The study’s methods may be deemed internally valid. Case-control studies are especially vulnerable to selection bias during the selection of cases and controls. This study selected all participants from a population-based surveillance system. Since the presence or absence of NVP, the exposure, had no influence on the registration of NTD cases and matched controls, selection bias due to faulty sampling procedures was minimized. Likewise, the high participation rates (>80%) and low levels of missing information (<3%) reduced selection bias due to attrition or other participation-related factors. However, two potential concerns should be noted. First, to increase the sample size, the authors used an unmatched analysis. The cases and controls were …show more content…
NVP was measured using face-to-face interviews, a method prone to recall bias. Since mothers from the case group would be more likely to recall adverse events that could be linked to NTDs in their children, the method would be more sensitive in cases than the population controls. This would lead to an overestimation of the risk. The study tries to minimize this bias by informing the participants about what NVP means (including that it necessitated bed rest or hospitalization) and giving a certain time frame to recall from (in the first trimester). Also, a limb defect control group, who too would be more likely to remember adverse exposures, was added to detect the presence of recall bias. The value of malformed controls in similar studies is debatable [3]. Nonetheless, the association between NVP and NTD when compared to this group achieved statistical significance, which strengthened the finding that an association existed, even if recall bias was present. Case-control studies are less prone to misclassification of the outcome (e.g. due to diagnostic suspicion bias) because the exposure status is known during the initial classification. Also, studies validate the two-stage process used by the surveillance system to classify NTD cases, as it has a sensitivity of 95.9% and assumed specificity near 100% …show more content…
Since most findings were statistically significant, the chance of a type 1 error was possible. In a few cases, such as during the analysis of the association between NVP and Encephalocele relative to limb defects control, the null hypothesis of no association was accepted. Here, a type 2 error may have been possible. This could be prevented by using larger samples sizes for the limb control group (123 limb defect controls) and NTD subcategory cases. However, for most purposes, the sample sizes (832 cases, 1271 population controls) used in the study were quite large, increasing the statistical power and reducing the effects of random error. This is reflected in the moderately sized confidence intervals, which further indicate that the results were moderately
There have been ten paediatric risk assessment scales created however six of which have been modifications of adult risk assessment scales. There has been no published study where statistical methods have been used to develop a predictive pressure ulcer risk assessment scale from direct paediatric patient data. (Willock et al., 2007).
This module of study has focused on many aspects of human health, anatomy, and the disease process. It has included such topics as the human organ systems, the mechanism of disease and the resulting disruption of homeostasis, the integumentary system, and the musculoskeletal system. The following case studies explore how burn classification will affect treatment, how joint injuries can disrupt mobility, and last, how a sedentary lifestyle can contribute to a decline in a person’s health status. The importance of understanding disease and knowing when to seek treatment is the first step toward enjoying a balanced and healthy life.
When horrific crimes occur in large cities, many of them can be chalked up to gang violence or to the larger population of that specific city. But when horrific crimes happen in small cities like Lincoln, Nebraska, people begin to ask questions like who did this and why. In 1958, a nineteen year old man named Charles Starkweather put the entire state of Nebraska and possibly the entire nation in a state of terror. With his murder spree taking only three days, Starkweather had collected a body count of ten bodies, including two teenagers and a young child. Understanding Starkweather’s past and state of mind begins to answer the second question of why.
The ethical discernment model described by Slosar (2004) and developed for use at Ascension Health will assist us as we analyze this case. It reminds us that discernment engages our spirituality, intellect, imagination, intuition, and beliefs. It is decision-making that reaches into the heart of our beliefs about God, creation, others, and ourselves. It therefore requires structured time for reflection and prayer from the beginning and throughout the process.
Case conceptualization and treatment planning is used by therapist to assist in determining a client’s diagnosis, goals, and treatment plan that is most effective in determining the issues surrounding the clients diagnosis. It is crucial that the client’s treatment plan is specific to the individual, is relational and appropriate to the needs of the client.
The patient, LL, is a twenty four year old female who was diagnosed with obsessive-compulsive disorder five years ago. Around the ago of eighteen, LL started to experience many symptoms of obsessive-compulsive disorder. She had just started her freshman year at a local college and moved into the dorms with a random roommate. LL was constantly washing her hands and grossed out by the germs, so she came to realize she had a phobia of germs. She would begin sweating and having major anxiety when people went to shake her hand or her roommate would touch her food or any of her things. LL started skipping class and isolating herself in her room in order to avoid contact with other people. When her grades dramatically declined,
Nearly every aspect of law enforcement has a court decision that governs criteria. Most court rulings are the result of civil lawsuit towards a police officer and agency. However, currently, there is no law that mandates law enforcement driver training. When it comes to firearms, negligence by officers has resulted in a multitude of court rulings. Popow v. City of Margate, 1979, is a particularly interesting case that outlines failed firearms training by an agency. In this case, an officer chasing a suspect during a foot pursuit fired at the suspect, striking and killing an innocent bystander (Justia.com, 2017). The court ruled that the agency was “grossly negligent” of “failure to train” (Justia.com, 2017). As a result, nearly every agency requires annual firearms training and has written policy concerning the same. Officers must show proficiency in firearms use every year to maintain their certification. Many states even impose fines on officers for
Maternal & Child Health Journal, 8(3), 107-110. Retrieved from http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=14089739&site=ehost-live.
The neurological disorder is generally diagnosed in children aged between six and twelve years, the condition affecting boys three times more often than girls (Hamilton, 2002; Gardner, 2008). Despite the fact that DCD affects roughly 6.4 percent of children, few individuals are familiar with the condition (Hamilton, 2002). In fact, a study by Kirby, Davies, & Bryant (2005) revealed that only 54.3% of teachers and 26.7% of general practitioners could accurately define DCD (p. 124). In response, the condition will be briefly outlined here.
It is most likely every major text on epidemiology involved in retrospective research is influenced by recall bias. Scientists have identified recall bias to occur when accuracy of recall regarding prior exposure is different for cases versus control (RAPHAEL, 1987). The possibility for recall bias exists whenever historical self-report information is elicited from respondents (RAPHAEL, 1987). Therefore, the potential for the occurrence is likely to be greatest in case-control studies or cross-sectional studies with retrospective elements, as well as some cohort prospective and control randomized trial designs (Hassan, 2006). Since recall bias is an undesired element, intended to potentially distort the study, the initial design of research study needs to implement a proper strategy. In construction of the design, an abstract, methods and conclusion alone do not restrict recall bias.
Nursing interventions are important in nursing and patients as they enable patients to get better for example a therapeutic session can help a depressed patient feel better due to the fact that someone is there communicating and listening to them. National Institute for Health and Care Excellence, 2009 (NICE) recommends that interventions should be monitored and reviewed to assess the effectiveness of treatment. In order for Mrs Smith to get medically fit there were some nursing interventions that were put into place for her by the nurses that were looking after her. Mrs Smith depression had been trigged by the death of her mother; she was referred to the Bereavement Counseling Team. This was because Mrs Smith had also been reporting that she had missed her mother greatly and was also being ambivalent towards her family members; they were finding it difficult to cope with her as she constantly moaned and complained which the family thought she was being ungrateful towards them.
One of the functions of epidemiologists is public health surveillance. In this role, epidemiologists gather data, analyze it, and disseminate the information to help guide in public health decision making (Savitz, Poole, and Miller, 1158). In gathering data, they use sources like the mortality reports and any other relevant healthcare information. They disseminate their findings to public health care officials involved in disease control. The information provided is relevant as it depicts the ongoing patterns of disease occurrence. Once submitted to the officials prevention measures are
Formulate from the above what issues requiring epidemiological research and select correctly the type of methodology to be used: ...
Write 2 mini case studies. One should recount an effective coaching or counseling situation. The other recount an ineffective coaching or counseling situation. The case should be based on a real event, either from your own personal experience or from the experience of someone you know well. Use principles of supportive communication and listening in your cases.