NURS 8310 WEEK 6 Discussion 2 Appraising the Literature MARY

NURS_8310_ Week6_Discussion2_Rubric

Discussion 2: Appraising the Literature

For the DNP-prepared nurse, it is important to hone skills related to reviewing and evaluating research literature to implement evidence-based practices. As you examine epidemiological research, in particular, it is essential to ask, “What are the strengths and weakness of the research method(s)? Are the data analysis and interpretation sound? Is there any evidence of bias?” This Discussion provides you and your colleagues valuable practice in critically analyzing research literature.

To prepare:

  • With this week’s Learning Resources in mind, reflect on the importance of analyzing epidemiological research studies.
  • Critically appraise the Oppenheimer (2010) and Elliott, Smith, Penny, Smith and Chambers (1999) articles presented in the Learning Resources using Appendix A in Epidemiology for Public Health Practice as a guide.
  • Determine the strengths and weaknesses of the research methods and data analysis of each study.
  • Ask yourself, “Is any bias evident in either study? What did the researchers do to control for potential bias?”
  • Finally, consider the importance of data interpretation in epidemiologic literature and the issues that may arise if potential confounding factors are not considered.

By Day 5

Post a cohesive scholarly response that addresses the following:

  • Appraise the Oppenheimer (2010) and Elliott et al. (1999) articles, summarizing the strengths and weaknesses of each study.
  • Analyze potential sources of bias in each study, and suggest strategies for minimizing bias.
  • Suggest possible confounding variables that may have influenced the results of each study.

Read a selection of your colleagues’ responses.

By Day 7

Respond to at least two of your colleagues in one or more of the following ways:

  • Ask a probing question, substantiated with additional background information, evidence, or research.
  • Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
  • Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.
  • Validate an idea with your own experience and additional research.
  • Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.
  • Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!

Week 6: Epidemiological Applications, Part 2 and Data Interpretation

Can a person’s experience with racial discrimination impact aging and his or her physical health? The answer may be yes, according to a preliminary epidemiologic research study sponsored by the National Institute on Aging (NIA) and the National Institute of Health (Szanton et al., 2011; NIH, 2011). The NIA looks at factors such as race and socioeconomic status in relation to health disparities and outcomes. The Szanton et al. study identified a sample population of African Americans living in the Baltimore area who reported experiencing racial discrimination in their lifetime. This sample population showed higher levels of red blood cell oxidative stress, a potential risk factor in cardiovascular and other age-related diseases. Although this study presents only preliminary findings, it is interesting to consider the role that stress and other psychosocial factors play in the overall health of individuals and populations.

This week, you will examine psychosocial factors that influence health and disease. By understanding the role of these factors in health, along with environmental and genetic factors, you will have additional tools to improve health outcomes for individuals and populations.

Finally, in order to develop evidence-based interventions, DNP-prepared nurses need to be able to critically appraise the research literature, including the conclusions drawn from the data analysis. To practice this skill, you will appraise two articles and consider potential sources of confounding and bias.

Learning Objectives

Students will:

  • Evaluate the influence of psychosocial factors in health and disease
  • Critically appraise epidemiologic literature
  • Analyze the potential influence of confounding variables in a research study
  • Analyze potential sources of bias in epidemiologic research

Learning Resources

Required Readings

Friis, R. H., & Sellers, T. A. (2021). Epidemiology for public health practice (6th ed.). Jones & Bartlett.

  • Chapter 10, “Data Interpretation Issues”

In Chapter 10, the authors describe issues related to data interpretation and address the main types of research errors that need to be considered when conducting epidemiologic research, as well as when analyzing published results. It also presents techniques for reducing bias.

  • Chapter 15, “Social, Behavioral, and Psychosocial Epidemiology”

Chapter 15 features psychosocial, behavioral, and social epidemiology.

 

Elliott, A. M., Smith, B. H., Penny, K., Smith, W. C., & Chambers, W. A. (1999). The epidemiology of chronic pain in the community. The Lancet, 354(9186), 1248–1252.

 

This article describes an early epidemiologic study on chronic pain. Carefully review this article noting the structure of the research design, assessment and data collection, and analysis strategies. You will refer to this article for Discussion 2.

Oppenheimer, G. M. (2010). Framingham Heart Study: The first 20 years. Progress in Cardiovascular Diseases, 53(1), 55–61.

 

The Framingham Heart Study is a landmark epidemiologic study that began in the 1940s. The author of this article reviews the history of the Framingham Heart Study and its contribution to population health. As you read this article, consider any sources of bias or potential conflict of interest. You will refer to this article for Discussion 2.

Phillips, C. V., & Goodman, K. J. (2004). The missed lessons of Sir Austin Bradford Hill. Epidemiologic Perspectives & Innovations, 1(3). Retrieved from http://www.biomedcentral.com/1742-5573/1/3

In 1965, Austin Bradford Hill worked on a paper that has become a standard in public health and epidemiologic study about how to make decisions based on epidemiologic evidence. Hill put forth strategies for inferring causation and stressed the need for considering costs and benefits when planning health-promoting interventions. Review this article, which examines how Hill’s strategies are often misused or misinterpreted.

Centers for Disease Control and Prevention. (2011). CDC health disparities and inequalities report—United States, 2011. Morbidity and Mortality Weekly Report, Supplement, (60), 1–114. Retrieved from http://www.cdc.gov/mmwr/pdf/other/su6001.pdf. [Read pages 11–32]

This report consolidates national data on disparities in mortality, morbidity, behavioral risk factors, health care access, preventive health services, and social determinants of critical health problems in the United States by using selected indicators. The required section of reading introduces the social determinants of health and environmental hazards.

World Health Organization. (2011). Social determinants of health. Retrieved from http://www.who.int/social_determinants/en/

According to the World Health Organization, “The social determinants of health are mostly responsible for health inequities—the unfair and avoidable differences in health status seen within and between countries.” This article presents an introduction to social determinants of health.

World Health Organization. (2011). Social determinants of health: Key concepts. Retrieved from http://www.who.int/social_determinants/thecommission/finalreport/key_concepts/en/index.html

This article outlines key concepts related to the social determinants of health.

Healthy People 2020. (2011). Social determinants of health. Retrieved from http://healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=39

This website presents an overview of the social determinants of health and addresses how the information relates to Healthy People 2020.

UCL Institute of Health Equity. (2018). ‘Fair society healthy lives’ (The Marmot Review). Retrieved from http://www.instituteofhealthequity.org/resources-reports/fair-society-healthy-lives-the-marmot-review

Optional Resources

Genaidy, A. M., Lemasters, G. K., Lockey, J., Succop, P., Deddens, J., Sobeih, & Dunning, K. (2007). An epidemiological appraisal instrumental – a tool for evaluation of epidemiological studies. Ergonomics, 50(6), 920–960.

Centers for Disease Control and Prevention. (2011). Social determinants of health. Retrieved from http://www.cdc.gov/socialdeterminants/

Name: NURS_8310_ Week6_Discussion2_Rubric

  Excellent Good Fair Poor
RESPONSIVENESS TO DISCUSSION QUESTION

Discussion post minimum requirements:

*The original posting must be completed by Wednesday, Day 3, at 11:59pm MST. Two response postings to two different peer original posts, on two different days, are required by Saturday, Day 6, at 11:59pm MST. Faculty member inquiries require responses, which are not included in the minimum number of posts. Your Discussion Board postings should be written in standard edited English and follow APA style for format and grammar as closely as possible given the constraints of the online platform. Be sure to support the postings with specific citations from this week’s Learning Resources as well as resources available through the Walden University online databases. Refer to the Essential Guide to APA Style for Walden Students to ensure your in-text citations and reference list are correct.

8 (26.67%) – 8 (26.67%)

Discussion postings and responses exceed the requirements of the Discussion instructions. They: Respond to the question being asked or the prompt provided; – Go beyond what is required in some meaningful way (e.g., the post contributes a new dimension, unearths something unanticipated); -Are substantive, reflective, with critical analysis and synthesis representative of knowledge gained from the course readings and current credible evidence. – Demonstrate significant ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Demonstrate that the student has read, viewed, and considered the Learning -Resources as well as additional resources and has read, viewed, or considered a sampling of colleagues’ postings; -Exceed the minimum requirements for discussion posts*.

7 (23.33%) – 7 (23.33%)

Discussion postings and responses meet the requirements of the Discussion instructions. They: -Respond to the question being asked or the prompt provided; -Are substantive, reflective, with critical analysis and synthesis representative of knowledge gained from the course readings and current credible evidence.re -Demonstrate ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Demonstrate that the student has read, viewed, and considered the Learning Resources and has read, viewed, or considered a sampling of colleagues’ postings -Meet the minimum requirements for discussion posts*.

6 (20%) – 6 (20%)

Discussion postings and responses are minimally responsive to the requirements of the Discussion instructions. They: – do not clearly address the objectives of the discussion or the question or prompt; and/or -May (lack) lack in depth, reflection, analysis, or synthesis but rely more on anecdotal than scholarly evidence; and/or -Do not adequately demonstrate that the student has read, viewed, and considered the Learning -Resources and/or a sampling of colleagues’ postings; and/or has posted by the due date at least in part. – Lack ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Do not meet the minimum requirements for discussion posts*.

0 (0%) – 5 (16.67%)

Discussion postings and responses are unresponsive to the requirements of the Discussion instructions. They: – do not clearly address the objectives of the discussion or the question or prompt; and/or – Lack in substance, reflection, analysis, or synthesis but rely more on anecdotal than scholarly evidence. – Lack ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Do not demonstrate that the student has read, viewed, and considered the Learning Resources and/or a sampling of colleagues’ postings; and/or does not meet the minimum requirements for discussion posts*.

CONTENT KNOWLEDGE 8 (26.67%) – 8 (26.67%)

Discussion postings and responses: -demonstrate in-depth understanding and application of concepts and issues presented in the course (e.g., insightful interpretations including analysis, synthesis and/or evaluation of topic; – are well supported by pertinent research/evidence from a variety of and multiple peer- reviewed books and journals, where appropriate; -Demonstrate significant mastery and thoughtful/accurate application of content, applicable skills or strategies presented in the course.

7 (23.33%) – 7 (23.33%)

Discussion postings and responses: -demonstrate understanding and application of the concepts and issues presented in the course, presented with some understanding and application of concepts and issues presented in the course (e.g., insightful interpretations including analysis, synthesis and/or evaluation of topic; -are supported by research/evidence from peer-reviewed books and journals, where appropriate; and · demonstrate some mastery and application of content, applicable skills, or strategies presented in the course.

6 (20%) – 6 (20%)

Discussion postings and responses: – demonstrate minimal understanding of concepts and issues presented in the course, and, although generally accurate, display some omissions and/or errors; –lack support by research/evidence and/or the research/evidence is inappropriate or marginal in quality; and/or lack of analysis, synthesis or evaluation of topic – demonstrate minimal content, skills or strategies presented in the course. ——-Contain numerous errors when using the skills or strategies presented in the course

0 (0%) – 5 (16.67%)

Discussion postings and responses demonstrate: -A lack of understanding of the concepts and issues presented in the course; and/or are inaccurate, contain many omissions and/or errors; and/or are not supported by research/evidence; and/or lack of analysis, synthesis or evaluation of topic -Many critical errors when discussing content, applicable skills or strategies presented in the course.

CONTRIBUTION TO THE DISCUSSION 8 (26.67%) – 8 (26.67%)

Discussion postings and responses significantly contribute to the quality of the discussion/interaction and thinking and learning by: -providing Rich and relevant examples; discerning and thought-provoking ideas; and stimulating thoughts and probes; – -demonstrating original thinking, new perspectives, and extensive synthesis of ideas supported by the literature.

7 (23.33%) – 7 (23.33%)

Discussion postings and responses contribute to the quality of the discussion/interaction and thinking and learning by -providing relevant examples; thought-provoking ideas – Demonstrating synthesis of ideas supported by the literature

6 (20%) – 6 (20%)

Discussion postings and responses minimally contribute to the quality of discussion/interaction and thinking and learning by: – providing few and/or irrelevant examples; and/or – providing few if any thought- provoking ideas; and/or -. Information that is restated from the literature with no/little demonstration of critical thinking or synthesis of ideas.

0 (0%) – 5 (16.67%)

Discussion postings and responses do not contribute to the quality of interaction/discussion and thinking and learning as they do not: -Provide examples (or examples are irrelevant); and/or -Include interesting thoughts or ideas; and/or – Demonstrate of critical thinking or synthesis of ideas

QUALITY OF WRITING 6 (20%) – 6 (20%)

Discussion postings and responses exceed doctoral -level writing expectations. They: · Use grammar and syntax that is clear, concise, and appropriate to doctoral level writing; · Make few if any errors in spelling, grammar, and syntax; · Use original language and refrain from directly quoting original source materials; -provide correct APA · Are positive, courteous, and respectful when offering suggestions, constructive feedback, or opposing viewpoints.

5 (16.67%) – 5 (16.67%)

Discussion postings and responses meet doctoral -level writing expectations. They: ·Use grammar and syntax that is clear and appropriate to doctoral level writing; ; · Make a few errors in spelling, grammar, and syntax; · paraphrase but refrain from directly quoting original source materials; Provide correct APA format · Are courteous and respectful when offering suggestions, constructive feedback, or opposing viewpoints;.

4 (13.33%) – 4 (13.33%)

Discussion postings and responses are minimally below doctoral-level writing expectations. They: · Make more than occasional errors in spelling, grammar, and syntax; · Directly quote from original source materials and/or paraphrase rather than use original language; lack correct APA format; and/or · Are less than courteous and respectful when offering suggestions, feedback, or opposing viewpoints.

0 (0%) – 3 (10%)

Discussion postings and responses are well below doctoral -level writing expectations. They: · Use grammar and syntax that is that is unclear · Make many errors in spelling, grammar, and syntax; and –use incorrect APA format · Are discourteous and disrespectful when offering suggestions, feedback, or opposing viewpoints.

  Total Points: 30

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Solution

Appraisal of literature allows researchers to identify strengths, benefits, and applications of such content and the inherent weak areas. The articles by Oppenheimer (2010) and Elliott et al. (1999) have particular strengths and weaknesses and potential sources of bias. The strengths in Oppenheimer’s article include the quantification and detailed description of chronic pain in the community under investigation based on social demographic status, sex, and age. The strengths of Elliott et al. article include offering a separate database to test a host of non-CVD issues and identifying aspects that statisticians and healthcare providers experience in developing an epidemiological study. The authors also draw the community under review into research support.

Conversely, the two articles also have weaknesses. The weaknesses of Oppenheimer’s article include the inability to provide feedback on areas where participants failed to give. Secondly, the author didn’t use responses from the participants during data analysis (Oppenheimer, 2010). The weakness of the second article is the multiple investments by different authorities in the project, which may demonstrate a conflict of interests.

Potential sources of bias in the articles include the failure to consider all possible variables, which leads to inaccurate interpretation of outcomes. Both articles used an inadequate representation of their respective populations. Researchers can avoid this bias by expanding the samples in their studies to represent the entire population. Convenience bias is evident in the first article due to selecting individuals aged 25 years and above. Researchers need to give equal chances to all potential subjects to be part of their survey. Again, the bias of self-selected cohort is evident in the second article. This leads to an unbiased estimate of the prevalence of aspects in the research (Elliott et al., 1999). Researchers can correct this by using a collective model in data collection so that all participants have an equal chance.

Confounding variables are extra variables that researchers fail to consider when doing trials. These variables can affect results and render them useless, increasing bias and affecting variance. The founding variables in the two articles include the inability to consider feedback from respondents during their data analysis. The studies should have also considered having control variables to mitigate bias.

References

Elliott, A. M., Smith, B. H., Penny, K. I., Smith, W. C., & Chambers, W. A. (1999). The

epidemiology of chronic pain in the community. The Lancet, 354(9186), 1248-1252. DOI: 10.1016/s0140-6736(99)03057-

Oppenheimer, G. M. (2010). Framingham heart study: the first 20 years. Progress in

            cardiovascular diseases, 53(1), 55-61. DOI: 10.1016/j.pcad.2010.03.003.

 

 

 

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