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Q1: You have just travelled to Thailand for a 4-week student exchange program, where you now have the opportunity to work with experts in a leading research institute in the country. During your visit, you observed that malaria remains a significant health issue, particularly among children and pregnant women. The Institute Director wants to reduce the number of child deaths and maternal mortality due to malaria in a particular endemic-community. She has proposed that insecticide-treated bed nets may be appropriate for use among children and pregnant women, and has asked for you to gather evidence to inform the development of a malaria prevention study.
a. Write a focused research question for this particular problem that will help you organise a search of the literature for an answer (use the PICO elements as appropriate).
b. Identify the PICO elements in your research question
Q2: Scott, a 78-year-old man with a history of hypertension and atrial fibrillation was discharged from the hospital following a fall. At a follow-up appointment in your GP practice, his wife Julie asks whether there is a better alternative to warfarin, a blood thinning medication, which he has been taking to prevent stroke. Her friend’s husband has recently been put on a newer blood-thinning medication (Rivaroxaban) which doesn’t require regular international normalisation ratio (INR) testing, a standardised measurement of the time it takes for blood to clot. Julie finds it difficult to get her husband to the pathology collection centre because he is quite immobile. She asks what whether the new blood-thinning medication could be an option for her husband in stroke prevention.
a. Write a focused research question for this particular problem that will help you organise a search of the literature for an answer (use the PICO elements as appropriate).
b. Identify the PICO elements in your research question
Q3: In the past 2 years, as a Consultant in Infectious Diseases in one of the tertiary hospitals in Sydney, you have attended to 15 migrant patients who were referred by their General Practitioners with symptoms not typical of pulmonary tuberculosis. After taking a detailed history and performing appropriate physical examinations, as well as reviewing a range of relevant investigations, you clinically diagnosed and microbiologically confirmed that those patients have multi-drug resistance pulmonary tuberculosis (MDR-TB). The Public Health Department was notified of disease and the patients were managed accordingly. Now, you and some colleagues from Western Sydney University want to investigate the risk factors for MDR-TB.
a. Write a focused research question for this particular problem that will help you organise a search of the literature for an answer (use the PICO elements as appropriate).
b. Identify the PICO elements in your research question
Q4: The Director of the Research and Strategic Policy Unit in New South Wales (NSW) Health has just read a non-government health report for Western Sydney, which indicates that the region has the highest burden of childhood obesity in Australia. You have been approached to gather evidence (to submit a research proposal) on patterns of overweight and obesity, and provide advice on strategies to reduce the burden of childhood obesity in the community because she wants an independent research facility to conduct a study to better understand the health issue.
a. Write a focused research question for this particular problem that will help you organise a search of the literature for an answer (use the PICO elements as appropriate).
b. Identify the PICO elements in your research question
Q5: Now choose ONLY ONE research question from any of the questions above (Q1–4) that will help you organise a search of the clinical literature for an answer. If you were to search Medline/PubMed/Web of science for original research on this question:
a. Describe what your search strategy would be, including keywords, MeSH terms, inclusion and exclusion criteria, as well as evidence of the Boolean operators used.
b. Explain your rationale for taking this approach and explain your reasoning.
c. What type of study design would best be able to address your selected research question? State why.
d. Cite the best article from among those you find, using any referencing style of your choice.
1.a. The research question in this case would be: Is insecticide treated nets an appropriate method in the prevention of Malaria among children and pregnant women?
b. PICO is a scientific process that guide on research about a clinical problem. Apparently, PICO is an acronym where P means population, the patient or problem in question as well. I stands for the Intervention measures while C is comparison, control or comparator as well .Finally, O stands for the Outcome. Based on this scenario, the patients or population are both children and pregnant women while the problem is mortality due to malaria infection. The other I element of the PICO is intervention and in this scenario it is the Insecticide treated nets. Apparently for outcome in this scenario is absent since the Intervention under study is not being compared to any other intervention process. Finally O for outcome in this case implies reduced mortality rates after the intervention of insecticide treated nets is in full swing.
2.a. Based on this Scenario, the best research question would be: Is blood thinning medication an effective method of treating stroke among aged males as compared to warfarin?
b. PICO stands for patient, problem and population. In my research question in this scenario, P are the aged individual’s i.e. 78 year old Julies husband as well as the husband to her friend. The problem in this case is stroke. I stands for intervention and in this case it is warfarin since this was the initial prescription to Julies Husband by the doctors. C stands for comparison or comparator and in my research question it is Blood thinning medication since we are to compare its effectiveness to the warfarin medication. Finally it is the outcome and in this scenario, the desired outcome is to prevent or rather treat stroke among the aged males.
3.a. Based on this scenario, my research question would be, what are the risk factors associated with MDR-TB among the Migrant populations?
b. In my research question, P stands for the problem and the population or patient. The patient in this scenario are the migrants and the problem is the risks due to the MDR-TB. Apparently, Intervention and comparison are missing in my research question because we are only investigating the risk factors.
4.a. According to this scenario, the general research question could be: What are the main causes of obesity in children and what can be the best strategies to reduce obesity in children?
b. As explained earlier, PICO is an acronym used in research for clinical problems and it stands for population, patient and Problem. In this case therefore stands for children as the patient and population the Obesity is the Problem. I stands for intervention and in this case it is missing and that is the focus of the research now. C for comparison in this case is also missing since there is no alternative intervention measures being compared to. Finally, O stands for outcome and based on this scenario, the outcome is reduced cases of Obesity among Australian children.
5.a. In this scenario, I would use the evidence-based literature search approach. The key words I would search for are obesity, children and Australia and finally strategies to reduce obesity in children. The MeSH terms in this case would be Obesity as well as Interventions for Obesity. The inclusion criteria would be anything related to obesity among children while the exclusion criteria will involve around anything that is not related to children. The Boolean operators are AND, OR. In this case I will use AND to relate obesity and intervention strategies among the children.
b. The aim of using the evidence based search strategy is to find out the work that has already been published in that line and build on that to make a new research and conclusion.
c. The best study design that I would utilise in this scenario is the Systematic review design. Which involves reviewing different literature materials to come up with a substantial information and conclusion.
d. (Dobbins, DeCorby, Robeson, Husson, & Tirilis, 2009)
Dobbins, M., DeCorby, K., Robeson, P., Husson, H., & Tirilis, D. (2009). School-based physical activity programs for promoting physical activity and fitness in children and adolescents aged 6-18. Cochrane Database of Systematic Reviews. doi:10.1002/14651858.cd007651
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