Running head: PICOT STATEMENT 1 PICOT STATEMENT 2 Picot Statement Liliana Faura GCU Professional Capstone and Practicum 12/08/2019 PICOT Statement P- Patients who have diabetes. I - Implementation specifically on dietary and lifestyle changes. C- Comparisons of levels before and after lifestyle and dietary modifications. O- Outcome whether there will be a reduction in levels. T- The time frame is usually three months after initial diagnosis PICOT Statement: Diabetic Condition in Patients. Introduction According to the World Health Organization, diabetes is one of the most serious conditions that affect a significant percentage of individuals in the worldwide population. It is estimated that more than 400 million people in the world are likely to be diagnosed with diabetes, while those that have not been diagnosed totaling to the same number. Although diabetes can be attributed to hereditary conditions during a person’s life, what is more, devastating is the increase in cases of diabetes type II, which is usually preventable, affecting more than 90% of individuals with diabetic conditions in the world (Abbade et al., 2017). This put a lot of questions on the effectiveness of the current assessment techniques and procedures applied to control the condition in the world. Diabetes II is usually attributed to a high intake of processed foods that are mostly sugary. Picot Statement Population Adults with early type II diabetes are more likely to be obese, whereby most of them are usually women. The type II diabetes is an epidemic especially in the US whereby it is estimated to have increased by 70% in adults. Research has estimated that close to 80% of individuals with diabetic conditions live in middle and low-income countries (Abbade et al., 2017). China had the highest number of individuals with diabetes, followed by India with more than 10% of individuals with diabetic conditions. Over the last three decades, there has been an increase in cases of diabetes prevalence, which has been noted at all ages, although the adults are more disadvantaged. Intervention Evidence-based intervention that seeks to reduce both childhood and adulthood diabetic incidences should target the preventive and treatment measures. Patient-level interventions usually include those directed at improved self-management including taking medication, proper diet and exercise and self- monitoring in the use of health care services. Professional education and knowledge activities are examples of strategies that can be put in place to cope with the condition. Since interventions are designed for the general population, the disadvantaged groups may not be able to take full advantage of the opportunities (Boswell & Cannon, 2018). In some cases, interventions may include change of school curriculum for students whereby physical education, change in meal provisions and physical exercise is usually encouraged. Comparison Since the physician is a member of the multidisci ...

1. Running head: PICOT STATEMENT
1
PICOT STATEMENT
2
Picot Statement
Liliana Faura
GCU
Professional Capstone and Practicum
12/08/2019
PICOT Statement
P- Patients who have diabetes.
I - Implementation specifically on dietary and lifestyle changes.
C- Comparisons of levels before and after lifestyle and dietary
modifications.
O- Outcome whether there will be a reduction in levels.
T- The time frame is usually three months after initial diagnosis
PICOT Statement: Diabetic Condition in Patients.
Introduction
According to the World Health Organization, diabetes is one of
the most serious conditions that affect a significant percentage
of individuals in the worldwide population. It is estimated that
more than 400 million people in the world are likely to be
diagnosed with diabetes, while those that have not been
diagnosed totaling to the same number. Although diabetes can
be attributed to hereditary conditions during a person’s life,

2. what is more, devastating is the increase in cases of diabetes
type II, which is usually preventable, affecting more than 90%
of individuals with diabetic conditions in the world (Abbade et
al., 2017). This put a lot of questions on the effectiveness of the
current assessment techniques and procedures applied to control
the condition in the world. Diabetes II is usually attributed to a
high intake of processed foods that are mostly sugary.
Picot Statement
Population
Adults with early type II diabetes are more likely to be obese,
whereby most of them are usually women. The type II diabetes
is an epidemic especially in the US whereby it is estimated to
have increased by 70% in adults. Research has estimated that
close to 80% of individuals with diabetic conditions live in
middle and low-income countries (Abbade et al., 2017). China
had the highest number of individuals with diabetes, followed
by India with more than 10% of individuals with diabetic
conditions. Over the last three decades, there has been an
increase in cases of diabetes prevalence, which has been noted
at all ages, although the adults are more disadvantaged.
Intervention
Evidence-based intervention that seeks to reduce both childhood
and adulthood diabetic incidences should target the preventive
and treatment measures. Patient-level interventions usually
include those directed at improved self-management including
taking medication, proper diet and exercise and self- monitoring
in the use of health care services. Professional education and
knowledge activities are examples of strategies that can be put
in place to cope with the condition. Since interventions are
designed for the general population, the disadvantaged groups
may not be able to take full advantage of the opportunities
(Boswell & Cannon, 2018). In some cases, interventions may
include change of school curriculum for students whereby

3. physical education, change in meal provisions and physical
exercise is usually encouraged.
Comparison
Since the physician is a member of the multidisciplinary team,
then standardized care in support of good care is likely to be
provided to ensure there is a healthy community. The physician
plays a greater role in ensuring there is proper access to
medicare through provision checkup services and screening
services to help in the diagnosis of the disease (Boswell &
Cannon, 2018). Individuals should focus on ensuring there is a
healthy living and the need to expand the role of health care
providers.
Outcome
When a physician is involved as one of the members of the
multidisciplinary team approach, then there is guaranteed better
care for an individual. The outcomes from the intervention
should include a reduction in cases of diabetes and the risks
related to the disease with the provision of affordable healthcare
services.
Time
The treatment of diabetes, especially type II, should take
approximately three months. The reason being that the focus is
usually on general behavior patterns of individuals. Therefore,
interventions should aim at the promotion of long term
outcomes.
Reference
Abbade, L. P., Wang, M., Sriganesh, K., Jin, Y., Mbuagbaw, L.,
& Thabane, L. (2017). The framing of research questions using
the PICOT format in randomized controlled trials of venous
ulcer disease is suboptimal: A systematic survey. Wound Repair
and Regeneration, 25(5), 892-900.

4. Boswell, C., & Cannon, S. (2018). Introduction to nursing
research. Jones & Bartlett Learning.
MBA 6100 Case Study #1
Spring 2020 Block 1
Each question refers to the same initial data. Treat each Part
individually. Ignore income taxes. Assume no beginning or
ending inventories. Unless stated otherwise, all calculations and
income statements should be based on a one-month period.
Calculations and backup should be completed and submitted in
Excel. Use proper Contribution Income Statement formatting –
example below. Analysis can either be typed into cells in Excel
(formatted to be easily legible) or typed into a text box in
Excel. One Excel file is to be submitted for this case study. No
additional files (Word documents or otherwise) will be accepted
or graded. This case study is worth 100 points total.
Contribution Margin Format Example:
Data for all questions: TrailPacker produces rugged backpacks
for outdoor sports (hiking, rock climbing, etc.) Their backpacks
are sold at many specialty outdoor stores across the country.
The cost of manufacturing and marketing their backpacks, at
their normal factory volume of 20,000 backpacks per month, is
shown in the table below. TrailPacker sells these backpacks for
$50 each. TrailPacker is making a small profit, but they would
prefer to increase their Operating Income.
Hint: Fixed costs are shown on a per-unit basis in the table
based on normal volume. However, fixed costs as a total do not
change when volume changes, so you will need to determine
total fixed costs first.
Data for all Questions:
Questions:

5. Part 1: (24 points)
A) TrailPacker wants to understand their basic starting financial
data. What is their monthly fixed cost, variable cost per
backpack, and contribution margin per backpack? Show your
calculations for each.
B) Prepare a one-month Contribution Margin Income Statement
for the company using the given financial data at their normal
factory volume. Include line items for each type of cost as well
as subtotals for the variable and fixed costs.
C) What is the break-even point in units? (Show your
calculations.)
D) What is the break-even point in sales dollars? (Show your
calculations.)
E) Using a one-month Contribution Margin Income Statement,
verify that your calculated break-even volume results in
Operating Income of Zero. (Prepare the entire Contribution
Margin statement at the break-even level.)
Part 2: (20 points)
An online superstore has offered to purchase 15,000 backpacks
(one time in one month) if the sales price was lowered to $40
per backpack for that one-time sale. (This specific sale is all or
nothing – they will not purchase less than 15,000 backpacks).
TrailPacker’s maximum capacity is 25,000 units, and this
special sale would not impact the sales price of TrailPacker’s
normal sales to their usual customer base.
A) List TrailPacker’s options based on this Special Sale offer,
their maximum capacity, and their usual production. (For
example, one option is that TrailPacker can not accept the
special sale and continue with their usual monthly sale to the
outdoor retailers.) There should be at least 3 options – including
the example provided.
B) Prepare a monthly contribution margin income statement for
each of the options in A. Label each option.
C) Do you think TrailPacker should accept this sale? Why?

6. Support your decision with evidence and analysis.
Hint: Compare your new contribution margin income
statement(s) including the special sale to the company’s normal
contribution margin income statement (from Part 1).
Part 3: (24 points)
TrailPacker is thinking of increasing sales by offering
backpacks with aluminum frames. The investment needed for
adding aluminum frames to their manufacturing process would
increase fixed overhead costs by $50,000 per month. The
variable materials cost (only variable material costs – not all
variable costs) would increase by $15.00 per backpack. Market
research estimates that the aluminum frame backpacks would
sell for $70 each, and volume would increase 10%.
A) Prepare a revised monthly Contribution Margin Income
Statement to include the revenues, detailed costs and income if
TrailPacker chooses to manufacture and sell backpacks with
aluminum frames instead of their regular backpacks.
B) What is the new break-even point in units for the aluminum
frame backpacks?
C) What is the new break-even point in sales dollars for the
aluminum frame backpacks?
D) If volume did not increase when making the aluminum frame
backpacks (stayed the same as original monthly volume), is
TrailPacker better off producing aluminum frame backpacks or
their basic backpacks? Support your answer with data in
contribution margin income statement format.
Part 4: (32 points)
TrailPacker is thinking of cutting costs by using a different
fabric (raw material) supplier. Their variable material costs
would decrease by 30% (only variable material costs – not all
variable costs). The quality of the fabric is lower, so
TrailPacker estimates that their additional fixed scrap costs
related to the fabric quality would be $25,000 per month. They
would not change the pricing of their backpacks.

7. Note: Use the initial data provided for all questions. Ignore the
special sale and aluminum frame data from Parts 2 & 3.
A) Prepare a revised monthly Contribution Margin Income
Statement to include the revenues, costs and profits of using the
different raw material (fabric) supplier.
B) If their sales end up decreasing because of the change in
quality, how much of a reduction in sales (dollars and units)
could TrailPacker handle and still keep their net operating
income the same as before the supplier change? Show your data
in a Contribution Margin Income Statement.
C) Write a memo to the CFO that presents the pros and cons of
the potential supplier change. Include the potential impacts on
revenue, costs, and operating income, as well as any other
factors or consequences of this decision. Be sure to include
quantitative evidence and backup as well as any qualitative
analysis.
Note: Your letter will be included in your Excel document –
either in the Excel cells or in a text box.
Hint: The analysis is expected to be thorough. Expect to present
approximately 400 words, and support your analysis with data
(either given or calculated). Remember that this is a letter to the
CFO, so proper grammar and spelling is expected.
Running Head: LITERATURE REVIEW
1
LITERATURE REVIEW
5
Literature Review
Name: Liliana Faura
Course: NRS-490
Professor: Tish Dorman
Date: 1/12/2020
Introduction

8. The continued prevalence of type II diabetes has been blame d
on sedentary lifestyle, but for a long time now, health experts
have suggested dietary and lifestyle changes to reverse the
trend, which may include but no limited to healthy eating and
regular exercise. Scholars and clinicians have been evaluating
the impact of the obesity on individuals and resources dedicated
to curb the problem as not confined only to health impacts such
as various types of diabetes and high-blood pressure, but also
economic-wise. To shed more light on the issue of type II
diabetes, this review compares the research questions, sample
population, and limitation of various research studies regarding
the topic of dietary and lifestyles changes for type 2 diabetic
patients.
Comparison of Research Questions
According to Czupryniak et al (2010), the underlying question
for the question is the impact of bariatric surgery on morbidly
obese type II patients. However, as compared to Brun et al
(2008), seek to answer the question of the targeted endurance
training as weight reduction as well as fitness strategy on type
II diabetic patients. Similarly, Umpierre (2011) seeks to
determine the difference between physical activity exercise and
structured exercise training on the regulation of glucose on type
two patients. While prior scholars have dealt with lifestyles
changes and surgery, Asemi et (2011) sought to answer the
question of the impacts of “multispecies probiotic supplements
on metabolic profiles, hs-CRP, and oxidative stress in diabetic
patients.” While surgery is not a common way of managing
weight for diabetic patients Picot et al (2012) echoes
Czupryniak et al (2010) in trying to answer the question of the
effectiveness of bariatric surgery as a way of managing weight
on diabetic patients. Evidently, both lifestyle and dietary
changes are some of the strategies used to manage
complications associated with type II diabetes but there are
other uncongenial ways such as bariatric surgery to manage
weight in diabetic patients.

9. Comparison of Sample Populations
Picot et al (2012) searched 17 electronic sources, which is an
according to the scholars, the meta-analysis was carried out
strictly on studies that met criteria of the subject matter.
Conversely Asemi et al (2013) randomly selected a sample size
of 54 diabetic patients for their research. While the two studies
use different reach methods, it is evident that quantitative
research is more reliable in terms of sample size that qualitative
research. Also, Brun and colleagues randomly selected 25
diabetic patients for their study, which pales only three (3)
patients selected by Czupryniak and colleagues. Comparatively,
Ninot et al (2011) randomly selected a total of 38 diabetic
patients for their study, but the difference between this study
and others is that, most of the selected patients were severely
sick and hospitalized. It can, therefore, be posited that the
study results differed with those with moderately-ill patients.
Conversely, Rubino et al (2016) selected a total of 48
international scholars and clinician on their study on the
effectiveness of bariatric surgery on type II diabetic patients,
which is departure from previous studies which focused majorly
on patients as population samples.
Comparison of the Limitations of the Study
The study by Rubino and colleagues was limited by the fact that
bariatric surgery is not yet included as one of the ways of
helping patients with type 2 diabetes. According to the
researchers, bariatric surgery could be effective in tackling
obesity but there are reimbursement policies to support the
same. Similarly, a study by Czupryniak and colleagues was
limited experience on bariatric surgery, which according to the
scholars has demonstrated unequivocal success in helping
diabetic patients. Li et al (2012) study was limited by undefined
difference in terms exercise duration and exercise duration.
Also, Picot and colleagues’ study was limited by the accuracy
of the electronic sources, which according to the scholars came
from inconsistent citations. Studies such as Brun’s and
colleagues were limited by the respondent bias, where in some

10. instances, patients gave inaccurate responses to the questions.
Conclusion
Diabetes is an epidemic that continues that continue to
overwhelm the health sector as well as ability to diagnose
different types of the disease. While research has been focused
on how to treat patients with diabetes, there are other
complications, such as obesity, that require different approaches
of treatment. Clinicians and scholars, however, recommend
dietary and lifestyle changes as prevention measure, but recent
development in the field of clinical medicine as focused
bariatric surgery as one of the approaches of treating obese
patients with type 2 diabetes. Hence, owing to the limited
experience in the area, there is a need to advance research to
explore the effectiveness of bariatric surgery on type II diabetic
patients.
References
Asemi, Z., Zare, Z., Shakeri, H., Sabihi, S., & Esmaillzadeh, A.
(2013). Effect of Multispecies Probiotic Supplements on
Metabolic Profiles, hs-CRP, and Oxidative Stress in Patients
with Type 2 Diabetes. Annals of Nutrition and Metabolism,
63(1-2), 1–9. doi:10.1159/000349922
Brun, J.-F., Bordenave, S., Mercier, J., Jaussent, A., Picot, M.-
C., & Préfaut, C. (2008). Cost-sparing effect of twice-weekly
targeted endurance training in type 2 diabetics: A one-year
controlled randomized trial. Diabetes & Metabolism, 34(3),
258–265. doi:10.1016/j.diabet.2008.01.010
Czupryniak, L., Wiszniewski, M., Szymański, D., Pawłowski,
M., Loba, J., & Strzelczyk, J. (2010). Long-Term Results of
Gastric Bypass Surgery in Morbidly Obese Type 1 Diabetes
Patients. Obesity Surgery, 20(4), 506–508. doi:10.1007/s11695-
010-0074-6
Li, J., Zhang, W., Guo, Q., Liu, X., Zhang, Q., Dong, R., …
Yu, D. (2012). Duration of Exercise as a Key Determinant of

11. Improvement in Insulin Sensitivity in Type 2 Diabetes Patients.
The Tohoku Journal of Experimental Medicine, 227(4), 289–
296. doi:10.1620/tjem.227.289
Ninot, G., Moullec, G., Picot, M. C., Jaussent, A., Hayot, M.,
Desplan, M., … Prefaut, C. (2011). Cost-saving effect of
supervised exercise associated to COPD self-management
education program. Respiratory Medicine, 105(3), 377–
385. doi:10.1016/j.rmed.2010.10.002
Picot, J., Jones, J., Colquitt, J. L., Loveman, E., & Clegg, A. J.
(2012). Weight Loss Surgery for Mild to Moderate Obesity: A
Systematic Review and Economic Evaluation. Obesity Surgery,
22(9), 1496–1506. doi:10.1007/s11695-012-0679-z
Rubino, F., Nathan, D. M., Eckel, R. H., Schauer, P. R., Alberti,
K. G. M. M., Zimmet, P. Z., … Cummings, D. E.
(2016). Metabolic Surgery in the Treatment Algorithm for Type
2 Diabetes: A Joint Statement by International Diabetes
Organizations. Surgery for Obesity and Related Diseases, 12(6),
1144–1162. doi:10.1016/j.soard.2016.05.018
Umpierre, D. (2011). Physical Activity Advice Only or
Structured Exercise Training and Association With
HbA1cLevels in Type 2 Diabetes. JAMA, 305(17),
1790. doi:10.1001/jama.2011.576
Literature Evaluation Table
Student’s name: Liliana Faura
University affiliation: GCU
Date: 12/15/219
Criteria
Article 1
Article 2

12. Article 3
Article 4
Author, Journal (Peer-Reviewed), and
Permalink or Working Link to Access Article
Weller, S. C., Baer, R., Nash, A., & Perez, N. (2017).
Discovering successful strategies for diabetic self-management:
a qualitative comparative study. BMJ Open Diabetes Research
and Care, 5(1), e000349.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5530238/
Ryninks, K., Sutton, E., Thomas, E., Jago, R., Shield, J. P., &
Burren, C. P. (2015). Attitudes to exercise and diabetes in
young people with type 1 diabetes mellitus: a qualitative
analysis. PloS one, 10(10), e0137562.
https://journals.plos.org/plosone/article?id=10.1371/journal.pon
e.0137562
Fink, A., Fach, E. M., & Schröder, S. L. (2019). ‘Learning to
shape life’–a qualitative study on the challenges posed by a
diagnosis of diabetes mellitus type 2. International journal for
equity in health, 18(1), 19.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6346523/
Messina, J., Campbell, S., Morris, R., Eyles, E., & Sanders, C.
(2017). A narrative systematic review of factors affecting
diabetes prevention in primary care settings. PloS one, 12(5),
e0177699.
https://journals.plos.org/plosone/article?id=10.1371/journal.pon
e.0177699
Article Title and Year Published
The article relates to the PICOT question as it describes the
strategies that can be used in managing diabetes.
The article relates to the PICOT question as it discusses
attitudes and exercises that can be used by young people with

13. Type 1 Diabetes Mellitus.
The article relates to the PICOT question as it provides about
challenges of diagnosis of diabetes mellitus type 2
The article relates to the PICOT question as it discusses the
factors that affect diabetes prevention in a primary care setting.
Research Questions (Qualitative)/Hypothesis (Quantitative), and
Purposes/Aim of Study
What strategies can be used in diabetic self-management?
Aim: to explore patients lifestyle in good and poor control to
identify practices and strategies that lead to a successful
diabetes management
What’s young people’s attitudes to physical activity on
glycaemic control in Type 1 Diabetes Mellitus
Aim: to investigate attitudes of young people to and
understanding of physical activity on glycaemic control in Type
1 Diabetes Mellitus
What are the challenges associated with a diagnosis of type 2
diabetes for those affected
Aim: To investigate the challenges that are associated with type
2 diabetes diagnosis
What are the factors related to the delivery and uptake of type 2
diabetes prevention interventions
Aim: To understand the factors that are related to delivery and
uptake of type 2 diabetes prevention intervention
Design (Type of Quantitative, or Type of Qualitative)
This article is qualitative research
This article is a qualitative analysis
This article is a qualitative study
This article is a narrative systematic review
Setting/Sample

14. Healthcare setting- university-affiliated Family Medicine
Clinics in Galveston, Texas
The Bristol and Weston Paediatric Diabetes Service
Halle/Saale, Saxony-Anhalt, Germany
Healthcare setting
Methods: Intervention/Instruments
Open-ended questions
Use of focus groups
Interviews
Revision inclusion and exclusion criteria
Analysis
The ideas presented were coded and verified independently.
AIC was acquired from patient medical records. The ideas and
themes were also estimated for each three glycemic control
groups
The focus groups were transcribed by a research assistant and
the patient identifiable details were removed. Super-ordinate
and master themes were developed through refining and
clustering
Personal data was protected by pseudonyms. Data management
and analyses were done with the use of MAXQDA software.
Data was broken down into parts, examined and compared.
The traditional systematic reviews focused on the measure of
effectiveness which helped in the provision of good quality
evidence-based data. data analysis was guided by narrative
synthesis and thematic analysis
Key Findings
Patients who did not their medications as prescribed were in
poor control. Patients who tested two or more times a day were

15. in good control.
Exercises helped in managing young people’s diabetes.
Difficulties at school and misunderstandings were reported to
impact diabetes in their life.
Diabetes mellitus type 2 affected professional and private life.
The process of learning to shape life was the central
phenomenon for the participants who were interviewed.
The risks of diabetes were linked with family history, obesity,
and lifestyle. Other factors identified were diet and physical
activity. Some participants stated that diabetes progression was
linked to genetics, stress and social isolation while others
believed that diabetes was widespread.
Recommendations
More emphasis on the importance of information and accuracy
should be improved.
More opportunities should be provided to empower young
people to take on responsibility for their Type 1 Diabetes
Structured diabetes education should be accessible to all
persons with T2DM
Further research is needed for the prevention and optimal
provision of knowledge for patients and professionals.
Explanation of How the Article Supports EBP/Capstone Project
It identified lifestyle strategies that can help manage type 2
diabetes.
It supports the project as it promoted awareness of the physical
and psychological benefits of exercise in managing diabetes
It supports the project as it has provided recommendations on
self-management to control diabetes.
It has identified factors that can be used in preventing diabetes
in primary care.
Criteria
Article 5

16. Article 6
Article 7
Article 8
Author, Journal (Peer-Reviewed), and
Permalink or Working Link to Access Article
Glechner, A., Keuchel, L., Affengruber, L., Titscher, V.,
Sommer, I., Matyas, N., ... & Gartlehner, G. (2018). Effects of
lifestyle changes on adults with prediabetes: A systematic
review and meta-analysis. Primary care diabetes, 12(5), 393-
408.
https://www.sciencedirect.com/science/article/pii/S1751991818
301967
Chen, J., Jing, X., Liu, X., Volkmann, A. M., Chen, Y., Liu, Y.,
... & Han, N. (2019). Assessment of factors affecting diabetes
management in the City Changing Diabetes (CCD) study in
Tianjin. PloS one, 14(2), e0209222.
https://journals.plos.org/plosone/article?id=10.1371/journal.pon
e.0209222
Gehlawat, M., Naik, B. N., Lakshminarayanan, S., & Kar, S. S.
(2018). Dietary practices and barriers to dietary modification
among diabetics and hypertensives in a rural health service area
of Puducherry: A qualitative study. International Journal of
Health & Allied Sciences, 7(3), 139.
http://www.ijhas.in/article.asp?issn=2278-
344X;year=2018;volume=7;issue=3;spage=139;epage=144;aulas
t=Gehlawat
Worku, A., Abebe, S. M., & Wassie, M. M. (2015). Dietary
practice and associated factors among type 2 diabetic patients: a
cross sectional hospital based study, Addis Ababa, Ethiopia.
SpringerPlus, 4(1), 15.
https://springerplus.springeropen.com/articles/10.1186/s40064-
015-0785-1
Article Title and Year Published

17. The article relates to the PICOT question as it discusses the
effects that lifestyle changes on prediabetes in adults.
The article relates to the PICOT question as it assesses the
factors that affect the management of diabetes.
The article relates to the PICOT question as it describes the
dietary practices and barriers that exist in modifying diet among
diabetic patients
The article relates to the PICOT question it assesses about the
dietary practices and factors that are associated with type 2
diabetic patients
Research Questions (Qualitative)/Hypothesis (Quantitative), and
Purposes/Aim of Study
What are the effects of lifestyle changes on adults with
prediabetes
Aim: to assess lifestyle intervention in comparison with
treatment in people with prediabetes
What are the factors that affect diabetes management in the City
Changing Diabetes in Tianjin
Aim: identification of local levels of vulnerability among
patients with Type-11 diabetes in Tianjin
What are the dietary practices and barriers presented to dietary
modification among diabetes hypertensive
Aim: to describe awareness of healthy dietary practices among
diabetic patients
What are the dietary practice and associated factors among type
2 diabetic patients
Aim: To describe the dietary management amongst type 2
diabetic patients
Design (Type of Quantitative, or Type of Qualitative)

18. This article is a meta-analysis research
This article is qualitative research
This article is qualitative research
This article is a cross-sectional research
Setting/Sample
Healthcare setting
Healthcare setting in Tianjin
Healthcare setting
Outpatient Department of Yekatit 12 Medical College Hospital,
Addis Ababa, Ethiopia
Methods: Intervention/Instruments
Literature analysis
Interview
Focus group discussion
Use of questionnaire and interview
Analysis
Evidence was summarized by a narrative format due to the
insufficiency of data for meta-analysis. Publication bias was
assessed using funnel plots, Egger’s regression intercept and
Kendall’s S static.
The records were transcribed into text and imported into NVivo
software. It was analyzed according to TCA.
Transcripts were reviewed independently by the authors by the
iterative process. intuitive coding was used for manual content
analysis
Data were analyzed manually for completeness. The
independent variables were selected into the model-based in the
literature, conceptual framework and effect on their analysis
Key Findings

19. Individuals with prediabetes who received lifestyle intervention
had a 54% lower risk of progression to type 2 diabetes than
people receiving the usual treatment.
After summarization of themes, it was concluded that certain
situations influenced wellbeing, health or emotions. Low
literacy was identified as a factor that limited the ability of
participants to manage their disease effectively.
The dietary modification was identified as essential if it makes
an impact on sugar control. Support from family members was
identified as a determinant of change in dietary behavior.
21.4% of the population had poor dietary practice. 16.6% of the
respondents provided that foods were not prepared based on
their disease.
Recommendations
Individuals with type 2 diabetes should consider lifestyle
intervention as it is a safe and cost-effective means.
Specific interventions that target an individual patient, family,
community and society are needed in improving diabetes control
Individuals with chronic diseases such as diabetes should
eradicate barriers such as consuming unhealthy foods.
Healthcare services should empower patients to heal themselves
by facilitating lifestyle changes through the use of health
promotion.
Explanation of How the Article Supports EBP/Capstone
It has provided that lifestyle intervention is the safest method
that can be used in reducing diabetes.
It supports the capstone as it has provided interventions that can
be used in improving diabetes control
It has provided the importance of dietary self-management in
controlling diabetes

20. It was suggested that the production of vegetables and fruits
will help in reducing diabetes.
References
Chen, J., Jing, X., Liu, X., Volkmann, A. M., Chen, Y., Liu, Y.,
... & Han, N. (2019). Assessment of factors affecting diabetes
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© 2015. Grand Canyon University. All Rights Reserved.
© 2017. Grand Canyon University. All Rights Reserved.
Rubic_Print_FormatCourse CodeClass CodeAssignment
TitleTotal PointsNRS-433VNRS-433V-O501PICOT Question
and Literature Search120.0CriteriaPercentageUnsatisfactory
(0.00%)Less than Satisfactory (75.00%)Satisfactory
(83.00%)Good (94.00%)Excellent (100.00%)CommentsPoints
EarnedContent80.0%Nursing Practice Problem and PICOT
Statement20.0%A nursing practice problem is not clearly
described and/or a PICOT statement is not included.PICOT
statement describes a nursing practice problem but lacks
reliable sources. PICOT statement describes a nursing practice
problem and includes a few reliable sources.PICOT statement
articulates a nursing practice problem using supporting
information from reliable sources.PICOT statement clearly
articulates a nursing practice problem using substantial
supporting information from numerous reliable
sources.Qualitative and Quantitative Research Requirements: At
least six references with the abstracts of research studies focus
on a selected nursing practice problem.60.0%Research articles
that address the selected nursing practice problem are not
identified.Fewer than six articles that address a selected nursing
practice problem are listed in the literature search, but two or

22. more are not research studies. Abstracts are incomplete.Six
articles that address a selected nursing practice problem are
listed in the literature search, but two are not research studies.
Abstracts are partially complete.Six articles that address a
selected nursing practice problem are listed in the literature
search, but one is not a research study. Abstracts are mostly
complete.Six articles that address a selected nursing practice
problem are listed in the literature search and include
abstracts.Organization and Effectiveness10.0%Mechanics of
Writing (includes spelling, punctuation, grammar, language
use)10.0%Surface errors are pervasive enough that they impede
communication of meaning. Inappropriate word choice or
sentence construction is used.Frequent and repetitive
mechanical errors distract the reader. Inconsistencies in
language choice (register), sentence structure, or word choice
are present.Some mechanical errors or typos are present, but
they are not overly distracting to the reader. Correct sentence
structure and audience-appropriate language are used. Prose is
largely free of mechanical errors, although a few may be
present. A variety of sentence structures and effective figures of
speech are used. Writer is clearly in command of standard,
written, academic English.Format10.0%Documentation of
Sources (citations, footnotes, references, bibliography, etc., as
appropriate to assignment and style)10.0%Sources are not
documented.Documentation of sources is inconsistent or
incorrect, as appropriate to assignment and style, with numerous
formatting errors.Sources are documented, as appropriate to
assignment and style, although some formatting errors may be
present.Sources are documented, as appropriate to assignment
and style, and format is mostly correct. Sources are completely
and correctly documented, as appropriate to assignment and
style, and format is free of error.Total Weightage100%