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Discussion 1: Epidemiology in the News: Randomized Trials

NURS 8310 Discussion 1: Epidemiology in the News: Randomized Trials

Discussion 1: Epidemiology in the News: Randomized Trials

Throughout the course of this discussion board a summarization of a research study addressing the purpose, study population, length of the trial, data collection methods, outcome measures, results and conclusion, and ethical issues associated with the study. In this posting, a link to the article selected will be provided.  Last, the identification and a discussion of the ethical issues associated with this study.

Cognizant of  the role that training plays when it comes to improving a nurse’s competencies in EBP and thus empowering them to contribute to the development of EBP, here are certain strategies that can be undertaken from both an organizational level, to the larger professional level. At the organizational level, the organization can organize for opportunities where their nurses can get trained on evidence based practice. On the greater professional levels, professional bodies such as the ANA and the ANCC have developed certification program for nurses. By including components of evidence based practice  in the certification exams, this ensures that nurses will prepare and apprise themselves on EBP and thus, in order to earn the certification, they will have to be competent in EBP. Alternatively, the institutions can include a whole different certification for EBP, where nurses will specifically be trained on EBP, tested on the same and thus, their competency will be proven by their certification. This will ultimately improve their ability to participate in the development and implementation of EBP.

A research design article that has been selected for the purpose of this discussion board post is “Omicron Hospitalization Risk 80 Percent Less Than Delta—South Africa Study” written by Jack Dutton which was featured in Newsweek magazine.  The purpose of the study was to discuss the severity of the exposure of the Omicron variant within the South African community.  The population of the study was of the thousands of exposed South African people both vaccinated and unvaccinated as well as the severity of their symptoms with the Omicron variant versus the Delta variant. The length of the trial consisted with a start date in November 2021 to the present.  The data collection methods that had been used was with those who had tested positive with PCR tests as well as with antibody surveys.  These outcome measures revealed that, according to antibody surveys, between 60 and 70 percent of people in the African country may have been infected by COVID previously (Dutton, 2021).  The outcome measures were also not reliable.  But the authors recognized several limitations to the study, including the number of Omicron infections being underestimated and biased towards geographic regions where the type of PCR test they used to detect the new variant was more commonly used (Dutton, 2021).  In the end the results were not reliable in the end with conflicting data.  Our finding of no difference in severity in SGTF [Omicron] compared to non-SGTF infected individuals in the same time period, and the lower risk of severity in SGTF compared to earlier Delta infected individuals, suggests that this reduced severity may be in part a result of high levels of population immunity (due to natural infection and/or vaccination),” the paper said (Dutton, 2021).  In the conclusion of the article the study had seen an increase in Omicron cases within the South African population.  The study did reveal that those who were affected had a prior infection and had presented with less severe symptoms compared to those symptoms with the Delta variant.  Per the study the current variant has now peaked and the cases of infection as well as death toll have started to decrease.  Ethical issues with the article include multiple issues.  The most significant concern is the data is not backed up or sited with contributing sources.  The article is always opinion based mainly versus scientific based as the majority.  There are again, many examples of studies that were done where the investigators influenced the outcome of the study by either conscious, or sometimes unconscious selection of controls in cases (Laureate Education (Producer), 2012).  In these cases of the study, the author needs to be able to verify their facts with the appropriate data.  The study would have benefitted from a cross-sectional study that was able to have comparative data to be able to have more validity with their results.

The following link is the direct link to be able to read and analyze the study in Newsweek magazine.

Omicron Hospitalization Risk 80 Percent Less Than Delta—South Africa Study (newsweek.com)

References

Dutton, J. (2021, December 22). Omicron Hospitalization Risk 80 Percent Less Than Delta—South Africa Study. Newsweek. Retrieved from https://www.newsweek.com/omicron-hospitalization-risk-80-percent-less-delta-south-africa-study-1662181

Laureate Education (Producer). (2012). Epidemiology and population health: Experimental studies [Video file]. Baltimore, MD: Author.

Click here to ORDER an A++ paper from our MASTERS and DOCTORATE WRITERS: Discussion 1: Epidemiology in the News: Randomized Trials

Week 4 Forum 1: Analytic Epidemiology Designs: Experimental

     The experimental design derives knowledge about the causes of disease by exercising control over who will receive the exposure

Discussion 1 Epidemiology in the News Randomized Trials
Discussion 1 Epidemiology in the News Randomized Trials

and the level of the contact; the investigator is more confident in the cause and effect association than in observational design (Friis &

Sellers, 2020). An online news article in U.S. News (https://www.usnews.com/news/health-news/articles/2021-07-23/drug-shows-

promise-in-easing-dementia-linked-psychosis) reported on clinical trial drugs to help with dementia psychosis.

Purpose

     The United States had approved the medication Nuplazid (pimavanserin) to treat hallucinations and delusions associated with

Parkinson’s (Norton, 2021). The purpose of the research study was to find out if the medication could help with hallucinations related

to dementia.

Study Population

            800 patients with dementia suffering from delusions and hallucinations

Length of the trial

            The trial was supposed to last for 26 weeks. After 18 weeks, a clear difference emerged ((Norton, 2021, para. 23).

Data collection

     Data collection was in different stages: the initial phase, after five weeks, at 12 weeks, and the final trial phase for patients who

responded to the medication. Those patients who responded were randomly split into two groups, one receiving the drug and one

receiving a placebo.

Outcome measures

     The outcome measures were to decrease the psychiatric and behavioral symptoms such as agitation, aggression, delusion, and

hallucinations are the most difficult for patients and caregivers (Norton, 2021).

Results and Conclusions

     After five weeks, 351 of the patients without medication still had symptoms. They all were given Nuplazid for 12 weeks. 62%

responded well to the medication invention. Once the patients were in two groups, 28% of the randomly assigned placebo patients

still suffered from delusion or hallucination compared to 13% on Nuplazid after 18 weeks (Norton, 2011).

Ethical Issues Associated with the Study

     Ethics is a system of moral principles dealing with values relating to human conduct concerning the rightness and wrongness of

motives and the results of such activities (Dictionary.com, 2021). An example of an ethical violation is the Tuskegee Study. In the

Tuskegee Study, 600 African American men never gave informed consent to participate, were misled about the project’s purpose, and

were never offered an effective treatment once it was available (Friis & Sellers, 2020).

     The study did not mention the placebo group receiving Nuplazid after psychosis decreased in patients receiving the drug. This

action could be unethical considering the heavy caregiver burden and safety risk psychosis can cause. Research has shown that family

caregivers of people with dementia are at greater risk for anxiety, depression, and poorer quality of life than caregivers of people with

other conditions (Centers for Disease Control and Prevention [CDC], n.d.). False beliefs, frightening or dangerous behaviors, and

auditory hallucinations (Norton, 2021) that dementia patients may experience could put them and their caregiver at a safety risk.

Discovery of Research Study by using Randomized Design

     The most significant discovery is the high regard randomized study designs received in epidemiology studies. According to Dr. Hull

(Laureate Education, 2021), randomized designs are considered the gold standard because of the minimizing bias of random picking

versus consciously picking. The study has more validity.

References

Centers for Disease Control and Prevention. (n.d.). Alzheimer’s Disease and Healthy Aging. CDC.gov. https://www.cdc.gov/aging/caregiving/alzheimer.htm

Dictionary.com. (2021). Ethics. In. Random House. https://www.dictionary.com/browse/ethics

Friis, R. H., & Sellers, T. (2020). Epidemiology for public health practice (6th ed.). Jones & Bartlett Learning. https://online.vitalsource.com/reader/books/9781284221718/epubcfi/6/98[%3Bvnd.vst.idref%3Dxhtml_13_chapter05_06]!/4/2[ch5-6]/12/6/1:460[s%20m%2Cay%20]

Laureate Education (Producer). (2021). Epidemiology and population health: Experimental studies [Video file]. Baltimore, MD: Author.

Norton, A. (2021, July 23). Drug shows promise in easing dementia-linked psychosis. U.S.News. www.usnews.com/new/health-news/article/2021-07-23/drug-shows-promise-in-easing-dementia-linked-psychosis