NR 503 Week 2: Discussion – Epidemiological Methods

Chamberlain University NR 503 Week 2: Discussion – Epidemiological Methods– Step-By-Step Guide

This guide will demonstrate how to complete the Chamberlain University NR 503 Week 2: Discussion – Epidemiological Methods   assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.

How to Research and Prepare for NR 503 Week 2: Discussion – Epidemiological Methods              

Whether one passes or fails an academic assignment such as the Chamberlain University NR 503 Week 2: Discussion – Epidemiological Methods  depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.

After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.

How to Write the Introduction for NR 503 Week 2: Discussion – Epidemiological Methods              

The introduction for the Chamberlain University NR 503 Week 2: Discussion – Epidemiological Methods  is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.

How to Write the Body for NR 503 Week 2: Discussion – Epidemiological Methods              

After the introduction, move into the main part of the NR 503 Week 2: Discussion – Epidemiological Methods assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.

Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.

How to Write the Conclusion for NR 503 Week 2: Discussion – Epidemiological Methods              

After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.

How to Format the References List for NR 503 Week 2: Discussion – Epidemiological Methods              

The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.

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Sample Answer for NR 503 Week 2: Discussion – Epidemiological Methods

Gestational Diabetes is tested with the 2-Step process after 24 weeks gestation in the United States.  The first step is the Oral Glucose Tolerance Test and depending on the thresh hold they may have to the second step which is Glucose Challenge test.  GDM is predicted to increase the risk of adverse outcomes including pre-eclampsia, miscarriages, preterm labor, c-section births, and neonatal metabolic complications (Fatima et al., 2018).  This process of testing is not 100% however it is this tool is used because the benefit of it outweighs the risk of not using the testing for pregnant women.

19 Studies where used to conclude the accuracy of GDM testing in Southeast Asia.  The two common standards for these test where the 100g and 75 grams oral glucose test. Sensitivity and specificity of the 50g Glucose Challenge Test followed by the 100g was 79%.  75g OGTT showed similar sensitivity to the 50g GCT/100g OGTT (Lappharat & Liabsuetrakul, 2020).  In another study where 267 patients the GCT truly diagnosed 74 patients as having GDM, and 167 patients were found to have normal glucose metabolism with true negative results.  16 patients had false negatives and 10 patients where diagnosed with false positives.  The PPV was 88% and the accuracy of GCT as a screening test was 90% (Fatima et al., 2018).

Testing for GDM is not 100% and there have been research done such as A1C, which has been found less effective in determining actual cases of GDM.  The 2-step Glucose testing is used in the United States at this time, and may not be 100% accurate as studies above have shown.  The validity and reliability of the test is around 90% and decreases the risk of those who have GDM them and the unborn child.  

References

Benhalima, K., Van Crombrugge, P., Moyson, C., Verhaeghe, J., Vandeginste, S., Verlaenen, H., Vercammen, C., Maes, T., Dufraimont, E., De Block, C., Jacquemyn, Y., Mekahli, F., De Clippel, K., Van Den Bruel, A., Loccufier, A., Laenen, A., Minschart, C., Devlieger, R., & Mathieu, C. (2018). A modified two-step screening strategy for gestational diabetes mellitus based on the 2013 who criteria by combining the glucose challenge test and clinical risk factors. Journal of Clinical Medicine, 7(10), 351. https://doi.org/10.3390/jcm7100351Links to an external site.

Fatima, A., Tanveer, Q., Naz, M., & Niaz, A. (2018). Accuracy of glucose challenge test in screening of gestational diabetes mellitus. JUMDC, 9(3), 31–35.

Lappharat, S., & Liabsuetrakul, T. (2020). Accuracy of screening tests for gestational diabetes mellitus in southeast asia. Medicine, 99(46), e23161. https://doi.org/10.1097/md.0000000000023161Links to an external site.

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Sample Answer 2 for NR 503 Week 2: Discussion – Epidemiological Methods

I also chose Gestational Diabetes Mellitus (GDM) as the topic for my discussion and research this week. Although I have three children and underwent screening for GDM myself I did not fully understand the implications of screening for and subsequently treating its occurrence before this assignment. I narrowed in on the 1-step screening test and found more accurate validity in testing than you did for OGTT as a whole. However, given the multitude of risks for both mother and baby surrounding GDM, I would also utilize the screening tool in future practice, as you also indicated. As iterated by Najmi et al. (2019) the adverse effects as a result of GDM includes hypertension for mom, increased need for c-section, diabetes occurrence for both mom and baby, as well as the need for neonatal ICU care following delivery. Our textbook readings this week presented that diagnostic tools have the intended purpose of reducing and preventing morbidity and mortality (Curly & Cupp, 2016). With that said, these occurrences in relation to GDM need to be closely monitored and treated/addressed in order to ensure optimal outcomes for both mom and baby and this could be achieved through implementation of an accurate and valid GDM screening tool.

Curley, A. L., & Cupp, A. L. (2020). Population-based nursing: concepts and competencies for advanced practice (3^rd ed.). Springer Publishing Company. https://chamberlain.primo.exlibrisgroup.com/permalink/01CUCON_INST/1jsf8v8/alma991000088180406766Links to an external site.

Najmi, A., Atal, S., Sadasivam, B., Singh, P., & Ray, A. (2019). Early onset gestational diabetes mellitus: A case report and importance of early screening. Journal of Family Medicine & Primary Care, (5), 1772-1774. https://chamberlain.primo.exlibrisgroup.com/permalink/01CUCON_INST/f6kb8f/cdi_doaj_primary_oai_doaj_org_article_d71c164af6914ed890138c0a11a4ebc5Links to an external site.

Sample Answer 3 for NR 503 Week 2: Discussion – Epidemiological Methods

This is an outstanding discussion about gestational diabetes mellitus glucose testing. Indeed, you have provided an in-depth analysis and I agree with you. Primarily, this glucose testing is intended to recognize abnormalities in how the body handles glucose after taking a meal. When a patient is tested for gestational diabetes mellitus, the physician considers the outcomes of every blood glucose test. If the blood glucose level is more than 140 mg/dL following the one-hour test, the physician should suggest the three-hour test. If the blood glucose is more than 190 mg/dL following the one-hour test, the patient is diagnosed with gestational diabetes (Kotzaeridi et al., 2021). Alternatively, if one of the outcomes is elevated than normal, the patient should be tested again in four weeks. However, if two or more results indicate an abnormality, the patient is diagnosed with gestational diabetes.

 The other glucose testing is oral glucose tolerance. In this test, the patient is required to drink Glucola, which is a sweetened liquid containing 50g of glucose. The body quickly absorbs the glucose leading to a rise in the blood sugar level. A blood sample is collected from the arm’s vein about an hour after taking the solution. The blood test measures how the metabolism of the solution occurred. During the oral glucose tolerance test, the glucose level in the blood is tested four times after three hours after taking a sweetened drink. If the outcome reveals an abnormality in two out of the four blood tests, the patient is considered to have gestational diabetes (Kotzaeridi et al., 2021). It is important to advise patients to drink and eat normally in the days before the glucose tolerance test. The patient should also be advised to reveal if he or she is on any medication because medications can affect the outcomes of the test.

References

Kotzaeridi, G., Blätter, J., Eppel, D., Rosicky, I., Linder, T., Geissler, F., … & Göbl, C. S. (2021). Characteristics of gestational diabetes subtypes classified by oral glucose tolerance test values. European journal of clinical investigation, 51(9), e13628. https://doi.org/10.1111/eci.13628

Sample Answer 4 for NR 503 Week 2: Discussion – Epidemiological Methods

Gestational Diabetes

Gestational diabetes occurs during pregnancy. It is glucose intolerance that is first noticed during pregnancy. Gestational diabetes increases risk for complications for pregnant woman, their unborn child, and risk for developing type 2 diabetes (Pillay et al., 2021 & Herrick et al., 2019). The US Preventive Services Task Force (USPSTF) recommends gestational diabetes screening in pregnant women who are asymptomatic after 24 weeks of pregnancy (Pillay et al., 2021).

Describe the diagnostic or screening tool selected, its purpose, and what age group it targets and has it been specifically tested in this age group? 

The American Diabetes Association (ADA) offers these two diagnostic tests including one-step test and two-step test to utilize for screening gestational diabetes in pregnant women after 24 weeks of pregnancy (Dugan & Ma-Crawford, 2019). The two-step diagnostic test has been commonly utilized screening method to diagnose gestational diabetes (nih.gov.,2021)

The two-step diagnostic test entails administering orally 50-g glucose loading screen test to a non-fasting pregnant woman then measuring the test in 1 hour. The test cutoff thresholds commonly used includes 130mg/dl or greater (135 or 140mg/dl).  This load test is followed by a 100-g 3-hour glucose tolerance test administered to patients who screen positive with the 50-g load test that is measured at first, second, and third hour to diagnose gestational diabetes (Dugan & Ma-Crawford, 2019).

What are the reliability and validity values? What are the predictive values? Is it sensitive to measure what it has been developed to measure, and would you integrate this tool into your advanced practice based on the information you have read about the test, why or why not?

For the 50-g oral glucose challenge test, using Carpenter and Coustan diagnostic thresholds, at a 140-mg/dL cutoff (Pillay et al., 2021) indicated that the sensitivity and specificity was 81.9 and 81.8 respectively. Using National Diabetes Data Group criteria, (Pillay et al.,2021) went on to say that at 140-mg/dL cutoff there was a sensitivity and specificity of 85% and 81.2% respectively.

Due to the complication risks associated with gestational diabetes, identifying, and managing gestational diabetes timely is vital. The screening tool is important in screening pregnant patients for gestational diabetes. Its sensitivity and specificity values are high enough to trust the tool.

References

Dugan, J. A., & Ma-Crawford, J. (2019). Managing gestational diabetes. JAAPA (Montvale, N.J.), 32(9), 21–25. https://doi.org/10.1097/01.JAA.0000578760.60265.e0

Pillay, J., Donovan, L., Guitard, S., Zakher, B., Gates, M., Gates, A., Vandermeer, B., Bougatsos, C., Chou, R., & Hartling, L. (2021). Screening for Gestational Diabetes: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA: the Journal of the American Medical Association, 326(6), 539–562. https://doi.org/10.1001/jama.2021.10404Links to an external site.

Herrick CJ, Keller MR, Trolard AM, Cooper BP, Olsen MA, Colditz GA. Postpartum diabetes screening among low income women with gestational diabetes in Missouri 2010–2015. BMC Public Health. 2019;19.

Screening and Diagnosis of Gestational Diabetes Mellitushttps://www.ncbi.nlm.nih.gov/pmc/articlesLinks to an external site.

Sample Answer 5 for NR 503 Week 2: Discussion – Epidemiological Methods

As you discuss screening for unhealthy behaviors  this week, I wanted to share with you.

I recently had a conversation with an MD who insists that any use of a substance is a “choice”. I hear this often and it is discouraging for me caring for so many people with addictions over the years, and having a son who was addicted and eventually passed due to an OD. As addiction progresses it no longer is pleasurable and becomes required for daily existence. Many do not understand the pleasure response and brain changes that do occur as a result of the repeated surges of pleasure chemicals from the drug (any substance, gambling, sex, etc) which disrupts normal pathways and creates brain chemistry changes.

Here is an excerpt from an interesting article that really explains what occurs. I encourage you to read the entire article when you have time.

Addiction as a Disease

In recent decades, researchers began to label addiction as a disease rather than a behavioral choice. This decision stems primarily from how addiction affects the brain by changing it, progressively forcing an individual to crave the drug until use eventually becomes an unconscious act rather than a conscious choice.  

When a person begins abusing a substance or regularly uses prescription drugs for too long, their body will begin to adapt itself to account for its presence in order to maintain homeostasis, or balance. Over time, this leads to what is known as tolerance Links to an external site.

Links to an external site.Links to an external site., which is when the body has adjusted itself enough that the individual will need to take more of their chosen drug in order to experience the same effects. This encourages them to further abuse the drug, and as this is happening, the individual’s brain will also be rewiring itself to desire more.  

Eventually this leads to the development of dependence, which means that their body has been altered so much that it loses the ability to function normally without their chosen substance. If use stops, they will experience a series of painful side effects known as withdrawal  Links to an external site. until either their body returns to its normal state without drugs, or when they use again. The first option may take several days or weeks to accomplish, so many people opt for the latter as it is less painful. By choosing this option, the user becomes locked in a progressive cycle of addiction.  

During this point, the part of the brain responsible for deciding to take the drug also shifts from the front of the brain to the back, which is the area in charge of regulating unconscious acts like breathing and blinking, as well as basic desires like hunger. As a result, drug abuse becomes fundamentally linked to their brain and is no longer a free choice.  

https://brookdalerecovery.com/is-addiction-disease-or-choice/ Links to an external site.

NR 503 Week 3 Discussion- Epidemiological Methods and Measurements

• What is the fundamental difference between the method you have chosen (either the case-control or cohort method) and the randomized controlled trial? 

Case control studies compare two separate groups. A control group in which participants are without the disease. The other group in which participants have the disease. Case control studies are observational and retrospective. Participants aren’t assigned randomly which can increase bias. 

Randomized controlled trials participants are randomly assigned to a control or intervention group which decreases bias. Randomized controlled trials can be expensive, laborious, with long durations. (Cupp, 2020). 

1. What are the advantages and disadvantages of the study method you chose (case-control or cohort study)? 

Case control studies don’t require a large sample size, typically have short durations, and are beneficial when conducting research on uncommon medical conditions. In addition, they are more cost-effective in comparison to randomized controlled trials (Cupp, 2020). 

Caturegli et. al (2020) conducted a case control study to assess the clinical validity of SARS-CoV-2 antibodies. It was retrospective, small sample size, and reported sample bias. Utilizing case-control study method was appropriate for this topic as limited information on SARS-CoV-2 antibodies was available when this study was conducted. It was during the height of the pandemic when researchers wanted to have data available as soon as possible. 

1. What are the characteristics of a correlational study? 

Correlation studies are valuable in categorizing event clusters and seasonal trends. A key fact-correlation studies can state a correlation is present, but unable to report an association. This is because the collection of data is aimed at population versus individuals. Data obtained from correlation studies is used to complete additional studies to further investigate a hypothesis (Cupp, 2020). 

1. Where does the method you chose (case-control or cohort study) fall on the research pyramid? What does where it is on the research pyramid mean? 

Case control studies are near the bottom of the research pyramid. The top of the pyramid is rated as high evidence quality, and as you go down the pyramid the evidence quality diminishes. Subsequently, the quality of evidence for case control studies are inferior to systematic reviews which are at the top of the pyramid 

References 

Caturegli, Materi, J., Howard, B. M., & Caturegli, P. (2020). Clinical Validity of Serum Antibodies to SARS-CoV-2 : A Case-Control Study. Annals of Internal Medicine, 173(8), 614–622. https://doi.org/10.7326/M20-2889 

Cupp, A.L. (2020). Population-based nursing: Concepts and competencies for advanced practice. (3rd ed.). Springer Publishing Company.