This research was permitted by the Human Rights Committee, the institutional assessment board of the Children's Hospital of Pittsburgh. There was conduction of a chart evaluation of three thousand a seven health administration visits to the Children's Hospital during a constant three-month period, from December 1, 2001, to February 28, 2002. The Patient visits were not included when the child's age was less than three months or when the visit was afterward recognized as a follow-up. If the patient had more than one health supervision visit during the selected period of study, his second visit was not included in the analysis. Four hundred and ninety two visits were not included on the foundation of these criteria .this left 2515 visits that were used for analysis.
As one goes through the essay, he will totally be perplexed by it. Presented in clear, simple and grammatically correct English, it should be a must read for people purporting to know more about the prevalence of obesity among the young children. The article is not very long and hence it can easily be read in one sitting with ease. This is will make one to get all the valuable information that it contains. Indeed there is not even a single page that does not contain useful information. Therefore, no page from it should be cut. The opening sentence attracts the reader. It is well written such that just a glimpse on the first line is enough to make one read the whole article.
Do the authors provide a rationale for their choice of the design?
The authors have indeed provided the reasons that drove them to the design. First and foremost, the authors were driven by the fact that the prevalence of obesity in young children has greatly increased, posing great challenge to the pediatricians. Besides, an exposition medical documentation assessment of all the health care visits for children of ages three months to sixteen years of age, looked at from December 1, 2001, to February 28, 2002, was conducted. The children whose ages were less than five years and a weight greater than 120% of the fiftieth percentile of weight-for-height was stated as being obese. The children whose age was greater than or equal to five years, a body mass index of greater than ninety fifth percentile for age and gender was stated as being obese.
Is there a clear link between the research purpose and questions and the choice of a design?
The main purpose of the study was to get the rates of detection of obesity by nurse practitioners and faculty members in a primary care location and to explain the actions that are taken by these providers in their assessment and administration of obesity. The questions that were asked were directly related to the purpose. Besides, the choice of design was also with the purpose.
The results were in line with the needs assessment questionnaire study that was used in which between 50 to 61% of respondents stated the commencement of treatment for overweight children with no obesity-associated conditions (Jonides, Buschbacher & Barlow,2002) Rates of obesity recognition in the study did not change according to the kind of provider.
What are the strengths of this research design for answering this question? What are the limitations of this research design?
The findings of the study were incomplete by dependence on self-reporting and besides, there was a low response rate which stood at less than 33%. The format of the questionnaire did not give the measurements of the occurrence of identification of obesity and neither did it give the interventions for the study inhabitants in every day practice. Another limitation of this study was its dependence on the documents providers of health care, which may not give complete reflection of the provider's observations of the patient. In future research should be conducted to detect whether records of obesity is a precise suggestion of provider recognition.
The Sampling Strategy
1. What is the population for this study?
The population of this study comprised of children in Children's Hospital of Pittsburgh Primary Care Center.
2. What is the sampling frame for this study?
The sampling frame included children more than three months of age
3. How were eligible participants recruited for the study? Describe any potential selection bias inherent in the recruitment process
The eligible participants in this study were selected on the basis of their height and weight and Body Mass Index. The potential bias that is inherent in the selection of the children
Body mass index (BMI) has several deficiencies when used in the measurement of obesity as pointed out by Rothman (2008).This is however more severe in the case of height and weight that is self-reported. BMI which is a method of measuring the body fat is an indirect technique.BMI never reflects the various changes that take place with age. This is attributed to the fact that the mass of muscles may decrease but the corresponding changes in an individual's height and weight as well as the BMI may never reflect these changes in the individual's muscle mass and body fat. The specificity and the sensitivity of BMI have been proven to be extremely poor (Rothman, 2008). The correlation between the percentage of body weight and BMI has also been proven to be nonlinear. It also differs according to gender. The outcome of the errors in the measurement of obesity using BMI does depend on whether the errors are differential or otherwise. The miscalculation which is differential posses a great problem in both cross-sectional and case-control studies as compared to cohort studies. They can cause bias either towards or away from the experimental null. In nondifferential studies however, the miscalculations can cause a bias towards the experimental null for exposure which is dichotomous. In a nutshell the main bias in this experiment is due to the use of BMI as a measure of obesity which introduces a lot of problems of miscalculation that causes bias in the estimation of the effects of obesity.
4. What measures were employed to encourage participants to join the study?.
The measures that are employed included the giving of advice on how to manage and prevent obesity. This is evident from the recommendations that are provided by the author on the evaluation of obesity and the recommendation of decreased television watching. This is coupled with advice on the need to observe and change the diet and activity behaviors of the children.
5. What incentives were employed to encourage participants to join the study?
There were no much incentives provided apart from the advice on how to avoid and manage obesity.
6. The participants in this study are self-selected. Discuss how the self-selection process may affect sampling bias.
Sample bias is a form of error that makes some of the members of the chosen population to be less likely be part of the rest. This causes sample bias. This is as a result of the non-random sample of a given population or other non-human factors. This is because all participants are never equally balanced or represented objectively (Medical Dictionary,2009;The Free Dictionary,2009)
7. Describe the type of attrition that occurred during this study process. How might this have affected the overall outcome of the study?
Marcellus (2004) pointed out that attrition which refers to the loss of the participants of a given study presents a major threat to the integrity of research. In this paper, was attributed to low response rate of the providers.
8. Discuss any characteristics of the sample that may have affected response rates. How might the different response rates affect the outcome of the study?
The characteristic of the sample that may affect the response rate is family discretion and privacy that might prevent them from participating fully in the research.
1. This research study expresses its research question as objectives. Are the concepts that are in the objectives defined as variables in an objective way? Are the variables clearly measureable?
Yes the concepts of the objects that are defined as variables in an objective manner. The main objective is to assess the performance of pediatric clinicians' level of performance in the identification and management of obesity. This is quite clear. The study objective of the study is to determine the different rates of obesity identification by various pediatric residents, faculty members and nurse practitioners in a primary health setting that is academic in nature as well as to provide a description of the specific actions to be initiated by the providers in the evaluation as well as the management of cases of obesity in children. Some of the variable is not measurable.
2. List the variables that are measures in this study and classify each variable as to its type.
The measurable variables are height, weight and age.
3. Describe methods the authors use to ensure that measures are consistent from rater to rater.
They compared them with the most recent recommendations from experts