Plase write discussion response to #1 and 2. Then for #3, this was a work you wrote in the discussion questions and the teacher’s response wasi poed in #3 and also I posted what you wrote, so please review and rewrite also on #3

1) According to the Center of Disease Control (CDC) the percent of children that are obese has tripled since the nineteen seventies. Today, about one in five school children have a BMI that is in ninety-fifth percentile, meaning that they are obese. Childhood obesity has been shown to have long term effects on children. According to the CDC (2017) childhood obesity can lead to high blood pressure, diabetes, depression, low self-esteem, sleep apnea, and joint problems. The children have increased risks for chronic health conditions, are bullied more than their normal weight peers, and are faced with the possibility of being obese as adults. This high rate of obesity has increased the risk for other health problems, causing a significant increase to national health care costs. Sometimes it can be difficult for parents to make healthy food choices for their children and get them to get enough physical activity when they have full time jobs or are too busy. As nurses we need to educate the parents on the consequences that childhood obesity.

Problem Statement- Can parents and children benefit from nurse-led education and interventions aimed towards the prevention of obesity in school aged children.

Research Question- Can childhood obesity be decreased by providing nurse-led educational programs to parents of school aged children that live in the urban areas in Houston, TX?

Sampling

The sample will be selected from school aged students and their parents that live in urban areas in Houston. We will select about 30 obese students and their parents to sample. Convenience sampling would be used for this research question. (Gray, 102016, p. 336). This sample reflects the population because the sample is selected in a school and subjects can be selected. The sample size of 30 is appropriate because enough evidence can be provided with a sample this size. A power analysis reported in the study identified 30 participants per group as adequate to determine significant differences between the intervention and control groups (Gray, 102016, p. 343). The findings are generalized to school aged children and their parents that live in urban areas in Houston, TX. The limitations in the generalizability are that results will only show the result for children that live in urban areas, not all areas of Houston.

Research design

In the case of outcome the research sample is an accessible population, small or large. Its research methodology is overwhelmingly quantitative, and its designs include a variety of established strategies that establish prevalence, investigate correlates of various outcomes, and occasionally test strategies to change outcomes (Gray, 102016, p. 284). The type of design that will be used is outcome research. This research will be a specific population with a specific health problem and an intervention will be done to measure the outcome. The outcome in this sample study would be decreasing childhood obesity in urban areas, by providing children and parents with educational programs and resources. This design seems to flow well with the proposed research problem, theoretical framework, literature review and hypothesis.

Resources

The Center for Disease Control and Prevention (2017). Childhood obesity causes & consequences. Retrieved from: https://www.cdc.gov/obesity/childhood/causes.html.

Gray, J. R., PhD, RN, FAAN, Grove, S. K., PhD, RN, ANP-BC, Sutherland, G. S., PhD. (102016). Burns & Grove’s the Practice of Nursing Research: Appraisal, Synthesis, and Generation of Evidence, 8th Edition [VitalSource Bookshelf version]. Retrieved from https://bookshelf.vitalsource.com/books/9780323377…

2)

Problem Statement:“Given the potential of prescription drug monitoring programs (PDMPs) to reduce doctor shopping, misuse, abuse diversion of prescription medication, and ultimately overdose, optimizing their use is important” (Irvine et al., 2014, para. 2). PDMPs are designed to help providers make informed clinical decisions when prescribing controlled substances; however, provider and acceptance and utilization of these systems are essential in maximizing their effectiveness (Carnes, Wright, & Norwood, 2017). The purpose of this research proposal is to examine ER physician and mid-level provider utilization of PDMPs and its correlation to the number of controlled substances prescribed. The ultimate outcome is to demonstrate that utilization of PDMPs by ER providers helps to decrease the dispensing of unwarranted controlled substance prescriptions. “A better understanding of effective PDMP use will facilitate access to treatment for patients with pain while curbing the prescription drug epidemic and may ultimately reduce abuse, misuse, and overdose death” (Irvine et al., 2014, p. 747).

Research Question:

Does mandatory utilization of PDMPs by ER providers decrease the number of dispensed controlled substance prescriptions?

Sampling:

Beginning July 1, 2018 the State of Georgia will require all prescribers of benzodiazepines and specified controlled II opiate drugs or cocaine derivatives to be registered to Georgia’s PDMP and will also require providers to check the PDMP before prescribing drugs from these groups (“PDMP Georgia,” 2017). Data will be taken retrospectively from July 1, 2017-July 1, 2018 and prospectively from July 1, 2018-July 1, 2019. The data from both time frames will be tabulated and then compared. The above information will be the basis and frame for sampling and research design.

The study will be conducted using a non-probable convenience sampling method. “Convenience sampling is a type of non-probability or nonrandom sampling where members of the target population that meet certain practical criteria, such as easy accessibility, geographical proximity, availability at a given time, or the willingness to participate are included for the purpose of the study” (Etikan, Musa, & Alkassim, 2016, para. 2). For this study, convenience sampling is appropriate due to the assumption that the members of the target population are homogenous and that no differences in research results would be seen from other methods such as random sampling (Etikan et al., 2016).

Sampling will take place in a large metropolitan hospital ER. Sample subjects will include all doctors and mid-level providers working full-time in the ER that dispense prescriptions for controlled substances. Grady Memorial in Atlanta, GA, which saw approximately 158,761 patients in the ER in 2016, would be an appropriate site for sampling due to its high volume (Grady Memorial Hospital, 2017). Wong et al. (2015) proposes that showcasing big data research in the ER is a cost-effective approach that can produce high-quality research at a faster pace.

Controlled substance prescriptions will be defined by the most common types as referenced by the CDC: oxycodone, hydrocodone, morphine, and methadone (“CDC,” 2017). These drugs have been selected due to studies that have shown that “…emergency departments are frequently targeted by opioid abusers as a source for opioids, and as many as 88% of emergency physicians report having treated an individual at least once a week who was doctor shopping or displayed signs of aberrant behavior” (Young et al., 2017. para. 7).

Only patients presenting with a complaint of pain that are given a prescription for the above mentioned drugs will be included in the patient population. Exclusionary criteria include type/scoring of pain and specification of disease or diagnosis. The Substance Abuse and Mental Health Services Administration (2017) reports that approximately 15 million people aged 12 or older have used prescription drugs non-medically in the past year. From the statistics found in this report, the group of patients that are to be included in the sampling will be ages 12 and up.

The research proposal may be generalized to those presenting to ERs with complaints of pain. Some of the limitations to this generalization include study design, non-specificity of pain and disease/diagnosis, representation of other hospitals or areas of the country, provider training, provider bias and patient population.

References

Carnes, N., Wright, E., & Norwood, C. (2017). A qualitative analysis of prescribers’ and dispensers’ views on improving prescription drug monitoring programs. Research in Social and Administrative Pharmacy, 13(6), 1167-1174. http://dx.doi.org/10.1016/j.sapharm.2016.12.002

Etikan, I., Musa, S., & Alkassim, S. (2016). Comparison of Convenience Sampling and Purposive Sampling. American Journal of Theoretical and Applied Statistics, 5(1), 1-4. http://dx.doi.org/10.11648/j.ajtas.20160501.11

Grady Memorial Hospital. (2017). Grady Fast Facts. Retrieved from https://www.gradyhealth.org/pdf/Grady_Fast_Facts.pdf

Irvine, J., Halvik, S., Hildebran, C., Marino, M., Beran, T., & Deyo, R. (2014). Who uses a prescription drug monitoring program and how? Insights from a statewide survey of Oregon clinicians. The Journal of Pain, 15(7), 747-755. http://dx.doi.org/10.1016/j.jpain.2014.04.003

Prescription Drug Monitoring Program. (2017). Retrieved from https://dph.georgia.gov/pdmp

What States Need to Know about PDMPs. (2017). Retrieved from https://www.cdc.gov/drugoverdose/pdmp/states.html

Wong, H., Yin, Q., Guo, Y., Murray, K., Zhou, D., & Slade, D. (2015). Big data as a new approach in emergency medicine research. Journal of Acute Disease, 4(3), 178-179. http://dx.doi.org/https://doi.org/10.1016/j.joad.2015.04.003

Young, H., Tyndall, J., & Cottler, L. (2017, April 18). The current utilization and perceptions of prescription drug monitoring programs among emergency medicine providers in Florida. International Journal of Emergency Medicine, 10(16). http://dx.doi.org/https://dx.doi.org/10.1186%2Fs12245-017-0140-0

3) Teacher’s response: You have a lofty idea for a research proposal. I think it is too big for your project for this program. You might be able to use part of the idea. Try to tweak it to be something you can actually do.

Your work: Problem statement

Recent studies reveal that consuming alcoholic beverages elevates the chances of acquiring breast cancer in the woman’s body (Scoccianti et al. 2014). The disease is prevalent in the current studies, and various studies exist for its treatment; however, there exist significant gaps for knowledge enhancement in determining the threats of breast cancer precisely on appropriate women population, for instance, the difference in preventive medication and lifestyle medication and specifically alcohol intakes. By coming up with a compelling program to minimize the chances of breast cancer, there will be a healthy population of women and the growing girls both for short-term and long-term basis. We will use the methods of creating awareness to the infected and non-infected as well as meet the patients with breast cancer to advise them on withdrawal steps by the integrative efforts of rehabilitation centers. Some of the steps for the patients will include; encouraging them to cut on their weight, in the expense of alcohol they can use consumer vegetables and fruits, and breastfeeding for at least a year among other steps to mitigate the risks. The women who drink alcohol are at a higher chance of acquiring cancer compared to the non-drinking.

Research question

What is the association between alcohol and breast cancer among women in the U.S.? The purpose of this study is to explore the existing relationship between alcohol and breast cancer in women.

Sampling plan

The research team will collect a small sample for the study by to represent the entire population of women due to factors of time and resources. The control group is an age-stratified random sample comprising of 1000 women to serve the whole community. The team will require administered questionnaires to collect information about the risk conditions contributing to breast cancer. About the relationship between alcohol and breast cancer we will vary age and dietary fat intake, in our case, we use women in the age range of 49-60 years (Scoccianti et al. 2014). The picked sample is appropriate for the general population as stated in the research question because there will be appropriately collected. The results of the study will be generalized for the entire community in the nation since there was random selection using a substantial sample size. One of the limitations of generalization is that for studies done on taking samples of specific individuals it will be ineffective to make conclusions by generalizing the whole population but instead it will only apply the particular example. The study bears the limitation of biases and selective memory during answering of the questionnaires from several members involved in data collection(Levy, & Lemeshow, 2013). In future, I propose that remedies to the barriers might include, having more time to conduct the research.

Research design

The research design of choice is case-control under the Observational model where we will conclude from comparing variables against a control group which in this includes 1000 randomly picked women (Scoccianti et al. 2014). This method is suitable because it provides insights into the phenomenon under research at the same time avoiding challenges within practicality and ethics grounds that would make the project cumbersome. The case study offers an in-depth analysis of addressing the statement of the problem up to the conclusion level of providing relevant solutions. Furthermore, it’s suitable for the research question since the topic has received insignificant studies. Finally, the design is overall as it ensures there is a consistent and logic process in collecting, recording, analyzing, interpreting, and presenting the project’s data.

References

Levy, P. S., & Lemeshow, S. (2013). Sampling of populations: methods and applications. John Wiley & Sons.

Scoccianti, C., Lauby- Secretan, B., Bello, P. Y., Chajes, V., & Romieu, I. (2014). Female breast cancer and alcohol consumption: a review of the literature. American journal of preventive medicine, 46(3), S16-S25.