and experimental studies like randomized controlled trials. It provides details on descriptive versus analytical epidemiology and cross-sectional studies specifically. Cross-sectional studies measure prevalence at a single point in time by surveying exposures and disease status simultaneously in a population cross-section. They are useful for assessing disease burden, comparing prevalence between populations, and examining trends over time.
This document defines statistics and its uses in community medicine. It outlines the objectives of describing statistics, summarizing data in tables and graphs, and calculating measures of central tendency and dispersion. Various data types, sources, and methods of presentation including tables and graphs are described. Common measures used to summarize data like percentile, measures of central tendency, and measures of dispersion are defined.
This document outlines a large systematic review conducted by the UK's Health and Safety Executive to develop evidence-based management standards for work-related stress. The review aimed to answer four questions: (1) What proportions of the population are exposed to harmful levels of nine key work stressors? (2) What are the effects of these stressors on health, well-being and performance? (3) What are the mechanisms by which stressors have these effects? (4) What organizational activities reduce stress? The review provides an example of a large, rigorous systematic review conducted to inform policy and practice guidelines.
This document discusses ethical issues in scientific research involving human subjects. It outlines several key principles of research ethics including informed consent, minimizing harm, protecting privacy and confidentiality, ensuring justice and beneficence, and maintaining integrity. International codes like the Nuremberg Code, Helsinki Declaration, and Belmont Report established foundational ethical standards. Indian guidelines also adhere to strict ethical protocols for research involving human participants. Institutional ethics committees play an important role in reviewing research proposals and protocols to ensure compliance with ethical standards.
This document discusses different risk measures used in epidemiology, including relative risk, odds ratio, and attributable risk. Relative risk measures the strength of association between an exposure and disease based on prospective studies. Odds ratio is used similarly in case-control studies when relative risk cannot be directly calculated. Attributable risk determines how much disease can be attributed to a specific exposure by comparing disease rates in exposed and unexposed groups. These measures provide important information for evaluating disease causation and determining potential disease prevention through reducing exposures.
This document discusses key considerations for designing a retrospective study. It explains that retrospective studies analyze existing data collected for other purposes. The document outlines different retrospective study designs including cross-sectional, case-control, and cohort studies. It emphasizes important elements like defining a research question, conducting a literature review, determining sample size and sampling strategy, developing data collection instruments, establishing inclusion/exclusion criteria, ensuring reliability of data abstraction, and piloting the study methodology. Overall, the document provides guidance on setting up a rigorous retrospective study design.
This document discusses how to read and understand medical research articles. It begins by outlining the common components of articles, including the abstract, introduction, methods, results, discussion, and conclusion sections. It then describes different types of articles like case reports, reviews, and editorials. Next, it covers levels of evidence in medical research and systems for grading evidence. It provides guidance on how to effectively read articles, including preparing, understanding the structure and content, and evaluating the findings. Finally, it discusses signs of dubious or unreliable data in articles. In summary, the document provides a comprehensive overview of medical research articles and how readers can critically analyze and understand their content and conclusions.
This document provides an overview of the key steps involved in research methodology. It discusses 14 steps that should be followed in research studies: 1) formulating the research question, 2) literature review, 3) drawing up a protocol, 4) formulating objectives, 5) defining the study population, 6) determining the sample and sampling technique, 7) defining the variables, 8) defining the disease, 9) determining the type and scale of measurements, 10) constructing questionnaires, 11) methods of data collection, 12) data processing methods, 13) analyzing and interpreting results, and 14) writing the report. For each step, important considerations and definitions are outlined.
1. The document discusses various types of medical research designs including observational and experimental studies.
2. Observational studies are divided into descriptive studies which aim to describe health problems without comparisons, and analytical studies which aim to identify associations between exposures and outcomes.
3. Experimental research designs involve assigning subjects to treatment or control groups randomly to evaluate new interventions while controlling for confounding factors. Randomized controlled trials are considered the gold standard for evaluating new treatments.
The document outlines the steps to choosing a research topic:
1. Brainstorm potential topics through considering relevance, feasibility, novelty, and ethics.
2. Conduct background research to understand aspects of the topic to focus on.
3. Specify the topic by identifying the area of interest, geographic area, time frame, and target population.
4. Formulate the research topic title using the framework of what, who, where, when and how, with proper capitalization and no abbreviations.
Data
Information
Intelligence
Health information system
Sources of data
Census
Registration of vital events
Sample registration system
Notification of diseases
Hospital records
Disease registers
Record linkage
Epidemiological surveillance
Other health service records
Environmental health data
Health manpower statistics
Population surveys
Other routine statics related to health
Non – quantifiable information
Health management information system
Central Bureau of health Ingelligence
National health profile
WHO Reports
Global Health Observatory
World bank
Health stats
An epidemiological experiment in which subjects in a population are randomly allocated into groups, usually called study and control groups to receive and not receive an experimental preventive or therapetuic procedure, maneuver, or intervention .
This module was developed at the School of Public Health, University for the Western Cape for the Postgraduate Certificate in Public Health which was offered as a distance learning module between 2001 and 2008. Health Systems Research is an integral part of the vision for a quality, comprehensive, community-based, participatory and equitable system. This module aims to provide an introduction to the kinds of research conducted within a health system, the research designs and methods used, and how to develop a research protocol.
A systematic review (SR) is a rigorous and organized method to synthesize
the evidence from multiple studies on a particular research question or topic.
The purpose of a systematic review is to identify, appraise, and summarize all
available evidence relevant to a specific research question in a transparent
and replicable manner.
It aims to provide a comprehensive overview of academic literature
concerning a particular research question of topic.
This presentation explores the steps nee
The document discusses various frameworks for rating the level of evidence in studies, including the NHMRC, GRADE, Oxford Centre for Evidence-Based Medicine, and Sackett scales. It outlines the different levels in each scale, with the highest levels reserved for systematic reviews and randomized controlled trials. The lowest levels include case series, case reports, and expert opinion without critical analysis. It also provides guidance on selecting the appropriate study design based on different types of clinical questions regarding therapy, diagnosis, etiology, prognosis, prevention, or costs.
Problem (how to form good research question)metalkid132
The document discusses how to form a good research question. It outlines the importance of having a well-defined research question and lists characteristics of effective questions such as being answerable, specific, and building on previous research. The document also provides guidance on developing a research question by selecting a topic and issue and determining if a topic can be researched. It describes how to transform a research question into testable hypotheses and common mistakes to avoid such as questions being too broad, subjective, controversial, familiar, or technical.
A systematic review is a structured review that pools the results of multiple studies on a topic using meta-analysis. It aims to summarize evidence from studies addressing a specific clinical question in a rigorous, unbiased manner to explain differences among studies on the same question. Systematic reviews are considered the highest level of evidence and are needed because individual studies may have biases or low statistical power to detect effects.
This document provides information on conducting a literature review. It defines a literature review and discusses the key components, including identifying and synthesizing existing works on a topic through a systematic process. The document outlines 7 steps for conducting a literature review: selecting research questions, sources, search terms, screening criteria, quality assessment, reviewing the literature, and synthesizing results. It also discusses different types of literature reviews and provides guidance on writing an introduction, body, and conclusion. Additionally, the document describes various resources and databases for searching literature, such as PubMed, Google Scholar, and Cochrane Library. It emphasizes developing a search strategy using keywords and Boolean operators to efficiently extract relevant information.
This document outlines a 2-day course on research methodology. The course objectives are to help students understand basic research concepts, identify appropriate research topics, and learn how to conduct, write, and propose research more effectively. The course consists of 4 modules that cover an overview of research methods, literature reviews, problem definition, conducting research, writing reports/theses/proposals, and examples of research. The course aims to provide students with skills to undertake research projects and better organize and write up their findings.
Portfolio Project - Simple yet versatile mobile friendly portfolio system for...MTD Lakshan
This document describes a portfolio project to create a home-brewed software solution for portfolio management. It aims to develop a minimum burden, reliable, accessible, simple, and multimedia capable portfolio system that is assessment ready and less technical. The system started development in 2010 using Drupal, an open source content management system. It allows data entry for a variety of portfolio elements such as academic qualifications, employment details, logbook entries, research publications, reflections, teaching, and professional commitments. The document demonstrates the mobile data entry features and discusses future plans to add offline data entry, mobile apps, integrated point calculation, categorization, accreditation, and usage data collection.
A systematic review is a rigorous analysis of published research on a focused question that collects and summarizes the evidence. It contrasts with an overview, which may include non-research articles and be influenced by other evidence. Meta-analysis uses statistical methods to combine results from multiple studies. To ensure validity, meta-analyses must have a well-defined methodology, including comprehensive searches and duplicate screening and data extraction to reduce bias. Important factors include assessing whether all relevant studies were found and the sources searched, as well as controlling for biases such as from selective data extraction or funding influences.
This document describes different types of epidemiological study designs, including observational studies like cross-sectional, case-control, cohort, and experimental studies like randomized controlled trials. It provides details on descriptive versus analytical epidemiology and cross-sectional studies specifically. Cross-sectional studies measure prevalence at a single point in time by surveying exposures and disease status simultaneously in a population cross-section. They are useful for assessing disease burden, comparing prevalence between populations, and examining trends over time.
This document defines statistics and its uses in community medicine. It outlines the objectives of describing statistics, summarizing data in tables and graphs, and calculating measures of central tendency and dispersion. Various data types, sources, and methods of presentation including tables and graphs are described. Common measures used to summarize data like percentile, measures of central tendency, and measures of dispersion are defined.
This document outlines a large systematic review conducted by the UK's Health and Safety Executive to develop evidence-based management standards for work-related stress. The review aimed to answer four questions: (1) What proportions of the population are exposed to harmful levels of nine key work stressors? (2) What are the effects of these stressors on health, well-being and performance? (3) What are the mechanisms by which stressors have these effects? (4) What organizational activities reduce stress? The review provides an example of a large, rigorous systematic review conducted to inform policy and practice guidelines.
This document discusses ethical issues in scientific research involving human subjects. It outlines several key principles of research ethics including informed consent, minimizing harm, protecting privacy and confidentiality, ensuring justice and beneficence, and maintaining integrity. International codes like the Nuremberg Code, Helsinki Declaration, and Belmont Report established foundational ethical standards. Indian guidelines also adhere to strict ethical protocols for research involving human participants. Institutional ethics committees play an important role in reviewing research proposals and protocols to ensure compliance with ethical standards.
This document discusses different risk measures used in epidemiology, including relative risk, odds ratio, and attributable risk. Relative risk measures the strength of association between an exposure and disease based on prospective studies. Odds ratio is used similarly in case-control studies when relative risk cannot be directly calculated. Attributable risk determines how much disease can be attributed to a specific exposure by comparing disease rates in exposed and unexposed groups. These measures provide important information for evaluating disease causation and determining potential disease prevention through reducing exposures.
This document discusses key considerations for designing a retrospective study. It explains that retrospective studies analyze existing data collected for other purposes. The document outlines different retrospective study designs including cross-sectional, case-control, and cohort studies. It emphasizes important elements like defining a research question, conducting a literature review, determining sample size and sampling strategy, developing data collection instruments, establishing inclusion/exclusion criteria, ensuring reliability of data abstraction, and piloting the study methodology. Overall, the document provides guidance on setting up a rigorous retrospective study design.
This document discusses how to read and understand medical research articles. It begins by outlining the common components of articles, including the abstract, introduction, methods, results, discussion, and conclusion sections. It then describes different types of articles like case reports, reviews, and editorials. Next, it covers levels of evidence in medical research and systems for grading evidence. It provides guidance on how to effectively read articles, including preparing, understanding the structure and content, and evaluating the findings. Finally, it discusses signs of dubious or unreliable data in articles. In summary, the document provides a comprehensive overview of medical research articles and how readers can critically analyze and understand their content and conclusions.
This document provides an overview of the key steps involved in research methodology. It discusses 14 steps that should be followed in research studies: 1) formulating the research question, 2) literature review, 3) drawing up a protocol, 4) formulating objectives, 5) defining the study population, 6) determining the sample and sampling technique, 7) defining the variables, 8) defining the disease, 9) determining the type and scale of measurements, 10) constructing questionnaires, 11) methods of data collection, 12) data processing methods, 13) analyzing and interpreting results, and 14) writing the report. For each step, important considerations and definitions are outlined.
1. The document discusses various types of medical research designs including observational and experimental studies.
2. Observational studies are divided into descriptive studies which aim to describe health problems without comparisons, and analytical studies which aim to identify associations between exposures and outcomes.
3. Experimental research designs involve assigning subjects to treatment or control groups randomly to evaluate new interventions while controlling for confounding factors. Randomized controlled trials are considered the gold standard for evaluating new treatments.
The document outlines the steps to choosing a research topic:
1. Brainstorm potential topics through considering relevance, feasibility, novelty, and ethics.
2. Conduct background research to understand aspects of the topic to focus on.
3. Specify the topic by identifying the area of interest, geographic area, time frame, and target population.
4. Formulate the research topic title using the framework of what, who, where, when and how, with proper capitalization and no abbreviations.
Data
Information
Intelligence
Health information system
Sources of data
Census
Registration of vital events
Sample registration system
Notification of diseases
Hospital records
Disease registers
Record linkage
Epidemiological surveillance
Other health service records
Environmental health data
Health manpower statistics
Population surveys
Other routine statics related to health
Non – quantifiable information
Health management information system
Central Bureau of health Ingelligence
National health profile
WHO Reports
Global Health Observatory
World bank
Health stats
An epidemiological experiment in which subjects in a population are randomly allocated into groups, usually called study and control groups to receive and not receive an experimental preventive or therapetuic procedure, maneuver, or intervention .
This module was developed at the School of Public Health, University for the Western Cape for the Postgraduate Certificate in Public Health which was offered as a distance learning module between 2001 and 2008. Health Systems Research is an integral part of the vision for a quality, comprehensive, community-based, participatory and equitable system. This module aims to provide an introduction to the kinds of research conducted within a health system, the research designs and methods used, and how to develop a research protocol.
A systematic review (SR) is a rigorous and organized method to synthesize
the evidence from multiple studies on a particular research question or topic.
The purpose of a systematic review is to identify, appraise, and summarize all
available evidence relevant to a specific research question in a transparent
and replicable manner.
It aims to provide a comprehensive overview of academic literature
concerning a particular research question of topic.
This presentation explores the steps nee
The document discusses various frameworks for rating the level of evidence in studies, including the NHMRC, GRADE, Oxford Centre for Evidence-Based Medicine, and Sackett scales. It outlines the different levels in each scale, with the highest levels reserved for systematic reviews and randomized controlled trials. The lowest levels include case series, case reports, and expert opinion without critical analysis. It also provides guidance on selecting the appropriate study design based on different types of clinical questions regarding therapy, diagnosis, etiology, prognosis, prevention, or costs.
Problem (how to form good research question)metalkid132
The document discusses how to form a good research question. It outlines the importance of having a well-defined research question and lists characteristics of effective questions such as being answerable, specific, and building on previous research. The document also provides guidance on developing a research question by selecting a topic and issue and determining if a topic can be researched. It describes how to transform a research question into testable hypotheses and common mistakes to avoid such as questions being too broad, subjective, controversial, familiar, or technical.
A systematic review is a structured review that pools the results of multiple studies on a topic using meta-analysis. It aims to summarize evidence from studies addressing a specific clinical question in a rigorous, unbiased manner to explain differences among studies on the same question. Systematic reviews are considered the highest level of evidence and are needed because individual studies may have biases or low statistical power to detect effects.
This document provides information on conducting a literature review. It defines a literature review and discusses the key components, including identifying and synthesizing existing works on a topic through a systematic process. The document outlines 7 steps for conducting a literature review: selecting research questions, sources, search terms, screening criteria, quality assessment, reviewing the literature, and synthesizing results. It also discusses different types of literature reviews and provides guidance on writing an introduction, body, and conclusion. Additionally, the document describes various resources and databases for searching literature, such as PubMed, Google Scholar, and Cochrane Library. It emphasizes developing a search strategy using keywords and Boolean operators to efficiently extract relevant information.
This document outlines a 2-day course on research methodology. The course objectives are to help students understand basic research concepts, identify appropriate research topics, and learn how to conduct, write, and propose research more effectively. The course consists of 4 modules that cover an overview of research methods, literature reviews, problem definition, conducting research, writing reports/theses/proposals, and examples of research. The course aims to provide students with skills to undertake research projects and better organize and write up their findings.
Portfolio Project - Simple yet versatile mobile friendly portfolio system for...MTD Lakshan
This document describes a portfolio project to create a home-brewed software solution for portfolio management. It aims to develop a minimum burden, reliable, accessible, simple, and multimedia capable portfolio system that is assessment ready and less technical. The system started development in 2010 using Drupal, an open source content management system. It allows data entry for a variety of portfolio elements such as academic qualifications, employment details, logbook entries, research publications, reflections, teaching, and professional commitments. The document demonstrates the mobile data entry features and discusses future plans to add offline data entry, mobile apps, integrated point calculation, categorization, accreditation, and usage data collection.
This document summarizes different types of ossicular reconstruction surgeries. It begins by classifying middle ear surgeries into 5 types based on concepts of sound transformation and protection proposed by Horst Ludwig Wullstein. It then describes the different types of tympanoplasty procedures in more detail, focusing on Types 2 and 3. Type 2 involves reconstructing the ossicular chain to restore the lever mechanism using prostheses, bone struts, or bone cement. Type 3 procedures directly connect the tympanic membrane to either the stapes or incus using various graft materials or prostheses like the stapes columella, minor columella, or major columella. The document provides examples of synthetic and bi
a basic description of temporal bone anatomy which is necessary for primary radiologic evaluation of temporal bone imaging and some important points and differential diagnoses in related imaging.
This document discusses diagnostic tools for common peripheral vestibular disorders. It describes how a thorough history, physical exam, imaging, and audio-vestibular tests are needed to accurately diagnose the underlying cause of vertigo. Specific disorders like BPPV, Meniere's disease, and vestibular neuritis are examined in terms of their characteristic symptoms, diagnostic criteria and tests. Superior semicircular canal dehiscence syndrome is also overviewed, with an emphasis on its variable clinical presentations and diagnosis using imaging and VEMP testing.
This document provides secrets and tips for success in tympanomastoid surgeries based on the experiences of Dr. Prahlada N B. The key points discussed include:
- Carefully selecting appropriate cases and understanding when not to operate.
- Using good anesthesia techniques like local anesthesia along with general anesthesia.
- Choosing the right surgical approach and technique for each individual patient.
- Mastering incision methods like endaural incisions.
- Performing procedures like canalplasty to improve outcomes.
- Considering whether cortical mastoidectomy is needed in each case.
- Perfecting ossiculoplasty and grafting techniques.
- Providing good post-operative
Time is precious and time is precious. Time is the only commodity which cannot be regained once last. Managing surgical time has many advantages. This presentation describes the advantages of time management during middle ear and mastoid surgeries and describes how to save time during these surgeries.
Canal wall up Mastoidectomy ( Intact Bridge Mastoidectomy) by Dr.Aditya TiwariAditya Tiwari
Canal wall up mastoidectomy is a surgical procedure that involves completely removing the diseased air cells and tissues lateral to the otic capsule while preserving the bony ear canal wall. It is often performed along with tympanoplasty and ossicular chain reconstruction to treat chronic otitis media or mastoiditis. The document outlines the history, anatomy, indications, techniques and complications of canal wall up mastoidectomy.
This document discusses endoscope-assisted middle ear surgery. Some key points:
1) Endoscopes allow wide field visualization with minimal exposure and can see behind obstructions or into recesses with less surgical exposure than conventional techniques.
2) Endoscopes are useful for visualizing the epitympanic recess, facial recess, sinus tympani, Eustachian tube, and hypotympanum.
3) Potential indications for middle ear endoscopy include unexplained conductive hearing loss, trauma, cholesteatoma, perilymph fistula, and follow-up for cholesteatoma.
Here I discuss about the current management guidelines from British Thyroid Association and American Thyroid Association comparing those with the current practice in Sri Lanka
This document provides classifications in various areas of ENT, including head and neck cancer TNM staging, otology classifications like chronic otitis media and presbyacusis, rhinology classifications like nasal polyps and fungal sinusitis, head and neck benign classifications like tonsil size grading and pharyngeal pouch classification, paediatric ENT classifications like croup grading and hemifacial microsomia, and other miscellaneous ENT classifications. The classifications are used for staging diseases, making management decisions, predicting outcomes, monitoring progress, and comparing data.
This document summarizes important anatomical variations of the paranasal sinuses that are relevant for sinusitis. It describes variations that can occur in structures like the agger nasi cells, uncinate process, middle turbinate, cribriform plate, and maxillary ostia. These variations include pneumatization of cells or bony structures as well as anatomical abnormalities that can obstruct drainage of the sinuses. Understanding these variations is important for evaluating patients with recurrent sinusitis as certain variations may contribute to obstruction and recurrence.
Recurrent Laryngeal Nerve and thyroid surgeryMTD Lakshan
This presentation discusses the recurrent laryngeal nerve (RLN) and its relevance to thyroid surgery. It covers the surgical anatomy of the RLN, including its origin, relationship to surrounding structures like the inferior thyroid artery, and anatomical variations. Risks of injury to the RLN during thyroid surgery are reviewed. The presentation emphasizes identifying the RLN to reduce risks of temporary or permanent paralysis, with identification allowing average permanent paralysis rates of 0.9% with localization only versus 0.1% with complete dissection. Factors like anatomical variations, branching patterns, scarring, and extent of disease must be considered during dissection to prevent mechanical, thermal, or severing injuries to the nerve.
Mastoidectomy is a surgical procedure to access and treat infections of the mastoid air cells behind the ear. Over time, the procedure has evolved from simple cortical mastoidectomies described in the 17th century to more advanced techniques using an operating microscope and drill. Modern mastoidectomies are typically classified as canal wall up or canal wall down depending on whether the bony ear canal wall is preserved. Indications include treatment of cholesteatoma, refractory ear infections, and approaches for other inner ear procedures. The surgery involves an incision behind the ear to access and clean out the infected mastoid air cells.
Myringoplasty is a procedure to repair a perforated eardrum using a graft without examining the middle ear. It aims to replace the missing fibrous layer and allow regeneration of skin and mucosa over the graft. The document discusses the indications, contraindications, surgical approaches, techniques, post-op care, complications and advantages/disadvantages of the underlay and overlay techniques. The key steps of underlay involve freshening the perforation edges, elevating the tympanomeatal flap, placing the graft under the flap and reposing the flap. Overlay places the graft over the remaining eardrum and covers it with the elevated skin.
This document provides an overview of endoscopic nasal anatomy. It begins with a brief introduction to endoscopy and its historical evolution. It then describes the external nose, nasal septum, lateral nasal wall including the inferior, middle, and superior turbinates. Various anatomical variations are also discussed. The paranasal sinuses, anterior skull base, and endoscopic approaches to different nasal and sinus structures like the frontal sinus and sphenoid sinus are summarized. Key landmarks and variations are highlighted to provide a concise yet comprehensive summary of the essential endoscopic nasal anatomy concepts covered in the document.
The mastoid bone is located behind the ear and contains air cells connected to the middle ear. A mastoidectomy is a surgical procedure to remove infections or growths from the mastoid bone in order to prevent further damage to hearing. There are different types of mastoidectomies including simple, radical, and modified radical mastoidectomies, which vary in their approach and extent of bone removal based on the condition being treated. Potential risks of mastoidectomy include injury to the facial nerve or semicircular canals.
This document provides an overview of research in medical and health fields. It discusses the importance of health research, defines different types of medical research including basic, applied, quantitative, qualitative, experimental and non-experimental research. It also outlines various research methodologies like descriptive research, exploratory research, cross-sectional research, longitudinal research and case study research. The document emphasizes that medical research facilitates learning, highlights issues, and helps advance treatment, diagnosis and understanding of human health problems through the scientific method.
INTRODUCTION LECTURE_RESEARCH DESIGN AND METHODOLOGY.pptxAkwasiOwusu6
This document discusses research design and methodology in health research. It defines research and health research, and explains that health research involves systematically collecting, analyzing, and interpreting data to answer questions and solve problems in order to improve health. The document discusses how research involves turning information into knowledge through critical assessment. It also explains the importance of health research for informing health policy decisions. The document outlines the research process and emphasizes the importance of ethics in research, discussing principles like beneficence, non-maleficence, respect, and justice when working with human subjects. It also discusses several important codes and declarations that guide ethical research practices.
Here are the answers to your questions:
1. FINER criteria of a good research question are: Feasible, Interesting, Novel, Ethical, Relevant.
2. A null hypothesis is a statistical hypothesis that predicts that no relationship exists between two variables.
3. The types of relationships that may exist between two variables are: positive, negative, or no relationship.
4. Read around comes first before read into. Read around gives a broad overview of the topic area, while read into involves an in-depth review.
5. The literature review is often called the "mother of the research" as it helps identify gaps and formulate the research question.
6. If we
This document discusses key concepts related to research, medicine, health, and the research process. It defines research as the systematic investigation and study of materials to establish facts and reach new conclusions. Knowledge is what is believed to be true about something, while facts are just data. Medicine is defined as the diagnosis, treatment, and prevention of disease. The research process involves identifying a problem, reviewing literature, developing a study design, collecting and analyzing data, and disseminating findings. Ethical considerations and developing a capable research team are also discussed.
This document provides an introduction to research methodology for 4th year midwifery students. It defines health research and describes the different types of research. The types of research are classified based on their objectives (basic vs applied), design (experimental vs non-experimental), population studied (individual vs population), level of analysis (biomedical, clinical, epidemiological, health systems), time required (cross-sectional vs longitudinal), data and techniques used (quantitative vs qualitative vs mixed methods). The purpose, scope, and characteristics of health research are also outlined.
This document provides an overview of qualitative research. It defines qualitative research as focusing on understanding human behavior and reasons for behavior through words rather than numbers. The document outlines different qualitative research approaches like phenomenology, grounded theory, ethnography, biographical studies, and case studies. It compares qualitative and quantitative research and discusses qualitative research purposes, methods of data collection including interviews, observations, documents, and focus groups. The document also covers qualitative sampling strategies, designing a qualitative study, and concerns of qualitative researchers.
Research Methodolog medical students.pptxLemiGebisa
This document defines and discusses different types of research methodology. It begins by defining research and explaining that research aims to systematically generate knowledge and answer questions. It then discusses the different drivers of research, including curiosity, addressing needs, profit motives, and available opportunities. The document also categorizes research as empirical vs theoretical, basic vs applied, and distinguishes research in biomedical sciences, population sciences, and health policy sciences. It further discusses quantitative and qualitative research approaches.
Intro Research Ethics 20th April Prof Dr Sanjev Dave.pptxSanjeevDavey1
This document provides an overview of health research ethics training. It begins with learning objectives around key values, theories, and principles that guide health research. It then discusses the definition and goals of ethics. Several key points are covered, including: the history of research ethics and important documents/events that shaped guidelines; principles of autonomy, beneficence, non-maleficence, and justice; roles and responsibilities of ethics committees and researchers; and issues like scientific misconduct, informed consent, and protecting participants. The document emphasizes applying fundamental ethical principles to ensure research is planned and conducted properly.
This document provides an overview of research methodology in public health and life sciences. It discusses key concepts like the meaning of research and health systems research. It outlines the importance of research, roles of health research, and desirable qualities of researchers. It also covers research phases, types of research like descriptive vs analytical and qualitative vs quantitative. It discusses classifying health research and finding research problems. The document aims to introduce important foundations for conducting research in public health.
This document provides an overview of oral health research. It discusses the history of medical research from ancient times through the modern era. Key developments include the rise of empiricism in Ancient Greece, advances during the Islamic Golden Age, and increasing use of the scientific method and clinical trials from the Renaissance onward. The document also examines the research cycle, how to formulate good research questions, common study designs, and disseminating research findings through publications and conferences.
This document discusses evidence-based public health. It defines evidence and describes the three types of scientific evidence. Evidence-based public health is defined as the development, implementation, and evaluation of effective programs and policies through applying scientific reasoning principles. Key elements of evidence-based public health include making decisions using the best available evidence, using data systems, applying program planning frameworks, engaging communities, conducting evaluation, and disseminating results. The evidence-based public health process involves developing statements, quantifying issues, searching literature, developing options, implementing interventions, and evaluating programs. Sources of public health evidence are also outlined.
This document provides an introduction to research fundamentals for activists. It discusses key concepts like quantitative and qualitative research, research ethics, study designs and interpreting results. The goal is to build activists' research literacy so they can engage in evidence-based advocacy. Some highlights include:
- Community advisory boards can help ensure research addresses community priorities and concerns.
- Quantitative research uses numerical data and closed-ended questions, while qualitative explores beliefs and experiences through open-ended questions. Both have pros and cons depending on the question.
- HIV activists have a long history of using scientific evidence to inform their advocacy agenda and influence research agendas to better address their communities' needs.
- Research ethics principles like respect,
This document provides an overview of qualitative research methods and question formulation. It discusses key aspects of qualitative research including theoretical backgrounds in ethnography, phenomenology and grounded theory. Examples of qualitative research questions and methods like observation and interviews are provided. The importance of qualitative research in understanding human experiences and perspectives is highlighted. Guidance on formulating focused qualitative research questions using frameworks like PICO, SPICE, ProPheT and CLIP is also given.
This document discusses evidence-based public health (EBPH). It defines EBPH as the development, implementation, and evaluation of effective programs and policies through applying scientific reasoning principles. The key steps of EBPH include quantifying the public health issue, conducting a literature review, developing and prioritizing program options, creating an action plan, and evaluating programs and policies. EBPH relies on diverse sources of evidence, both quantitative and qualitative research. It differs from evidence-based medicine in its focus on populations rather than individuals and emphasis on environmental and social factors.
This document is a lecture on introductory health research. It defines research as a systematic investigation to gain new knowledge. It discusses how to define a research project by considering the five W's: what, why, who, where, when. It also explains the research cycle, which involves identifying ideas, prioritizing topics, designing the study, obtaining funding, managing the research, recruiting participants, collecting and analyzing data, publishing findings, and applying the results. Finally, it outlines four purposes of research: to gain new insights, describe characteristics, determine frequencies, and test hypotheses.
This document discusses the multidisciplinary nature of health policy and systems research (HPSR) and the importance of understanding different perspectives within research. It addresses how a researcher's lenses and disciplinary background can influence their view. It also explores understandings of knowledge, including whether knowledge is discovered or constructed, and what role researchers play. The document emphasizes that HPSR embraces complexity and knowledge generation through engagement between researchers and policy actors. It stresses the need for researchers from different disciplines to work together to understand each other and generate new ideas about phenomena.
EMPHNET-PHE Course: Module seven ethical issues in public health research& in...Dr Ghaiath Hussein
This is a series of presentations I gave in the Eastern Mediterranean Public Health Network (EMPHNET)'s Public Health Ethics (PHE) that was held in Amman in June 2014.
This presentation outlines the ethical issues in research, especially the international research in low-middle income countries
This document discusses various ear, nose, and throat problems that may present in the emergency department. It covers conditions like airway obstruction, stridor, epistaxis, foreign bodies in the nose, vertigo, sudden sensorineural hearing loss, perichondritis, mastoiditis, otitis externa, otitis media, and traumatic ear perforations. For each problem, it provides details on symptoms, examinations, differential diagnoses, and management principles. The document aims to educate physicians on evaluating and treating common ENT emergencies.
This document provides information on tracheostomy care including indications for tracheostomy, post-operative care, complications, suctioning and tube changes, emergencies, home care, and decannulation. Tracheostomies are performed for prolonged ventilation, airway obstruction, or other medical reasons. Post-op care includes monitoring, humidification, and exercises. Complications can include infection, bleeding, or fistulas. Suctioning frequency is every 4-6 hours for 5-10 seconds. Tube changes and emergencies like accidental decannulation are also addressed. Home tracheostomy care requires education on suctioning, eating, and supplies. Decannulation is done gradually by downsizing tubes
This document discusses obstructive sleep apnea (OSA), including its prevalence, risk factors, clinical diagnosis, investigations, and management options. Some key points include:
- OSA is underdiagnosed, with 80-90% of cases estimated to be undiagnosed.
- The 3S criteria (snoring, sleepiness, witnessed apneas) can help with clinical diagnosis. Questionnaires like STOP-Bang are also useful.
- Polysomnography is needed to confirm diagnosis and determine severity based on apnea-hypopnea index (AHI).
- Management involves patient education, behavioral changes like weight loss, and treatments ranging from oral appliances to CPAP to sur
Using information technology in medical professionalismMTD Lakshan
This document discusses using information technology in medical professionalism. It presents several case scenarios of using technology: a home-brewed portfolio system to track knowledge, skills, and attitudes; virtual multidisciplinary team meetings to overcome barriers like distance; and professional websites and social media presences guided by ethical standards. The objectives are to illustrate sensible technology uses beyond conventional internet applications and overcome challenges like geographical barriers through solutions like video conferencing and mobile apps for daily medical tasks.
Managing Upper airway problems in children for ENT / Paediatric / Anaesthetic...MTD Lakshan
Here I discuss approach to managing an obstructed upper airway of a child. Details about clinical assessment, investigations and management stratergies are outlined.
Leading a busy life with multiple roles, medical consultants need to balance work with rest of the life. Here I discuss GTD principles and applying it to our lives
This document discusses the surgical management of benign thyroid disease. It covers:
1) Evaluation of thyroid enlargement including clinical examination, FNAC, ultrasound, and TSH levels.
2) Surgical principles including pre-operative, per-operative, and post-operative care.
3) Surgical options for thyroid enlargement including lobectomy, isthmusectomy, and total thyroidectomy.
4) Potential complications of thyroid surgery including recurrent laryngeal nerve injury, hypocalcemia, and bleeding.
Common ENT casualties / emergencies and management strategiesMTD Lakshan
This document provides an overview of common ENT emergencies and casualties that general practitioners may encounter. It discusses acute airway obstruction, otology issues like otitis externa and media, rhinologic emergencies including epistaxis, and various head and neck problems such as tonsillitis, peritonsillar abscess, and foreign bodies. Management strategies are outlined for these conditions. The document concludes with asking for feedback on the educational lecture via text message.
Vertigo is an illusion of movement that can be rotatory or postural. The clinical evaluation of patients with vertigo involves determining if they have true vertigo or other similar symptoms, identifying the type of vertigo, assessing precipitating and accompanying factors, and performing a neuro-otological examination. Common causes of vertigo include BPPV, vestibular migraine, Meniere's disease, and vestibular neuronitis. Management depends on correct diagnosis and may involve medications, repositioning maneuvers like the Epley maneuver for BPPV, or surgery.
Acute otitis media is an infection and inflammation of the middle ear cleft and eustachian tube that typically lasts less than 3 weeks. It is usually caused by bacteria like streptococcus pneumoniae or viruses like RSV. Children are more susceptible due to factors like horizontal eustachian tubes and smaller lumens. Symptoms include earache, discharge, fever, irritability, and hearing loss. Treatment involves antibiotics, nasal decongestants, steam, analgesics, and antihistamines. Complications can affect the inner ear, mastoid bone, or brain and include hearing loss, perforation, and infections.
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Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Adhd Medication Shortage Uk - trinexpharmacy.comreignlana06
The UK is currently facing a Adhd Medication Shortage Uk, which has left many patients and their families grappling with uncertainty and frustration. ADHD, or Attention Deficit Hyperactivity Disorder, is a chronic condition that requires consistent medication to manage effectively. This shortage has highlighted the critical role these medications play in the daily lives of those affected by ADHD. Contact : +1 (747) 209 – 3649 E-mail : sales@trinexpharmacy.com
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotesPsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...
How to Conduct Medical Research
1. How to conduct a research
Dr. Padmal de Silva MBBS. MSc (Community Medicine), MD (Community Medicine)
Consultant Community Physician
Department of Research and Evaluation
WHO Collaborating Centre for Public Health Workforce Development
National Institute of Health Sciences
Nagoda, Kalutara, Sri Lanka
2. What is Research ?
Department of Research– NIHS : Inspiring Public Health through Innovative Research
3. Department of Research– NIHS : Inspiring Public Health through Innovative Research
What research is
Step by step approach in conducting a
‘research’
Learning objectives?
4. • Research is the search for or creation of (valid)
knowledge.
• Knowledge is what is believed to be true about
something, what is believed to be a correct
understanding of something.
• Facts are just data. Knowledge is an expert’s best
interpretation of facts.
What is research?
Department of Research– NIHS : Inspiring Public Health through Innovative Research
5. • Research is defines as “the systematic approach to
obtaining new and reliable knowledge”.
• Notes that critical thinking is an essential element for
research.
Ethridge (1995)
What is research?
Department of Research– NIHS : Inspiring Public Health through Innovative Research
6. • It is the systematic investigation into and study of
materials, sources, etc, in order to establish facts and
reach new conclusions.
• It is an endeavour to discover new or collate old facts
etc by the scientific study of a subject or by a course
of critical investigation.
[Oxford Concise Dictionary]
What is research?
Department of Research– NIHS : Inspiring Public Health through Innovative Research
7. What is research?
Research is the
Systematic
Collection,
Analysis and
Interpretation of data
To answer a certain question or
Solve a problem
Department of Research – NIHS : Inspiring Public Health through Innovative Research
8. What is Health ?
Health
Is a state of “complete physical,
mental and social wellbeing
and not merely the absence of
disease or infirmity”
Preamble to the Constitution of the World Health Organization as adopted by the
International Health Conference, New York, 19-22 June, 1946; signed on 22 July 1946 by
the representatives of 61 States (Official Records of the World Health Organization, no. 2,
p. 100) and entered into force on 7 April 1948.
Department of Research – NIHS : Inspiring Public Health through Innovative Research
9. Determinants of Health
Agriculture
and food
production
Education
Work
environment
Living and working
conditions
Unemployment
Water and
sanitation
Health
care
services
Housing
Age, sex and
hereditary
factors
Health
Human Health is a complex and a dynamic issue
Department of Research– NIHS : Inspiring Public Health through Innovative Research
10. What is a health system?
• The institutional arrangements
within which the behavior occurs
• A set of cultural beliefs about health
and illness that forms the basis for health
seeking behavior
• The socio economic / political /
physical context for those beliefs and
institutions.
(the social determinants of health)
Department of Research– NIHS : Inspiring Public Health through Innovative Research
11. Institutional arrangements within which the
behavior occurs ……
1.The individual, family and community
2.Health care services
I. Public sector
a) Health workers
b) Health centers
c) Field care
II. Private sector
a) Traditional medicine
b) Private practitioners
c) Pharmaceuticals
d) NGO
Department of Research– NIHS : Inspiring Public Health through Innovative Research
12. Institutional arrangements within which the
behavior occurs ……
3. Health related sectors
I. Agriculture and food distribution
II. Education
III. Water and sanitation
IV. Transport and communication
4. The international sector
I. Bilateral and multilateral agencies
Department of Research– NIHS : Inspiring Public Health through Innovative Research
13. Cultural beliefs about health and
illness?
• What people believe (god, past deeds, planetary
alignment, hot and cold, etc…)
• Actual cause of illness ?
• Pathway to cure/ wellbeing?
Department of Research– NIHS : Inspiring Public Health through Innovative Research
14. Why do we need to conduct
research?
To see what is normal
To identify the abnormal
To find out what and which are associated
with the abnormal
To determine “causality”
To test new interventions
And finally “explore strange new
phenomena, seek out the truth, & to
boldly go where no one has gone
before”
Department of Research– NIHS : Inspiring Public Health through Innovative Research
15. Evidence Based Medicine (EBM)
What is E.B.M?
Are we practicing EBM?
Is practice / treatment based on evidence ?
This evidence they are referring to is from
research or studies …
Department of Research– NIHS : Inspiring Public Health through Innovative Research
16. Evidence Based Medicine (EBM)
In Sri Lanka
Are we conducting adequate research in Sri
Lanka?
Do we have a culture of conducting research?
To both these questions the answer is
“NO”
Department of Research– NIHS : Inspiring Public Health through Innovative Research
17. Some food for thought
Is evidence from other countries relevant to Sri
Lanka?
Do we blindly follow them?
Is it ethical to submit our people to Evidence
generated from Europe and USA?
Department of Research– NIHS : Inspiring Public Health through Innovative Research
18. Some more food for thought.
Do we share the same potential as Americans
and Europeans to use their growth standards?
When we say “our children are stunted or wasted”
are they really so?
Is western medical treatment really better than
“Ayurvedic treatment”
What sort of behavioral modifications do we need
for the NCD problems? Are western modifications
really applicable to us?
Department of Research– NIHS : Inspiring Public Health through Innovative Research
19. Why don’t we conduct enough “Research”?
• Don’t know how to conduct Research
• Don’t have the time
• Don’t have adequate facilities
• Don’t see a need to conduct research
• Conduct research but don’t publish it
• Research evidence not taken up for action
• No culture for “research”
THERE IS LACK OF RESEARCH
Department of Research– NIHS : Inspiring Public Health through Innovative Research
20. Components of a research
• Statement of the problem
• Literature review
• Aims
• Design of study
• Study setting
• Study population
• Study sample and sample size calculation
• Sampling Methods
• Data collection methods and study instruments
• Data collectors
• Analysis of data and presentation of results
• Ethical issues
• Discussion
• Conclusions
Department of Research– NIHS : Inspiring Public Health through Innovative Research
21. A researcher needs to develop capabilities in
• Conducting a literature review - Pub med / HINARI
• Referencing and bibliography - Endnote / Mendally / cite fast
• Calculating of sample size - Open epi or Win pepi
• Developing instruments
• Adhering to ethics and getting ERC approval
• Preparation of a research proposal
• Data base development using Epidata
• Data quality assessment
• Performing simple analysis SpSS OR Epi Info
• Writing a research report
– Abstracts
– Policy briefs
– Short report
Department of Research– NIHS : Inspiring Public Health through Innovative Research
23. • It demands a clear statement of the problem.
• It requires clear objectives and a plan (it is not
aimlessly looking for something in the hopes that you
will come across a solution).
• It builds on existing data, using both positive and
negative findings.
• New data should be systematically collected and
analyzed to answer the original research objectives.
Characteristics of a research
Department of Research– NIHS : Inspiring Public Health through Innovative Research
24. • First priority is to formulate your research question
• Then figure out how you are going to answer it
– How have others answered it?
– How does your proposal fit in with what others
have done?
– How will you know when you have answered it?
• Then you can present your answer
Department of Research– NIHS : Inspiring Public Health through Innovative Research
From where do I begin?
25. Steps of Scientific
Research
Selection of area
Selection of topic
Crude research question
no answer
Refined research question
Research hypothesis, goals and objectives
Study design
Population & sampling
Variables confounding bias
Research tools
Pilot study
Work plan
Collection of data
Data management
Interpretation
Reporting
no need for study
answers found
Literature review
Ethical issues
26.
27. Is based on criteria such as:
1. Relevance
2. Avoidance of duplication
3. Urgency of data need
4. Political acceptability of the study
5. Feasibility of the study
6. Applicability of results
7. Ethical considerations
Criteria for selecting a research
topic
Department of Research– NIHS : Inspiring Public Health through Innovative Research
32. It need not be so………….
Department of Research– NIHS : Inspiring Public Health through Innovative Research
33. Why do it?
• Identify/focus topic
• Enhance knowledge about the problem
• Identify study variables
• Formulate hypothesis
• Interpret results
• Identify research method
– Including data analysis, sample size
determination
Department of Research– NIHS : Inspiring Public Health through Innovative Research
34. When do you do it?
• Start reading/reviewing early
– What you are planning may already have been done
• Continue throughout the project
• Drawback of an early exhaustive review
– May inhibit originality
Department of Research– NIHS : Inspiring Public Health through Innovative Research
35. How to start?
• Talk to: experts, colleagues, librarian
• Read a textbook, bibliography
• Identify key original papers and review articles
• Key words and MeSH words (Medical Subject
Headings)
• Medline/PubMed
• Google scholar
Department of Research– NIHS : Inspiring Public Health through Innovative Research
36. Published Material
• Books
• Journal articles (original research, review)
• Conference proceedings/abstracts
• Reports
• Dissertations
Department of Research– NIHS : Inspiring Public Health through Innovative Research
37. Sources of Published Material
• Libraries – PGIM, Ministry of Health,
Universities, SLMA, SLAAS, etc.
• Private collections
• Internet/ web resources
Pubmed
http://www.ncbi.nlm.nih.gov/entrez/
Department of Research– NIHS : Inspiring Public Health through Innovative Research
38. Sources of Unpublished Material
• Experts
• Teachers
• Colleagues
Department of Research– NIHS : Inspiring Public Health through Innovative Research
40. Learning PubMed is easy as A, B, C…………..
Department of Research– NIHS : Inspiring Public Health through Innovative Research
Demonstration videos @ http://www.nlm.nih.gov/bsd/disted/pubmed.html#qt
43. Identify researchable areas in the problem
State Objectives
General Objective Specific Objectives
Department of Research– NIHS : Inspiring Public Health through Innovative Research
44. Once the research topic is identified
We can proceed with….
Literature review
Identifying/clarifying methodology
Identifying ethical issues etc….
Department of Research– NIHS : Inspiring Public Health through Innovative Research
45. Why do we need objectives for a
research
• To verify the extent of research
• To have a clear guidance on the research
• To focus the research topic to achievable
targets
• To build necessary skills and experiences
needed for the research
• To prepare the research plan ……
Department of Research– NIHS : Inspiring Public Health through Innovative Research
46. Research objectives should be
• S -Specific
• M -Measurable
• A -Achievable
• R -Realistic/ reliable
• T -Time bound
Department of Research– NIHS : Inspiring Public Health through Innovative Research
47. Specific
In both meaning and focus
Department of Research– NIHS : Inspiring Public Health through Innovative Research
48. Measurable
Outcome of the research should be
measurable
Need to identify indicators for measuring
Department of Research– NIHS : Inspiring Public Health through Innovative Research
49. Achievable
Does your resources and capacity
allow you to reach the target
Department of Research– NIHS : Inspiring Public Health through Innovative Research
50. Reliable/Relevance/Realistic
are the resources available reliable to
carryout the research
Are the planed methods correct and
appropriate for the study
Department of Research– NIHS : Inspiring Public Health through Innovative Research
51. Time bound
Am I able to finish this within the
target timeDepartment of Research– NIHS : Inspiring Public Health through Innovative Research
52. An “objective” starts with
Action verbs
As we are trying to solve a problem or clear up a
situation
Verb is combined with “To”
To describe To recommend
To develop To analyze
To identify To design
To assess To compare
Department of Research– NIHS : Inspiring Public Health through Innovative Research
53. An “objective” includes
What you are going to do specifically
Where you are going to do this OR for whom
you are going to do this for
When you are going to do this
Why you are going to do this is not included
here Department of Research– NIHS : Inspiring Public Health through Innovative Research
54. Some examples
To describe the patient profile treated at PCU -
BH Panadura during first quarter of 2014.
To estimate the prevalence and selected risk
factors for DM in Hambantota district for 2014.
To describe the knowledge on breast feeding
technique among the pregnant primiparas
females in the MOH area of Hambantota in
2014.
Department of Research– NIHS : Inspiring Public Health through Innovative Research
55. Study Designs
Descriptive studies Analytical studies
Case report
Case serial
reports
Cross-sectional
studies
Ecological
studies
Observational
studies
Experimental
studies
Case-control
studies
Cohort
studies
Prospective
Retrospective
(historical)
Randomized
Controlled Clinical
trials
Randomized
Controlled field
trials
Non-randomized
experiments
Department of Research– NIHS : Inspiring Public Health through Innovative Research
64. What is the measure of interest?
What is the underlying probability distribution of the
characteristic of interest?
What is the sampling distribution of the measure?
(i.e., type of study design and how the samples were obtained)
How accurate do the results want to be?
Department of Research– NIHS : Inspiring Public Health through Innovative Research
65. The accuracy of the estimate depends on two
quantities:
1. how narrow the width of interval
2. how confident the results to be(e.g. 95%).
Department of Research– NIHS : Inspiring Public Health through Innovative Research
66. S – Sample size for infinite population
Z 1-α/2 – Percentile of the standard normal distribution determined by the
specified confidence level (1.96 for 95% confidence level)
p – Estimated proportion in study population
d – Acceptable margin of error (width of interval)
Formula to calculate sample size for a cross sectional
study having a binomial distribution for the characteristics
of interest
(i.e., to calculate a proportion of a certain event)
Department of Research– NIHS : Inspiring Public Health through Innovative Research
68. Problem identificationProblem identification
& Prioritization& Prioritization
Problem analysisProblem analysis
Literature ReviewLiterature Review
Developing ObjectivesDeveloping Objectives
Study DesignsStudy Designs
Selecting study populationSelecting study population
Sample size calculationSample size calculation
Data Collection TechniquesData Collection Techniques
69. What is data collection?
• Systematic collection of information about the
Objects of the study and about the settings in
which they occur
• Objects
– People
– Phenomena (Occurrences, Happenings)
– Objects (Things)
Department of Research– NIHS : Inspiring Public Health through Innovative Research
70. What is data collection?
• Data collection need to be Systematic
• Haphazard data collection will not answer the
research question well
Department of Research– NIHS : Inspiring Public Health through Innovative Research
71. Different data collection techniques
• Using available information
• Observing
• Interviewing
• Administering questionnaires
• Observational check list
• Focus Group Discussions / In depth interview
• Other methods
Department of Research– NIHS : Inspiring Public Health through Innovative Research
74. Anything that can
be measured and is
observed to vary is
called a variable
Variable
Department of Research– NIHS : Inspiring Public Health through Innovative Research
75. MEASUREMENT
ERROR
When ever we make
measurements we must be
aware of the possibility of
error
Department of Research– NIHS : Inspiring Public Health through Innovative Research
76. Two kinds of errors
Systematic error
Random error
Department of Research– NIHS : Inspiring Public Health through Innovative Research
77. How to minimize Subject
variation
•Planning data collection in almost
similar settings, environments
•Training data collectors on
questioning (tone, mood, time of the
date etc)
Department of Research– NIHS : Inspiring Public Health through Innovative Research
78. How to minimize observer
error
Training observers or data
collectors (Inter observer
variation)
Repeat measurements and take the
average (Intra observer variation)
Department of Research– NIHS : Inspiring Public Health through Innovative Research
79. How to minimized Instrumental
errors
•Standardizing instruments and
procedures
•Instruments has to standardize/
calibrate repeatedly
•Procedures or techniques has to
be cross check during the study
Department of Research– NIHS : Inspiring Public Health through Innovative Research
80. Characteristics of an indicator
• Valid
• Reliable
• Sensitive
• Specific
Department of Research– NIHS : Inspiring Public Health through Innovative Research
81. Validity
Validity is the ability of a
instrument/ questionnaire
to measure what it suppose
to measure
Department of Research– NIHS : Inspiring Public Health through Innovative Research
82. Reliable
Reliability / Repeatability
is the level of agreement
between two replicate
measurements
Department of Research– NIHS : Inspiring Public Health through Innovative Research
87. Data collection flow
The following needs to be thought of and decided upon……
1.Who is going to collect the data ?
2.From whom ?
3.Where ?
4.How ?
5.Using what?
6.How is information given to the participants?
7.How are they recruited to the study?
8.How is consent to be obtained?
9.How to conclude the data collection?
10.What to do with positive cases?
11.Checking for quality of the collected data? Who? When ? Where ? How ?
12.Entering the data?
13.Analysis of the data
Department of Research– NIHS : Inspiring Public Health through Innovative Research
88. Ethical considerations
– Do no harm
– Do good
– Voluntary participation
– Informed consent
– Conflict of interest
– Scientific validity
Department of Research– NIHS : Inspiring Public Health through Innovative Research
90. Getting Ethics clearance
Very Very Very important
No publisher is going to publish your work without ERC approval
Essential for getting your research allowance
Forum for Ethics Review Committees of Sri Lanka (FERCSL)
ERC you submit needs to be accredited from FERCSL
Else your proposal will be re channeled for review by MoH
Some of the FERCSL accredited review committees
1. University ERCs
2. NIHS
3. MRI
4. SLMA
5. NHSL
Department of Research– NIHS : Inspiring Public Health through Innovative Research
91. ERU - NIHS: Centre of Excellence in Public Health Research
Time series chart – GANTT Chart
Item description MAR AP
R
MAY JU
N
JU
L
AU
G
SE
P
OC
T
NO
V
DEC
Initial discussion X
Literature review X X
Finalizing methodology X X
Ethical clearance X
Pre testing X X
Data collection proper X X
Data entry X X
Initial analysis X X
Draft report X
Final report submission X
Presentation of findings X
92. ERU - NIHS: Centre of Excellence in Public Health Research
Preparing a budget
Steps in preparing a budget
1.Perform a task analysis and list out the tasks for the study
2.Define the cost categories for each identified task
1. Manpower
2. Machinery
3. Materials
4. Time
3.Decide on the time requirement for each activity
4.Decide who is going to perform each activity and how
much it is going to cost / person / time unit
5.Perform cost estimation for each activity / task
6.Sum cost of activities to get the total cost for the study
93. ERU - NIHS: Centre of Excellence in Public Health Research
Preparing a budget
Steps in preparing a budget
7.Don’t forget to cost for….
• Travelling, food and accommodation of data
collectors
• Refreshments for discussions / meetings
• Translation and typesetting of questionnaires
• Printing of data collection formats
• Data entry and analysis
• Dissemination of results
• Publication of data
• Licensed software
94. Plan of analysis
Descriptive statistics
Measures of central tendency
Measures of dispersion
Inferential statistics
Statistical significance
Population parameter estimation
Testing of hypothesis
Statistical modeling
What statistical software is going to be used?
Department of Research– NIHS : Inspiring Public Health through Innovative Research
95. ERU - NIHS: Centre of Excellence in Public Health Research
Disseminating research evidence into policy
and practice
1. Research reports
2. Abstract presentation: poster or oral
3. Journal articles
4. Advocacy briefs
5. Policy briefs
96. ERU - NIHS: Centre of Excellence in Public Health Research
Report writing
1. Abstracts and key words
2. An introduction including a justification
3. Appropriate review of literature
4. Objectives and methodology
5. Results
6. Discussion
7. Conclusions and recommendations
8. References
9. Annexures
97. Quiz
• Please complete this short quiz to test and
increase your knowledge of referencing.
…Good Luck !!
Department of Research– NIHS : Inspiring Public Health through Innovative Research
98. Why do we need to reference material that we
use?
1. Avoid accusations of
plagiarism
2. Acknowledge others work
3. Support academic
arguments
4. Prove that you have
researched a topic
5. All of the above
10
Department of Research– NIHS : Inspiring Public Health through Innovative Research
99. No. 5 is correct
It is crucial in academic writing to acknowledge
the work of others in support of your
argument. Plagiarism is a growing problem
and there are disciplinary procedures for
anyone caught plagiarising other people’s
work.
Department of Research– NIHS : Inspiring Public Health through Innovative Research
100. In which case would you need to reference the
source of information?
1. When you copy word for word
a paragraph from a journal
article/book
2. When you copy word for word
a paragraph from a web site
3. When you write in your own
words ideas from a journal
article/book
4. When you write in your own
words ideas from a web site
5. None of these
6. All of the above 10
Department of Research– NIHS : Inspiring Public Health through Innovative Research
101. No. 6 is correct
• It is important to acknowledge any other
person’s ideas/words that you include in your
work, either directly or indirectly. If you do
not make reference to someone else’s
ideas/work you may be accused of passing it
off as your own (plagiarism).
Department of Research– NIHS : Inspiring Public Health through Innovative Research
102. Which style of referencing is usually followed?
1. Harvard
2. Vancouver
3. Endnotes
4. Reference
footnotes
5. Don’t know
10
Department of Research– NIHS : Inspiring Public Health through Innovative Research
103. No. 1 is correct
• Harvard style of referencing, which is the
author/date style is frequently used. Some
journals and publishers continues to use the
Vancouver, or number, style of referencing.
Department of Research– NIHS : Inspiring Public Health through Innovative Research
104. What are the essential elements of a book
reference?
1. Author’s name and title
2. Author’s name, title
and date
3. Title, date and
publisher
4. Author name,
publication date, title,
place of publication
and publisher
5. Don’t know 10
Department of Research– NIHS : Inspiring Public Health through Innovative Research
105. No. 4 is correct
• It is important that you give these required
elements about the books we use as this
makes it easier for someone to find the
edition of the book that you have used.
Department of Research– NIHS : Inspiring Public Health through Innovative Research
106. What are the essential elements of a
journal article reference?
1. Author name and article
title
2. Author name and
journal title
3. Author name, article
title and publication
date
4. Author name, article
title, journal title,
publication date,
volume and issue
number, inclusive page
numbers
5. Don’t know
10
Department of Research– NIHS : Inspiring Public Health through Innovative Research
107. No. 4 is correct
• It is important to include all of these elements so
that someone else can find the article that you have
referred to.
NB. If you are adding a reference to an electronic
journal please refer to the ‘Quoting and Preparing
References’ guidelines.
Department of Research– NIHS : Inspiring Public Health through Innovative Research
108. What must you include in a web site reference that is
different from other references? (Please choose two
options.)
1. Web site author
2. Date accessed
3. Full URL
4. Don’t know
10
Department of Research– NIHS : Inspiring Public Health through Innovative Research
109. No. 2 & 3 are correct
• Materials on the web may be removed. Including the date
that you looked at the website tells other people when the
material was available.
• Including the full URL will direct other people to the correct
web site.
Department of Research– NIHS : Inspiring Public Health through Innovative Research
115. Putting together a team
Department of Research– NIHS : Inspiring Public Health through Innovative Research
116. A research team needs persons capable of………
• Conducting a literature review - Pub med / HINARI
• Referencing and bibliography - Endnote / Mendally / cite fast
• Calculating of sample size - Open epi or Win pepi
• Developing instruments
• Adhering to ethics and getting ERC approval
• Preparation of a research proposal
• Data base development using Epidata
• Data quality assessment
• Performing simple analysis SpSS OR Epi Info
• Writing a research report
– Abstracts
– Policy briefs
– Short report
Department of Research– NIHS : Inspiring Public Health through Innovative Research
117. Together Everyone Achieves More
Department of Research– NIHS : Inspiring Public Health through Innovative Research