Incidence of Type 1 Diabetes in Sweden among Individuals Aged 0-34 Years, 1983-2007

In this task you will:
• Critique 10 pieces of evidence to apply to your nursing practice.
• Search the library databases for pieces of original evidence on a topic that is of interest to you and your practice. (You will need the full article to find all the answers to both Part A and Part B.)
Part A of this task will first review one piece of evidence in detail.
Part B of this task will compare and contrast 9 more pieces of evidence as a group.
A. Select one example of a primary research report from a nursing research journal on a topic of interest to you in nursing and critique the article (suggested length of 2–3 pages) by doing the following: (What does primary research mean? Find out in Brown or Houser before you search for articles
Authors Name: Dahlquist Gisela and Associates
Article: Incidence of Type 1 Diabetes in Sweden among Individuals Aged 0-34 Years, 1983-2007
Author’s Thesis Statement: Explaining if the increase in childhood type 1 diabetes is mirrored by a decrease in older age-groups, resulting in younger age at diagnosis of autoimmune type 1 diabetes.
There have been an upsurge of younger patients of a chronic disease, type 1 diabetes, in the past decades in and the hardest hit countries are those in the Europe block where increase rate is 3.9% per annum. Upsurge in childhood diagnosis of diabetes are linked to: prenatal exposure to viral infections, caesarean delivery, blood group incompatibility, maternal age, parity and preeclampsia.
The study was conducted prior to consent by either the patients or parents. This research carried out combined statistics from two registers: the Swedish Childhood Diabetes register and Diabetes Incidence in Sweden Study. The first register, dealt only with patients under the age of 14.9 who were referred to pediatric departments. However, the registration organization and format were dissimilar to those used in the previous years and the learnt completeness staggers between 96 and 99%. The writer puts it that for a period of two years, three pediatrics didn’t forward data prospectively, though it was “adjusted afterward”.
On the other hand, Diabetes Incidence in Sweden Study covered between ages 15 and 34, basing its reports from a correspondent, a physician or diabetes nurse. The classification of the diabetes into either type 1 or 2 is according to that of the clinical classification of the doctor.
In precise terms, the author’s argument about type 1 diabetes and which are based on the Sweden register based on the population and more than twenty thousand cases of diabetes: “the pattern of change over time in type 1 diabetes reflects a shift to younger age at diagnosis. The author also pipes it that “there still is an increase over time which possibly reflects that a shift to younger age is ongoing also among older-age-at-diagnosis groups.” In the conclusions at page 1, the author points out that, “the dominance of cohort effects over period effects suggests that exposures affecting young children may be responsible for the increasing incidence in the younger age-groups.”
Review and Evaluation of the Article
The author does a remarkable work of compiling data spanning a very long period of 24 years. However, in his so called analysis, there is more than meets the eye. In an analysis, some terms make the author’s analysis of type 1 diabetes dubious. Use of terms such as,” it has been speculated that the shift…” (page 1, 1st paragraph) and”The Swedish Childhood Diabetes Register registers almost all incident cases…” (Page 2,1st paragraph) makes the analysis wobble. Speculation is a synonym of guesswork and medicine research deals with real facts rather than baseless guesses which can’t be proved. Consequently, the author aptly points out that the Swedish Childhood Register registers almost all cases. Without the need for further explanation, it therefore implies that the study was done on a selected few cases.
While they were conducting the research, the author says that,” parents or patients gave individual informed consent to be registered.” In the case that they conducted a research on patients between the ages of 0-14.9, assuming that they did so with the consent of the patient, a person aged less than 14 years can’t give reliable data. Perhaps due to the embarrassment in front of the patient’s peers over not knowing their personal data such as the date of birth, it would compel them to guess their data, and would they be over 15 but give it as 14, it would be a mighty shunt on the results of the analysis. Where the parents give the ages of their children, it may be negative since the birth certificates may have got lost making them resort to guesswork. While the author gives several reasons that could be the causative of type 1 diabetes there is one causative, crucial, that he overlooks: diet. The fast foods that are on the rise, and where young people crowd on fast food restaurants could as well cause diabetes to people who never had any of the reasons that the author points.
I totally oppose the views of the author: his views are weak, crushed as easily as moths. Perhaps the author’s analysis could have been effective if, on the long period of study that spanned 24 years, he could taken his own firsthand data on patients rather than relying on second hand data from sources which he couldn’t prove. The author kind of tries to prove whether the speculation that,”speculated that the shift to younger age…”(page 1) is true or not. The speculation is a feat he doesn’t prove but adds another speculation on top of it, in his conclusions, “suggests that the exposures affecting young children may be responsible for the increasing incidence in the younger age-groups”(pg 1)
1. Identify the article you have chosen in an APA-formatted citation. (This is where you demonstrate your competency on formatting a full APA citation. You can place this citation in the graphic below where it states ‘full APA citation’

2. Design a graphic or chart to show how the researcher addressed the five areas of a research report (background information, review of the literature, discussion of methodology, specific data analysis, and conclusion). (You can use the example below or make your own chart covering these fives areas.)

Article Dahlquist Gisela. (2011). Diabetes Care. Incidence of Type 1 Diabetes in Sweden Among Individuals Aged 0-34 Years, 1983-2007,6 pages
Background Information Dahlquist, page 1: proving if the upsurge of type 1 diagnosis in younger people is reflected by older age-groups. It doesn’t make sense to me because the authors base their arguments and statistics from other sources. The analysis was put in such layman terms and could be understood well, however, save for the few introductory paragraphs, the authors wrote extensively about the statistics from the Registrars’ registers.The authors’ abstract wasn’t so well structured (had a shoddy structure).Indeed,instead of the article shedding light on the theme, it threw me in a mire of confusion,what with the way the authors used maybe, speculation. Moreover, the authors’ conclusion was based on a presumption,”may be responsible for…”(page 1)
Review of Literature Dahlquist,page 2: I can only peg the abstract to be outdated, reason?, since 1983, when the research starts, the world has changed a great deal, new fast and diabetes related foods that could as they claim in their study, increase the level of diagnosis of diabetes in the young people since they are mostly eaten by the young people.The variables were understandable but weren’t (the theme) put forth by the authors.Much was given by the authors in their review concerning their research but the study was a study that was never was, a question that was never solved seeing that they didn’t answer they didn’t shed more light into it rather a mere,”maybe responsible…”
Methodology Dahlquist, page 2 & 3: Quantitative analysis is a theory that uses information that deals with numbers. Dahlquist and Associates uses this type of research method in a correlation design(because it uses the statistical relation between variables: age of the patients and years
The other research methods that are used by researchers follow under descriptive research method.

Comparative design is used by researchers to illustrate more sets of participants. A simple descriptive method is employed by researchers when they want to illustrate individual persons, settings.
Data Analysis From page one throughout to six, Dahlquist and Associates analyze the data the researchers analyze the data in understandable way, and the figures arranged in a flowing way even though the researchers tend to veer off the main subject.
Conclusion The work of the researchers cant go down the drain, it gives the outline of the theme. However, their work, regardless of the more than two decades that it has spanned: falls out with the kilter to me as a clinician. Most of their work is based on other resources, such as registers from the two pediatricians whose accuracy can’t be vouched for.

A 3. Based on your analysis of the five areas, assess whether the evidence presented in the research report supports the conclusion (suggested length of 1/2–1 page).
Never does the evidence put forward by the researchers at one time give satisfactory information that would make my conclusion positive. In the information background, the author aptly puts it that the data was obtained from two pediatric registers. They could be dealing with second hand information, i.e., information passed over from other sources whose accuracy can’t be determined. Therefore, the conclusions of the researchers were merely based on other sources. In the literature review, the researchers did a good work of drawing the tables, of which were understandable but no matter the perfection of the tables, the theme remained unanswered. The methodology used by the researchers, the correlation design, dealt with statistics (two valuables): ages and years. But, a inserting a single digit in a place where it isn’t supposed to be would make great changes and changes the twist the actual reality. Rather than adhere to the main theme, the researchers fill their study with figures and tables but no conclusions are justified. Nothing else is plausible about their conclusions which arte in any case, conclusions drawn from the figures and tables. In other terms, the researchers’ conclusions are drawn on conjectures: maybe, speculation.
A 4. Discuss ethical issues that may have arisen for the researcher while conducting the research for the article (suggested length of 1/2–1 page).
Among the ethical issues that may have risen are those concerning respect. Assuming ages of some of the researchers were lower compared to that of those being studied on, some people don’t take questions from people who are younger than them lightly. Those researched on Can you come up with any ethical issues from the research? How did they protect the rights of the study participants? Did they mention IRB or informed consent? Read Houser chapters on legal and ethical issues in research.
A 5. Discuss the type of research used for the study (suggested length of 1/2–1 page).
Houser defines types of research that you can review to identify the research type (methodology) for each article. Discuss the type (methodology) used for this study.
Was it: Quantitative– Correlational design? Experimental design? Descriptive? or Qualitative- Grounded Theory, Phenomenology? Descriptive?
a. Explain whether or not other types of research would have been appropriate in the same situation.
Would there be another way to examine these same variables to answer the research question (such doing a qualitative study versus quantitative or visa versa?) Did they answer their own research question enough for you? Would you suggest another way they could have studied the same research question that would be more efficient?, less cost?, less burdensome on the subjects/participants?
B. Continue to conduct a literature search for 9 more pieces of research to evaluate this nursing care or management problem related to nursing by doing the following:
B 1. Identify a nursing care or management problem for a nursing care or leadership situation (suggested length of 1/2–1 page).
Develop your own problem statement that is driving your review of research. Use evidence (citations) to demonstrate the need for your problem if you can, make a case for your problem needing to be assessed.
B 2. Complete the attached matrix to list 10 primary research articles (peer-reviewed, original research articles) you locate in major medical databases/sources. (What does primary research mean? Find out in Brown or Houser before you search for articles)
Note: You may submit your completed matrix as a separate attachment to the task.
Note: Credible sources of original research may include professional journals, research reports, professional Web sites, governmental reports, current texts less than five years old, and presentations from professional meetings. If you have an article that is meaningful to you and over five years old, justify this in your analysis of the article.
Evidence Matrix of 10 pieces of Primary Research on one Topic related to Nursing
Author, Title Source Date (year) Research Type (experimental, quasi-experimental, case series, ethnographic, etc) Population/
sample size Outcome measures Pertinent data from results Suggested Conclusions Comments

APA citation Journal and database where the article came from ie CINAHL or PubMEd Use Houser to identify the research type. Also, the author’s should indicate type of research so look closely at their methodology. How many participants? Where was the study conducted? Geographic region as well as sample setting (hospital, clinic, community?) What variables did they measure? And what were their outcomes? What did the author’s identify as their key findings? Were these important to you? Make notes here as to why this piece of research/evidence is important to you, why you chose to make this part of your 10 article review.
Next article

B 3. Conduct a review of the 10 peer-reviewed research articles in which you:
a. Develop an annotated bibliography for each article (suggested length of 2–3 pages total for all annotations, suggested length of each annotation is found in the examples from
Note: An annotated bibliography is includes a brief summary of content for each book or article reviewed and other relevant comments of importance to you as well as and information that you believe can be of help for your future study.
NOTE B3b through B4 compare and contrast all of the articles and discuss them as a group.

B3b. Discuss whether the researchers present a case for the efficacy of a specified therapeutic approach.
Look at broad credibility issues (Brown, chapter 15 is a good source for critiquing credibility—previous chapters good too!). Make a case for your review of the author’s research approach… did they form their research methods to answer their questions, were their methods the most ‘efficacious’. What is efficacy in research? Can be most cost-effective, can be the quickest way to the answer they are asking. Think most efficient manner to answer the question.
B3c. Identify whether the researchers chose tools that were similar or different.
Where the actual tools used to measure the variables similar in all the studies, were they different? IE what did the researchers measure? Did they measure the same variable with different tools? IE for measuring obesity?– did some measure self-reported ht and wt and convert to BMI versus some that measured body fat with doubly-labeled water?
B3d. Discuss whether you believe the tools the researchers chose could have affected their results.
After you know how they measured their variables… could some of the researchers have less accurate measurement than others?, did some researchers pick better variables to measure the phenomena?

B 4. Develop an evidence summary of the articles, identifying what key criteria were used to develop it (suggested length of 1/2–1 page).
Synthesize your evidence, summarize all key points, be sure to include how some pieces are similar or how some are contrary, and how they fit together as a group, as a body of knowledge. And indicate what was the most important ‘key criteria’ you found that influenced your belief that the article was credible and important to your topic.

B 5. Recommend a specific nursing strategy based on the evidence or the theoretical models you found in your review (suggested length 1/2 page).
How would you change your practice based on the evidence (the new theoretical model the researchers provided)? Use your articles to back up your proposed strategy. The term theoretical model here refers to the ‘theory’ or ‘model’ that the researchers constructed as a new practice recommendation or care regime.
B 6. Explain why you believe it is important to use a theoretical model for nursing research (suggested length of 1/2–1 page).
Use Houser text to see how theory influences or constructs research (Chapter 7). Many researchers do not mention that they used or tested a theoretical framework/model for their research. In this task you are talking in generalities about how theory influences research. You are not necessarily reviewing what framework these researchers used (unless you were fortunate enough to have a researcher talk about their theory).
C. Include all in-text citations and References in APA format.

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