Physical Activity Versus Usual Care Report Writing – Arts and Humanities Assignment Help

Task

Section A:

Q1. Read the following article: Malhotra, A. (2013). ‘Saturated fat is not the major issue’, British Medical Journal, Oct 22; 347, f6340.

a) Comment on the choice and method of selection of studies used to support the article.

The article presents data from the following article:

‘Discontinuation of statins in routine care settings.’, Annals of Internal Medicine, Vol. 158, pp.526-34.

Find and retrieve the article through PubMed. 

a) What kind of study is it? 

b) What is the difference between a retrospective cohort and a prospective cohort study.

c) Comment on why the side effects reported in a cohort study might be “massively at odds with the [findings of the] major statin trials”.

d) The article comments on an early study that concluded “a correlation existed between the incidence of coronary heart disease and total cholesterol concentrations, which then correlated with the proportion of energy provided by saturated fat.”

e) What is meant by the term ‘incidence’

f) Do you think there is any justification for reducing saturated fat intake based on this statement?

Q2. Please read the following article –

Pfaff, J.J., Alfonso, H., Newton, R.U., Sim, M., Flicker, L., Almeida,O.P. (2014). ‘ACTIVEDEP: a randomised, controlled trial of a home-based exercise intervention to alleviate depression in middle-aged and older adults’, British Journal of Sports Medicine,
48:226-232.

We would like you to critically appraise elements of this research article using the CASP checklist for Randomised Controlled Trials (RCTs).

a) Consider the study population and study methodology and answer the following:

i. Were patients, health workers and study personnel blinded? 
ii. Were the groups similar at the start of the trial? 
iii. Aside from the experimental intervention, were the groups treated equally?

b) What were the main outcome measures in this study? Do you think that all clinically important outcomes were considered? 

c) Summarise your opinion about the quality of this article, using your own words. Consider the relevance of this research for clinical practice.

SECTION B.

Q3.Complementary and integrative medicine (CIM) is often used in the management of headache. However, high quality robust scientific evidence on the effectiveness of these therapies remains limited. Please access and read the following:

Millstine,D., Chen,C.Y. and Bauer,B. (2017). ‘Complementary and integrative medicine in the management of headache’, British Medical Journal, 357, j1805. http://www.bmj.com/content/357/bmj.j1805

The article describes that there is generally low and occasionally moderate evidence of the effectiveness of CIM in treating headache.

We would like you to conduct a literature search in order to identify an article that describes an RCT using any type of CIM that shows that CIM is effective in treating headache.

a) Create a literature search using the structured search worksheet (provided in the course material on Blackboard). Please restrict your search to articles written in the English language, published in the last ten years. 

b) Run the search and review the results. Select ONE appropriate article and provide the full Harvard style reference, adhering to the University of Manchester Harvard referencing style (accessible through the University of Manchester Library website). 

c) Tell us about your chosen reference:

i. State which treatment your article has identified as likely to benefit patients experiencing headache.

ii. Briefly justify your choice of article by providing a short description of the study, including details about why it was successful.

iii. Comment on the quality of the evidence provided in your reference, with particular reference to the study design.

Q4. Choose a health related topic that you think would be suitable for an observational study. We would like you to design a research study on your chosen topic. This must be an original proposal.

a) Provide a brief outline of your chosen study topic. State the study aim and the study objectives. 

b) State the specific study design you have chosen for your study. Briefly explain your choice, providing details of the suitability of the selected study design for your research question. 

c) Provide a PECO for the study. 

d) State two potential types of bias in the study and discuss steps you might take to minimize the bias. 

Q5. A systematic review has evaluated whether exercise programs for older people with dementia improve cognition (Forbes et al. 2013). The review included sixteen randomized controlled trials of both parallel and cross-over design. Eleven trials reported on cognition, eight of which provided data suitable for meta-analysis.

Physical activity versus usual care. Outcome: cognition Forbes, D., Thiessen, E.J., Blake, C.M., Forbes, S.C. and Forbes. S. (2013). ‘Exercise programs for people with dementia’, Cochrane Database of Systematic Reviews, Issue 12. Art. No.:CD006489. DOI: 10.1002/14651858.CD006489.

a) Comment on the choice of study designs included in the review.

b) Interpret the results presented in Figure 1 in terms of the effectiveness of physical activity.

c) What is meant by the ‘standardised mean difference’ and why is it used in the analysis?

d) Define statistical heterogeneity.

e) Comment on the presence/absence of statistical heterogeneity in the two analyses presented in Figure 1.

Q6.  Please read the following scenario:

Adolescents undertaking bracing for a spinal deformity (scoliosis) are recruited to a surgical intervention clinical trial which will compare clinical outcomes based on the degree of severity of spinal deformity and whether corrective spinal surgery undertaken at a lower curvature severity (earlier intervention) leads to improved long term outcomes. None of the participants have life threatening deformities nor require urgent surgery.

Participants are aged 13-17 at recruitment and, on average, are operated on within 15.5 months. Participants attend a screening and consent appointment, a baseline assessment, and then annual follow up appointments for 3 years. Please consider the scenario above in the context of the UK NHS Health Research Authority guidance for researchers and answer the following:

a) There are a series of consent procedures that should be in place for the duration of this study. State three consent considerations for this study and provide a reason why they must be addressed.

b) A 14 year old girl has been consented to participate by both her parents but does not want to have the surgery until she finishes school. State whether or not surgery should proceed. Explain your answer.

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