- QUESTION
Evidence-Based Project, Part 4: Critical Appraisal of Research
Assignment: Evidence-Based Project, Part 4: Critical Appraisal of Research
Realtors rely on detailed property appraisals—conducted using appraisal tools—to assign market values to houses and other properties. These values are then presented to buyers and sellers to set prices and initiate offers.
Research appraisal is not that different. The critical appraisal process utilizes formal appraisal tools to assess the results of research to determine value to the context at hand. Evidence-based practitioners often present these findings to make the case for specific courses of action.
In this Assignment, you will use an appraisal tool to conduct a critical appraisal of published research. You will then present the results of your efforts.
To Prepare:
Reflect on the four peer-reviewed articles you selected in Module 2 and the four systematic reviews (or other filtered high- level evidence) you selected in Module 3.
Reflect on the four peer-reviewed articles you selected in Module 2 and analyzed in Module 3.
Review and download the Critical Appraisal Tool Worksheet Template provided in the Resources.
The Assignment (Evidence-Based Project)
Part 4A: Critical Appraisal of Research
Conduct a critical appraisal of the four peer-reviewed articles you selected by completing the Evaluation Table within the Critical Appraisal Tool Worksheet Template. Choose a total of four peer- reviewed articles that you selected related to your clinical topic of interest in Module 2 and Module 3.
Note: You can choose any combination of articles from Modules 2 and 3 for your Critical Appraisal. For example, you may choose two unfiltered research articles from Module 2 and two filtered research articles (systematic reviews) from Module 3 or one article from Module 2 and three articles from Module 3. You can choose any combination of articles from the prior Module Assignments as long as both modules and types of studies are represented.
Part 4B: Critical Appraisal of Research
Based on your appraisal, in a 1-2-page critical appraisal, suggest a best practice that emerges from the research you reviewed. Briefly explain the best practice, justifying your proposal with APA citations of the research.Evaluation Table
Use this document to complete the evaluation table requirement of the Module 4 Assessment, Evidence-Based Project, Part 4A: Critical Appraisal of Research
Full APA formatted citation of selected article. Article #1 Article #2 Article #3 Article #4 Evidence Level *
(I, II, or III)
Conceptual Framework
Describe the theoretical basis for the study (If there is not one mentioned in the article, say that here).**
Design/Method
Describe the design and how the study was carried out (In detail, including inclusion/exclusion criteria).
Sample/Setting
The number and characteristics of
patients, attrition rate, etc.
Major Variables Studied
List and define dependent and independent variables
Measurement
Identify primary statistics used to answer clinical questions (You need to list the actual tests done).
Data Analysis Statistical or
Qualitative findings
(You need to enter the actual numbers determined by the statistical tests or qualitative data).
Findings and Recommendations
General findings and recommendations of the research
Appraisal and Study Quality
Describe the general worth of this research to practice.
What are the strengths and limitations of study?
What are the risks associated with implementation of the suggested practices or processes detailed in the research?
What is the feasibility of use in your practice?
Key findings
Outcomes
General Notes/Comments - Level I
Experimental, randomized controlled trial (RCT), systematic review RTCs with or without meta-analysis
- Level II
Quasi-experimental studies, systematic review of a combination of RCTs and quasi-experimental studies, or quasi-experimental studies only, with or without meta-analysis
- Level III
Nonexperimental, systematic review of RCTs, quasi-experimental with/without meta-analysis, qualitative, qualitative systematic review with/without meta-synthesis
- Level IV
Respected authorities’ opinions, nationally recognized expert committee/consensus panel reports based on scientific evidence
- Level V
Literature reviews, quality improvement, program evaluation, financial evaluation, case reports, nationally recognized expert(s) opinion based on experiential evidence
**Note on Conceptual Framework
- The following information is from Walden academic guides which helps explain conceptual frameworks and the reasons they are used in research. Here is the link https://academicguides.waldenu.edu/library/conceptualframework
- Researchers create theoretical and conceptual frameworks that include a philosophical and methodological model to help design their work. A formal theory provides context for the outcome of the events conducted in the research. The data collection and analysis are also based on the theoretical and conceptual framework.
- As stated by Grant and Osanloo (2014), “Without a theoretical framework, the structure and vision for a study is unclear, much like a house that cannot be constructed without a blueprint. By contrast, a research plan that contains a theoretical framework allows the dissertation study to be strong and structured with an organized flow from one chapter to the next.”
- Theoretical and conceptual frameworks provide evidence of academic standards and procedure. They also offer an explanation of why the study is pertinent and how the researcher expects to fill the gap in the literature.
- Literature does not always clearly delineate between a theoretical or conceptual framework. With that being said, there are slight differences between the two.
References
The Johns Hopkins Hospital/Johns Hopkins University (n.d.). Johns Hopkins nursing dvidence-based practice: appendix C: evidence level and quality guide. Retrieved October 23, 2019 from https://www.hopkinsmedicine.org/evidence-based-practice/_docs/appendix_c_evidence_level_quality_guide.pdf
Grant, C., & Osanloo, A. (2014). Understanding, Selecting, and Integrating a Theoretical Framework in Dissertation Research: Creating the Blueprint for Your" House". Administrative Issues Journal: Education, Practice, and Research, 4(2), 12-26.
Walden University Academic Guides (n.d.). Conceptual & theoretical frameworks overview. Retrieved October 23, 2019 from https://academicguides.waldenu.edu/library/conceptualframework
Racial/ethnic
discrimination in
Healthcare Settings.
Why racial discrimination?
Racial discrimination in healthcare system refers to the
unequal and unfair administration of healthcare services
on the basis of race and ethnicity.
Racial discrimination has for a long time been a major
issue facing the healthcare system in the states.
Research and records show that minority communities
consisting of Black-Americans and the Hispanic
community have a challenge of accessing quality
healthcare. This happens in form of financial ways and at
personal levels with the healthcare providers.
It is open knowledge that healthcare practitioners from
minority groups seldom serve in top managerial positions.
Keywords used.
The search terms/keywords used consisted of a
combination of the following words;
Racism
Ethnicity
Perceived discrimination
Healthcare
Bias
Racial discrimination
Quality of care
Health inequalities.
Databases that were used
PsycNet; the American Psychology Association provides artcles
and information on psychology literature.
PubMed; this site is an archive of life sciences and biomedical
journals and literature.
Scopus; scopus has a wide base of peer reviewed articles.
EMBASE; this is a large pharmaceutical and biomedical database
CINAHL; Cumulative Index of Nursing and Allied Health literature
MEDLINE; (Medical Literature Analysis) it is a bibliographic
database of biomedical information and life sciences.
EBSCO; this database provides top nursing journals and
healthcare resources.
References
Shavers, V. L., Fagan, P., Jones, D., Klein, W. M., Boyington, J., Moten, C., &
Rorie, E. (2012). The state of research on racial/ethnic discrimination in the
receipt of health care. American journal of public health, 102(5), 953-966.
Benjamins, M. R., & Middleton, M. (2019). Perceived discrimination in medical
settings and perceived quality of care: A population-based study in Chicago.
PLOS ONE, 14(4), e0215976. https://doi.org/10.1371/journal.pone.0215976
Armstrong, K., Putt, M., Halbert, C. H., Grande, D., Schwartz, J. S., Liao, K. ... &
Shea, J. A. (2013). Prior experiences of racial discrimination and racial
differences in health care system distrust. Medical Care, 51(2), 144.
Hausmann, L. R., Kressin, N. R., Hanusa, B. H., & Ibrahim, S. A. (2010). Perceived
racial discrimination in health care and its association with patients' healthcare
experiences: does the measure matter?. Ethnicity & disease, 20(1), 40.
| Subject | Nursing | Pages | 9 | Style | APA |
|---|
Answer
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Is the food consumption in American society an example of social and economic inequity?
Introduction
Recent studies have outlined strong positive correlations between food consumption and social and economic status. Indeed, extant reviews by Kaya (2016) and Dong et al. (2020) among others have established connections between socioeconomic status indicators (SES) and nutritional health of populations in the Americas, New Zealand, and other parts of the world. Specifically, these studies have and others have established negative impacts of inadequate food supplies on poverty stricken members of society, further entrenching social and economic inequity (Metcalf, Scragg, and Jackson 2014). The aim of this paper is to establish whether food consumption in American society is an example of social and economic inequity by focusing on relationships between income, education, and hedonic eating patterns on inequity. Subsequent discourse affirms the role of food consumption as an exemplifier of inequity and recommends concerted action to increase access to quality food as a way of preventing escalation of inequity.
Evidence from Income Disparities
In recent times, income has emerged as a key mediating variable in the exploration of food consumption as an example of socioeconomic inequity. Quantitative data by Metcalf, Scragg and Jackson (2014) have provided useful insight into the moderating roles of food consumption on income induced disparities. Available data shows that individuals in the 30k - $50k bracket tend to favor high calorie carbohydrates and starch in contrast to their counterparts in the ≥$70k income bracket. However, the investigations showed no significant disparities after other SES indicators were considered. Yet, the same findings also reveal a startling proclivity for high cholesterol consumption among individuals in the $30k to $50k. Alcohol consumption was reportedly lower among the <$30k earners (Metcalf, Scragg and Jackson 2014).
Similar patterns of inequality have been inferred from study of nutrients “expressed as their contribution to total energy intake” by families in various income strata (Metcalf, Scragg and Jackson 2014. For instance, alcohol use was observed to be considerably lower among the under $30k income groups as high income earners exhibited high levels of alcohol consumption.. Similarly, less than typical calcium consumption was reported among workers earning a monthly salary of <$30k (Metcalf, Scragg and Jackson 2014). The same low income cohort had greater consumption of starch as well as greater carbohydrate ingestion interspersed with comparatively lower consumption of fiber. There were also markedly fewer regular users of calcium in the $50k - $70k categories. On the whole, the least earners were associated with lower fiber and calcium consumption in contrast to higher income earners. Further analysis of geometric mean data on “food group servings” ordered according to net average incomes corrected for “age, gender, ethnicity and total energy intakes” seem to reinforce the preceding findings. In comparison to the higher earning cohort, the materially deprived members of American society registered fewer servings of “vegetables, fruit, cheese, milk and spirits” (Metcalf, Scragg and Jackson 2014). The high consumption of wine by income groups also served as a reminder of food accentuated inequities across America. Yet, it is instructive to note that the considerably lower vegetable intake among workers in the $40k - $50k income category still remains inconsequential upon consideration of all other factors in the SES considerations. The findings show that “milk, cheese, cereal, wine, beer and spirit” consumption among members of the lower income groups (Metcalf, Scragg and Jackson 2014.
Evidence from Variations in Educational Attainment
While conceding to the dearth of research data linking education and nutritional consumptions, on one hand, and socioeconomic equity on the other, it is noteworthy that several studies have specifically showed peculiar eating patterns among different demographic segments in America. For instance, studies have highlighted low fiber and calcium consumption in people without post-secondary education in comparison to individuals with tertiary education (Metcalf, Scragg and Jackson 2014). However, the study failed to establish connections with the ratio of “contribution of nutrients to total energy intakes” It should be noted, however, that lower intakes of “vegetables, cheese, milk, and wine”, and higher consumptions of “eggs, bread, cereal and beer” still remained higher among the college educated individuals in relation to the populations under review.
Similarly, a cross-sectional a study by Dong et al (2020) seems to delineate unique nutritional needs to teenagers and young adults. In fact, numerous data on human growth and development associate the two stages as critical, and desperately in need for support to engender impressive growth. That being the case, it is sensible to conclude that continued growth of children and adolescents will naturally require the right quality and quantity of nutrients. Correspondingly, should nutritional supply from foods be limited, it may be important to provide additional nutritional supplements for the affected individuals to safeguard critical growth stages. Suitable supply of food could support “adolescent growth and development”, cognitive capabilities, brain growth, and development, and psychosocial development. It is possible that children and adolescents from economically disadvantaged and materially deprived socioeconomic backgrounds will endure poor nutrition, in addition to other foods common to low income earners. The same are seldom balanced, and are generally in low supply as richer members enjoy expensive and more nutritionally balanced foods. The research findings have a caveat to them: the data is moderately old with certain limitations. However, the results have been passed as reliable and consistent.
Evidence from Hedonic factors
This is illustrated by the fact that many people will pay an equivalent price for
artificially sweetened versions of liked foods or drinks. Operant studies show a powerful
reinforcement effect of non-nutritive sweeteners,
17
which can exceed that of cocaine,
18
demonstrating that caloric consequences are not necessary for sweet taste to maintain
food-seeking behavior. Since the spending on artificially sweetened products like diet
soda is not offset by compensatory increased spending on calories in ordinary foods,
19
a
behavioral economic perspective suggests that people, at least “health conscious” ones,
are often willing to pay a caloric cost to obtain sweetness per se.
The importance of sensory pleasure is further illustrated by consequences of
removing it. Nutrients infused intravenously or via nasogastric tube (therefore not tasted,
chewed, or swallowed) are generally less satisfying. In studies of healthy volunteers,
tube-fed participants still consume near-normal meals when permitted to do so.
20
In long-
term clinical cases, tube-fed individuals become preoccupied by food cravings.
21
Healthy
volunteers who consumed nothing for several days except a sweet, nutritionally complete
drink experienced cravings caused by lack of sensory variety.
22
During a chocolate
craving, it is only the tasting, smelling, and eating of chocolate, rather than its post-
ingestive effects, that satisfy the craving.
23
Thus, not only will people pay a significant
cost to obtain taste pleasure, but nutritional repletion without oral stimulation is
unsatisfying, and sensory deprivation can powerfully stimulate interest in food and evoke
mental imagery of food’s desirable sensory characteristics.
This is illustrated by the fact that many people will pay an equivalent price for
artificially sweetened versions of liked foods or drinks. Operant studies show a powerful
reinforcement effect of non-nutritive sweeteners,
17
which can exceed that of cocaine,
18
demonstrating that caloric consequences are not necessary for sweet taste to maintain
food-seeking behavior. Since the spending on artificially sweetened products like diet
soda is not offset by compensatory increased spending on calories in ordinary foods,
19
a
behavioral economic perspective suggests that people, at least “health conscious” ones,
are often willing to pay a caloric cost to obtain sweetness per se.
The importance of sensory pleasure is further illustrated by consequences of
removing it. Nutrients infused intravenously or via nasogastric tube (therefore not tasted,
chewed, or swallowed) are generally less satisfying. In studies of healthy volunteers,
tube-fed participants still consume near-normal meals when permitted to do so.
20
In long-
term clinical cases, tube-fed individuals become preoccupied by food cravings.
21
Healthy
volunteers who consumed nothing for several days except a sweet, nutritionally complete
drink experienced cravings caused by lack of sensory variety.
22
During a chocolate
craving, it is only the tasting, smelling, and eating of chocolate, rather than its post-
ingestive effects, that satisfy the craving.
23
Thus, not only will people pay a significant
cost to obtain taste pleasure, but nutritional repletion without oral stimulation is
unsatisfying, and sensory deprivation can powerfully stimulate interest in food and evoke
mental imagery of food’s desirable sensory characteristics.
Choice and intake are intrinsically bound up with hedonic evaluation of food’s sensory
attributes—the pleasures of tasting, smelling, and feeling food as it is consumed.
Understanding hedonic influences becomes especially important now that technologized
food production brings an increasing variety and ease of access to foods that are
specifically designed with sensory appeal in mind. It will always be difficult to elucidate
a causal role of palatability per se in eating patterns, since palatability is neither a
physical property of a food nor a fixed response tendency of the individual, but rather an
interaction between the food, the external context, and internal signals for current
physiological state.
14,15,16
Nonetheless, virtually all acts of eating generate some degree of
sensory pleasure.
This is illustrated by the fact that many people will pay an equivalent price for
artificially sweetened versions of liked foods or drinks. Operant studies show a powerful
reinforcement effect of non-nutritive sweeteners,
17
which can exceed that of cocaine,
18
demonstrating that caloric consequences are not necessary for sweet taste to maintain
food-seeking behavior. Since the spending on artificially sweetened products like diet
soda is not offset by compensatory increased spending on calories in ordinary foods,
19
a
behavioral economic perspective suggests that people, at least “health conscious” ones,
are often willing to pay a caloric cost to obtain sweetness per se.
The importance of sensory pleasure is further illustrated by consequences of
removing it. Nutrients infused intravenously or via nasogastric tube (therefore not tasted,
chewed, or swallowed) are generally less satisfying. In studies of healthy volunteers,
tube-fed participants still consume near-normal meals when permitted to do so.
20
In long-
term clinical cases, tube-fed individuals become preoccupied by
Choice and intake are intrinsically bound up with hedonic evaluation of food’s sensory
attributes—the pleasures of tasting, smelling, and feeling food as it is consumed.
Understanding hedonic influences becomes especially important now that technologized
food production brings an increasing variety and ease of access to foods that are
specifically designed with sensory appeal in mind. It will always be difficult to elucidate
a causal role of palatability per se in eating patterns, since palatability is neither a
physical property of a foo
New cross-sequential data from a study by Myers (2016) have been idealized for outlining the impact of Hedonic factors on choice of food, and by extension, the social and economic realignments in America. The findings appear to prove the existence of hedonic evaluations in the minds of individuals ultimately swaying their decisions on which food is appropriate for them. Still on the choice of food, hedonic considerations tend to view eating as a pleasurable undertaking, and the food so desired should yield the greatest corporeal benefits (Myers 2016). Similar studies have shown that hedonic factors not only provide an inclusion principle as far as certain foods are concerned, but they also control the reflexive actions responsible for influencing the substitution concerned nutritional and concomitant behavior. Myers (2016) has illuminated the “significance of hedonics in the psychology of twenty-first century eating” by proving that decisions to eat or not to eat are embedded in hedonic assessments which seem to control the richer members of American society (Myers 2016). In this way, hedonic patterns will mostly be exercisable by the aristocratic elite whose vast resources accord them the luxury and pleasures of expending their sensory powers to the preferences of “tasting, smelling, and feeling food as it is consumed” (Myers 2016). For members in the upper echelons of the social order, a clear grasp of hedonic factors is important particularly with the emergence of new technological innovations which have automated food production and processing to the extent that there are countless food varieties to choose from at any given time.as pointed out, each of the novel food varieties come with unique and delightful allures which the rich can readily access. In light of the above, it is plausible to acknowledge the impossibilities surrounding attempts to establish causality of palatability in nutritional decision making. The preceding challenge has been compounded by the fact that “palatability” as a concept does not refer to “physical characteristics” of food nor does it imply a need for a predetermined response inclination of the individual respondents, but rather an “interaction between the food, the external context, and internal signals for current physiological state” (Myers 2016). Even so, there is no denying the fact that almost every interaction with food is bound to elicit varying degrees of sensory pleasure.
This fact has been amply demonstrated the glaring human inclination to appropriate sufficient amounts of resources as “equivalent price” for industrially flavored brands of popular foods and drinks. In fact, numerous studies have revealed a potent knock on effect of nutritionally bereft flavors with calorific values exceeding cocaine. From the food manufacturer’s perspective, these findings have gone a step further to validate the established view that calorific concerns should not be regarded as consequential in sustenance of food-seeking behavior. Also, considering the fact that expenditure on “artificially sweetened products” such as diet soda is not counterbalanced by corresponding increase in calories in ordinary foods, a social economic viewpoint submits that consumers in general, and “health conscious” ones in particular, are generally keen to meet caloric costs associated with sweetness. Remarkably, the significance of corporeal inclination is further demonstrated by potential demerits of abolishing it. Perhaps, this explains why intravenous and nasogastric tube will almost always be less stimulating and satisfying.
Conclusion
From the foregoing discussion, it is apparent that food consumption, through 3 mediating variables, namely income disparity, education level, and hedonic factors is pivotal as a lasting example of social and economic inequity. Income disparities have been found to influence the way different classes coalesce around meal times, and the foods they eat. Similarly, level of educational attainment continue to divide society as less educated folk prefer high calorie carbohydrates compared to their more erudite counterparts. Correspondingly, hedonic factors have given rise to various tastes and preferences among various classes. As a result, it has been observed that the wealthy tend to go for expensive wine, an effective delimiter from their poorer counterparts who pursue cheap liquor. To reduce inequity, perhaps it would be better for interventions are initiated from the food distribution and access
More people of color reported perceived discrimination on all measures.
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References
Myers, Kevin P. “Why Do We Eat What We Eat?” Hedonic Eating: How the Pleasure of Food Affects Our Brains and Behavior, by Nicole M. Avena, Oxford University Press, 2015, pp. 9–38.
Kaya, Iraz Haspolat. "Motivation factors of consumers’ food choice." Food and Nutrition Sciences 7.3 (2016): 149-154.
Dong, Bowei, et al. "Nutritional Status of Students in Poverty-Stricken Areas." Open Journal of Epidemiology 10.2 (2020): 91-99.
Metcalf, Patricia A., Robert RK Scragg, and Rod T. Jackson. "Dietary intakes by different markers of socioeconomic status: A cross-sectional study." Health 2014 (2014).