EPIDEMIOLOGY2 Epidemiology Question 1 After a thorough review of the journal’s authors, title, and abstract, my impression is that the article is of good quality. The article is authored by Nicholas Glasgow, one of the medical icons and a doctor of philosophy in medicine. Nicholas Glasgow is one of the renowned palliative medicine specialists as well as a general practitioner (Glasgow et al., 2017). He has done a lot of significant work and high-quality research in medicine; for instance, he examined or assessed the interface amidst secondary and primary care in developing nations in his doctoral thesis (Dolan et al., 2018). Additionally, he is considered as one of the excellent primary health care researchers. As result of the authors’ experience, this article’s quality is unquestionable. In the same token, the journal’s title also speaks for the paper, for example, it mentions the research’s population and disease of research. Generally the critical and creative evaluation and analysis of the article abstract show a logical and well-organized presentation looking towards meeting the authors’ intended objectives. The abstract outlines the study’s objective, methodology, results, and conclusion thus gives the readers a clear aim and content preview. Therefore, all the aforementioned reasons are clear indications of a high quality paper. Question 2 The rationale of the study is to measure or examine atopic disease and respiratory symptoms in Torres Strait Islander and Aboriginal children. It measures the respiratory symptoms of both non-indigenous and indigenous children in the Australian Capital Territory. The rationale is well articulated by the authors since it clearly outlines the study’s intended purpose or aim, therefore, demonstrating resilient convincing power in the entire journal. Question 3
EPIDEMIOLOGY3 The research embraces a non-experimental study design, employing cross-sectional and correlational analyses to help in generating the research findings. It also employs cohort study design. It can be said to be a descriptive design because it involves survey and observation, for example, two-stage questionnaires survey is conducted among children in the Australian Capital Territory. On the other hand, the study is a cohort because it involves sampling a group of individuals sharing defining characteristics, for examples, kindergarten children of the same age bracket. The researchers used prospective cohort study to help in determining the risks factors for contracting the respiratory diseases. In addition, the researchers follow the participants over time and they assess outcome and exposure during the follow-up. The study’s abstract outlines its objectives, methods, results, and conclusion, therefore, giving a clue of its content. In its subsequent pages, it uses the abstract’s outline to discuss the topic. Question 4 The major outcome variables in the study include respiratory health and prevalence of respiratory system. These are considered the major outcome variables because they have been used in the study to determine the sample size. Additionally, it is important to note that the research’s objective depend on them. The research is interested in studying the prevalence of the respiratory the diseases such as asthma. Question 5 The primary exposure variable is always related to either decrease or increase of a particular health outcome (Sackett, 2000). Remarkably, the primary exposure variable in the study is respiratory health. It is significantly associated with the study’s outcome which is the prevalence of respiratory symptoms in Torres Strait Islander and Aboriginal children in the ACT
EPIDEMIOLOGY4 (Glasgow et al. 2003). The study examines respiratory health of kindergarten children through assessing the prevalence of respiratory symptoms. Question 6 It is important to note that the overall research design was appropriate for the study question. The critical review of the authors’ methodology is based on the approach. The overall study design as well as hypothesis testing exhibits a well-organized, relevant, and appropriate presentation of research’s questions, ideas as well as results which are duly interpreted to support the aims and goal of the research. The research design aids the article to draw its strength from a coherent and consistent thesis, which matches up the both the introduction and conclusion. Notably, this demonstrates a strong convincing power in the findings or results, integral text as well as interpretation. Question 7 It is important to acknowledge that the study employs a large sample, for example, a sample of 10,600 non-indigenous children. Such a large sample size help in gathering more information as well reduces uncertainty, therefore, increasing the study’s validity and reliability. Additionally, such a large sample size leads to greater precision, gives greater power of detecting differences, and reduces the margin error. In the same vein, the response rate was quite recommendable. Out of the possible 100% recruited individuals, 92% participated in the study up to the end and the research found that the response rates were consistent for both the non- indigenous and indigenous subpopulations. The researchers also standardized the calculations of the response rates. Notably, the response rates and sample size positively impacts the study by reducing uncertainty and increasing its reliability and validity. Question 8
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EPIDEMIOLOGY5 The study found that indigenous children were highly prevalent to a dry cough at night, wheeze with colds (Raanan et al., 2015) as well parent-reported asthma in comparison to the non-indigenous children. Similarly, the results showed that the prevalence of hay-fever and eczema were higher in non-indigenous children in comparison to indigenous children (Glasgow et al. 2003). The indigenous children were found to be having much exposure to the household as well as environmental tobacco smoke as opposed to the non-indigenous children. The study found that there existed too much dry coughing during the night and breathe shortness of exercise. Question 9 The presence of asthma was measured through examining the associations or relations between atopic disease, the prevalence of respiratory symptom, and indigenous status. This was conducted through a number of univariate analyses via the use of Haenszel and Mantel odd ratios (Glasgow et al. 2003). The adjusted odds ratios were derived using logistics regression model to assess the effects of interaction with the covariates. Data analysis was conducted through the use of statistical package for the social science program. The rates were truncated to whole percentages points while the P values <0.5 were taken as statistically viable. This particular measurement had one limitation that is, rounding off of the percentage points to the whole number. This can raise uncertainty in regards to the research. Question 10 Some of the sources of bias in the study include confounding factors and selection bias (Miller et al., 2001). Selection bias manifested itself through the over-representation of children acknowledged by their parents as having asthma. Additionally, bias was introduced by the
EPIDEMIOLOGY6 diverse understanding of the questionnaires amidst the two respondent groups. It is, however, important to note that these biases had minimal effect on the study’s outcome or result. Question 11 Chance influences the effect of bias. It was entertained in the study to act as a cause of the observed association between the indigenous and non-indigenous children and the respiratory symptoms (Sarna et al. 2018). Chance also played a role in determining the confidence interval and P-values which play a significant role in results’ interpretation. Question 12 The effects of possible confounders in the study were eliminated through logistic regression models, matching, and restriction (Hayes and Preacher, 2014). For example, in the study, the confounding factors such as age group and sex were handled by selecting subjects of the same age group. Matching was used to handle potential confounders, for instance, the girls and boys in the same age group were matched. Similarly, the Mantel-Haenszel estimator was employed to offer an adjusted outcome in accordance with the strata (Elo and Kyngäs, 2008). Question 13 These findings can be applied to all indigenous and non-indigenous children. Furthermore, it can be generalized to those suffering from respiratory diseases in the country. First, the study had a high response rate ranging between 82 percent and 90 percent. Secondly, the subjects were selected through a non-random probability (Haby et al., 2001). The study did not apply a random selection of the subjects; it attested all the kindergarten children in the Australian Capital Territory. It is also important to note that there was no late respondent; all the respondents responded within the study’s timeframe. In the same token, all the target population members had an equal opportunity of being selected in the study.
EPIDEMIOLOGY7 Question 14 Generally, the creative and critical assessment and analysis of the article background and abstract demonstrate a well-organized as well as logical presentation which meets the authors’ objectives and intended purpose. The journal draws its strength from a coherent and consistent thesis which matches up the introduction and conclusion thus demonstrating a strong convincing power in the interpretation, findings, and integral text. The critical review of the writers’ methodology is founded on the overall study design, therefore, demonstrating well-organized and appropriate presentations research questions and results, and ideas which are properly interpreted to support the research’s goal (Graneheim and Lundman, 2014). The authors rely on old sources and literature review which date back to 1990s to support the research. This weakness hinders the credibility of the research. In spite of the limitation, the article is authored by some of the professional and experienced authors in the healthcare industry. Nicholas Glasgow is one of the renowned palliative medicine specialists as well as a general practitioner. He has done a lot of significant work and high-quality research in medicine, for instance, he examined or assessed the interface amidst secondary and primary care in developing nations in his doctoral thesis. Additionally, he is considered as one of the excellent primary health care researchers. As result of the authors’ experience, this article’s quality is unquestionable.
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EPIDEMIOLOGY8 References Dolan, R., Tilling, E., Kong, C. Y., MacLeod, N. J., McSorley, S. T., Park, J. H., ... & McMillan, D. C. (2018). Evaluation of systemic inflammation based prognostic scores in patients with advanced oesophageal cancer receiving palliative radiotherapy. Elo, S. and Kyngäs, H., (2008). The qualitative content analysis process.JOURNAL OF ADVANCED NURSING,62(1), pp.107-115. Glasgow, N. J., Goodchild, E. A., Yates, R., & Ponsonby, A. L. (2003). Respiratory health in aboriginal and Torres Strait Islander children in the Australian Capital Territory. Journal of paediatrics and child health, 39(7), 534-539. Glasgow, N., Butler, J., Gear, A., Lyons, S., & Rubiano, D. (2017). Using competency-based education to equip the primary health care workforce to manage chronic disease. Graneheim, U.H. and Lundman, B., (2014). Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness.Nurse Education Today, 24(2), pp.105–112. Haby, M. M., Peat, J. K., Marks, G. B., Woolcock, A. J., & Leeder, S. R. (2001). Asthma in preschool children: prevalence and risk factors. Thorax, 56(8), 589-595. Hall, K., Chang, A. B., Anderson, J., Arnold, D., Kemp, A., & O'Grady, K. A. (2015). Incidence and outcomes of acute respiratory illness (ARI) with cough in urban Indigenous children. Hayes, A.F. and Preacher, K.J., (2014). Statistical mediation analysis with a multicategorical independent variable.British Journal of Mathematical and Statistical Psychology,67(3), pp.451–470. Miller, K. D., Rahman, Z. U., & Sledge Jr, G. W. (2001). Selection bias in clinical trials. Breast disease, 14(1), 31-40.
EPIDEMIOLOGY9 Raanan, R., Harley, K. G., Balmes, J. R., Bradman, A., Lipsett, M., & Eskenazi, B. (2015). Early-life exposure to organophosphate pesticides and pediatric respiratory symptoms in the CHAMACOS cohort. Environmental health perspectives, 123(2), 179. Sackett, D. L. (2000). Therapy. Evidence-based medicine. Sarna, M., Lambert, S. B., Sloots, T. P., Whiley, D. M., Alsaleh, A., Mhango, L., ... & Ware, R. S. (2018). Viruses causing lower respiratory symptoms in young children: findings from the ORChID birth cohort. Thorax, thoraxjnl-2017.