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Task:
Assignment extract:
Essay 1500 words
Select an epidemiological study that has been published in a peer-reviewed
journal in the past 10 years:
1. Summarise the study (300 words) and critically evaluate using an appropriate
critical appraisal tool (700 words). (100 words total; 60% of marks).
2. Using a style appropriate to a lay audience (for example, newspaper
readers), outline the public health and/or health promotion implications of
this study (500 words; 40% of marks).
Solution:
Article Summary
The article is
an epidemiological study in Japan. The review is a focus on the relationship
between smoking, especially cigarettes and the risk of type 2 Diabetes Mellitus
(T2DM) in the country. The study was developed in the backdrop of an
understanding that the rate and percentage of smokers in Japan remains high in
proportion to the overall population. Although the percentage of smokers has
declined, the decline rate is not big enough and thus a majority of the
Japanese citizens remain smokers. The study investigated the three elements of smoking
including the status (smokers or non-smokers), the intensity of smoking (the
frequency of smoking and number of cigars smoked on a daily basis), and
cessation (the extent of quitting and the number of years since quitting)
(Akter, Goto & Mizoue, 2017). The study used the existing MEDLINE and
Uchushi databases to get the relevant articles and acquire a qualified sample
base in the context. The review used a statistical analysis approach to review
the relationship between the variables.
It established
that there exists a relationship between smoking and the risk of T2DM among the
populace. As such, over 18.8% of the men T2DM cases were linked to smoking
while 5.4% similar cases among women were linked to smoking. Moreover, it was
also noted that the process of quitting smoking was related to reducing risk
exposure to T2DM. As such, the risk of exposure to the illness remained high
for the first 5 years preceding quitting but the risk decreased to the level of
non-smokers after 10 years of quitting. Thus, smokers who quit smoking for over
10 years were categorised to be within the same risk bracket and exposure
category with the non-smokers. The article concluded by affirming the
hypothesis that there is a direct positive relationship between smoking and
exposure risk to T2DM (Akter, Goto & Mizoue, 2017).
Article
Appraisal
The article
under review is a peer-reviewed article. This means that prior to its
publication; the article had been evaluated for accuracy and relevance by a
panel of experts. Consequently, this appraisal does not seek to invalidate any
part of the content of the article. Instead, it seeks to explore on the
weakness and strength areas of the article methodologies, as well as the
systems and processes applied in arriving at the user data. In the process of
appraising the article, this review applies the strength and weakness analysis
model (Pan, Wang, Talaei, Hu & Wu, 2015).
Strengths
One of the major
strengths of the article and its findings is on the applied and used source of
data for the review. Overall, the review used a sample base of two credible
databases. In this case, the review used both the MEDLINE and Uchushi
databases. These are databases with credible medical records and files for
patients. The fact that the study findings relied on the data obtained from
these databases increased the possibility for the accuracy of the obtained
findings (Sattar et al., 2015). The databases have a large pool of information
that could have been relied upon in formulating the findings. This is actually
the basis through which the study large sample base was obtained from. In this
case, through a perusal of the database, it was possible to identify over 22
eligible articles that contained over 343,573 subjects and of which 16,383 were
T2DM patient. This meant that the study had a large and enough sample bases to
evaluate the different study variables.
Additionally,
the use of secondary data ensured that the study would evaluate data longitudinally.
Its focus was not only on the relationship between the variables of smoking and
T2DM but also on the effect of quitting smoking and the exposure risk over
time. Consequently, it was imperative for the study to observe the characters
and the exposure risks of the patients and the subjects' overtime (Taylor,
Davies & Munafo, 2015). This was estimated for a 10 years period of time.
In the case of using primary data, the evaluation of a ten years longitudinal
process would not have been viable. This is because the study would have taken
10 years to develop findings. Consequently, the use of an accurate database
provided an opportunity for the review to analyse the data over the last 10
years (Bilano et al., 2015). This was the bases through which the relationship
between quitting years and exposure to 2TDM was developed.
Weakness
Although the
study use of secondary data was vital in offering a longitudinal analysis, it
has its share of weakness. On the one hand, the use of secondary data meant
that the review relied on a sample base that the reviewers and authors lacked
control over. Consequently, the risk of errors in the initial 22 eligible
articles used could be relocated in the eventual study findings developed.
Thus, the risk of the article is that it is as accurate as the each and every
one of the sued 22 articles. The fact that it lacks the ability to guarantee
the credibility and accuracy of the data and findings used, besides citing the
credibility of the user databases weakness the study findings effectiveness
(Uchimoto et al., 1999).
The second
weakness area in the developed article was in the distribution of the contents
of the articles. In this case, there were two ain aspects evaluating the relationship
between smoking and 2TBM, and the impact of cessation years on the exposure
risks (Willi, Bodenmann, Ghali, Faris & Cornuz, 2007). It would have been
therefore expected that the study articles would be distributed across the two
evaluation issues. However, the study selected articles were more focused on
the smoking relationship to 2TBM. In this context, 19 studies were on the
current smokers and their exposure to the illness. However, only 3 articles
were oriented towards the cessation years. This is a very small article and
database through which the decision on the impact of cessation years on the
risk of exposure to 2TBM (Facchini et al., 2012). Therefore, although the
eventual conclusion of the context was developed, this was not sufficient enough
and raises a credibility of the findings question. The major weakness area and
arising research question are on whether the use of a wider scope of articles
would result in differing results and conclusions' on the issues. Nevertheless,
despite the weakness areas, the strengths of the article outweigh the weakness
areas implying that it is a strong and reliable literature base.
Health
Issue
The health issue
at hand is the type 2 diabetes mellitus illness. This is a rising cause of
concern not only in Japan but globally. In the past, Diabetes was closely
linked to old age. In this case, as the insulin production in the ageing
declined, they were increasingly exposed to the risk of T2DM. However, this
content has since changed (Attvall, Fowelin, Lager, Schenck & Smith, 2013).
Currently, the risk of exposure to diabetes mellitus has expanded to include
both the aged and the young equally. One of the core emerging aspects in the
rise of the illness is that it is closely related to the social lifestyle. For
instance, in the case of smoking, it was established that at least 18.8% of men
with T2DM were smokers and smoking was directly linked as the cause of the
illness.
This means that
smoking has an impact on both the society and the government at large (Van der
Vaart et al., 2004). On the one hand, this has reduced the society economic
capability as those ill are unable to optimally function and as such denting
their economic performance progress. On the other hand, it equally has an
impact on the government. This is the disease burden. A disease burden bestows
the responsibility of the government on ensuring that disease prevalence is
reduced and the existing illness cases are catered for. In the case of the
Japanese government, the burden is in the form of caring and ensuring that the
right medication is available to the patients. Additionally, it weighs on the
government to institute proper systems and structures that ensure that the risk
of prevalence and new illness contracting are reduced into the future.
Based on the
article findings, there are three probable outcomes and implications of the
review findings. The first such an outcome is an increased public awareness’ on
the negative effects of smoking and the value of cessation (Chowdhury, Rayford
& Chang, 2008). In this regard, the article demonstrated that although the
risk of exposure was high in the first 5 years preceding quitting smoking, the
risk decreased substantially at 10 years, equalling those of non-smokers. This,
this will increase the hope and motivation by the current smokers to quit
smoking in the hope that after 10 years their risk of exposure would be as low
as for the non-smokers. Secondly, the implication of the review is on
government increased focus on regulating smoking. It is evident that smoking
increases the disease burden in the nation (Barrett-Connor & Khaw, 2009).
The most probable government action would be to increase the tax rates on the
cigarettes as well as the starting up of rehabilitation programs. Such programs
would help and motivate those willing to quit smoking on their recovery
journey. Thus, the government will not place more emphasis and focus on
reducing smoking rates in the nation.
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