Name Victoria Adesina student ID 0283752 Journal Club Assignment Question 1: Yes patient were Randomized. Participants were randomly assigned to a placebo –controlled multicenter trial for smoking cessation in patients with mild to moderate COPD conducted in 27 centers in four countries: United states(17 sites), Spain( 3 sites), France(four sites) and Italy (3 sites). Patient were randomized at baseline into 2 groups to receive either Varenicline 0.5mg once daily for 3 days, 0.5mg bid for 4 days, then 1.0mg bid for a total of 12 weeks or Placebo (with identical regimen). The method used to generate the random allocation of product was not stated in the study. Question 2: Randomization concealment was not specified. Question 3: Yes the …show more content…
The trial consist of patient who were 35 years old or older with clinical diagnosis of mild to moderate COPD (confirmed FEV1/FVC LESS 70% and FEV1 % predicted normal value greater or equal to 50% and willingly to stop smoking. Participants has higher percentage of male and Caucasians populations, smoked for an average of 40 years also smoked 10 or more cigarettes per day over the past year. Participants treated with systematic steroids or hospitalized for COPD exacerbation during the 4 week period were excluded. Aslo excluded are participants with uncontrolled medical …show more content…
73.8% Participants receiving Varenicline and 65.3% receiving placebo reported an adverse event, which seldom led to treatment discontinuations in either group (5.2% and 5.6% respectively. Serious Adverse Event were few in both groups and were not considered to be treatment related. The most frequent Adverse events occurring in the Varenicline group compared with the placebo group were nausea (27.0% vs 8.0%), Abnormal dreams (10.9% VS 7%), sleep disorders or disturbances (20.6% vs 9.2%). Question 13: Overall Assessment of the study; Not a high quality Randomized control trial. Intention to treat Analysis was not detailed. Strength of the Trial include: Randomization. Patients were randomized in the group to which they were analyzed which help to balance prognostic factor within the two groups. Patient were also randomly assigned to treatments Trial was double blinded to minimize any form of bias Length of trial was sufficient for smoking cessation. Trial was not stopped early All study participants were analyzed. Intention to treat principle was applied to help reduce bias due to loss to
Mrs. Jones has a history of COPD. She was already taking albuterol for her illness and it was ineffective when she took it that day. Mrs. Jones had been a smoker but had quit several years ago. According to Chojnowski (2003), smoking is a major causative factor in the development of COPD. Mrs. Jones's primary provider stated that she had a mixed type of COPD. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) was established to address the growing problem of COPD. The GOLD standards identify three conditions that contribute to the structural changes found in COPD: Chronic bronchiolitis, emphysema, and chronic bronchitis. A mixed diagnosis means that the patient has a combination of these conditions (D., Chojnowski, 2003). Mrs. Jones chronically displayed the characteristic symptoms of COPD. "The characteristic symptoms are cough, sputum production, dyspnea on exertion, and decreased exercise tolerance." (D., Chojnowski, 2003, p. 27).
For patients diagnosed with chronic obstructive pulmonary disease with a history of smoking cigarettes (P) can the use of nicotine replacement therapy (I) compared to only using nicotine replacement therapy (C) increase the patient's ability to permanently stop smoking (T) and slow down the progression of the effects of the disease?( O)
Carone M, D. C. ( 2007). Clinical Challenges In COPD[e-book]. (Oxford: Clinical Pub) Retrieved March 24, 2014, from (EBSCOhost).
Simple actions plans usually yield positive outcomes as they are comprehensible easily by the clients and the caretakers. So do the simple evaluation plans, which will show the more direct and accurate results because of their direct approach. In suggested implementation plan, target is to improve self reliance in patients by increasing their confidence and building their positive thinking habit with psycho-analytical approach.
Radelet & Borg address the most common arguments for and against the death penalty, and how views on capital punishment have changed over time in respect to six specific areas: deterrence, incapacitation, caprice and bias, cost, innocence, and retribution.
There are many different opinions about the differences between faith and reason. Traditionally viewed differences between reason and faith are that reason is something that requires empirical, factual evidence while faith relies merely on, well, faith. For something to have reason it must have some kind of factual evidence to make it true, or at least very good sound reasoning to believe that whatever it is, is factual. Faith is far from something that attains empirical evidence, faith usually relies on personal accounts which are usually of mystical content. Many philosophers have different opinions about how the two can coexist; some say under no circumstances at all, while others claim they can justify each other, and some claim faith is reason alone. Some philosophers claim that believing in God is an obvious choice by the claim that just because you can’t see it, doesn’t mean it isn’t there like Blaise Pascal. Blasé Pascal and Clifford offer two completely different standpoints on the role of reason and faith.
Within this set, the investigators randomized how many trials the participants would complete: 7, 10, or 13. Then, they were giving the chance to do 3 or 6 more trials and were ask to record their results.
The leading cause of COPD is cigarette smoking, either people that smoke or used to smoke or had long term exposure to other lung irritants. “There are significant data to suggest that people who smoke are at a much higher risk of developing COPD than people who do not” (Clancy & Turner, 2013, p. 820). Lung irritants include second hand smoke, air pollution, chemical fumes or industrial dust and frequent use of cooking gas or fires without proper ventilation. Symptoms of COPD usually begin at age 40. Smoking is the main risk factor for COPD. People either smoke or used to smoke and smokers who have a family history of this disease are more likely to develop COPD. Asthma, although uncommon, can also cause development of this disease if treatments do not work.
This objective is important because there is evidence in the literature that PCPs offering smoking cessation interventions in primary care can have a significant positive impact on a smoker’s likelihood of attempting to quit (Ong, Zhou and Sung, 2011). Receiving advice from a primary care provider (PCP) to quit smoking increased the likelihood that a smoker will quit by a factor of 1.3. Even more interesting is that receiving physician treatment for smoking, such a medication, counseling or referral, boosts the odds that that smoker will quit by 2.2 (Fiore, Jaen, Baker et al, 2008). Evidence also suggests that such brief interventions are cost effective (Fiore et al, 2008).
conducted using a sample of French smokers (36 F, 60 M) and non-smokers (23 F,
Through public education, most elementary school kids can understand that smoking is bad for them and that cigarettes are additive. Cigarettes are addictive due to nicotine, a drug found in tobacco (“Quitting Smoking”, 2015). According to Schneider (2016), some of the greatest health problems associated with smoking include: lung cancer, other cancers, coronary heart disease, other heart disease, cerebrovascular disease, other vascular disease, diabetes mellitus, pneumonia, influenza, tuberculosis, chronic obstructive pulmonary disease (COPD), prenatal conditions, and sudden infant death syndrome. As stated by the Authority of the American Lung Association in an article titled “Health
The prevalence of COPD is heavily associated with elderly persons that are predisposed to various risk factors (Viegi et al., 2001). The prevalence of these risk factors is often a major aspect in the diagnosis of the disease, the most detrimental of these being cig...
Vijayan, V. K. (2013). Chronic obstructive pulmonary disease. Indian Journal Of Medical Research, 137(2), 251-269.
...f patients’ doctors recruited participants, patients may not ease to refuse participating a trial. Therefore recruitment may be better to be done by a person who does not normally treat the patients.
Each year, more than 30,000 people die of lung cancer and 4 out of 5 of them will get it because of cigarette smoke. Studies have proven that there is no safe way to smoke. Tobacco contains many dangerous cancer-causing chemicals that affect the lungs of the smoker and the nonsmoker, so smoking just a small amount can increase your chances of getting lung cancer. The Surgeon General has said that "smoking is the single most important cause of death in our society, and it is responsible for more than one out of every five deaths in the United States." The purpose of this report is to inform and educate the reader about smoking and why it is considered the biggest cause of lung cancer. This subject is near and dear to me because my grandfather, who was once a heavy smoker, is now fighting this awful disease.