Writers name: wizzy, hophead, writingptb, researchpro, FLWriter2011,
Boethius, Assco5522, rbwpenn

Reflect on the following

1. Falls are common in the elderly population and result in injuries that decrease their independence and may result in nursing home placement. Tai chi is an intervention used in the elderly population to decrease the incidence of falls. A randomized controlled trial was conducted in Australia to determine if Tai chi is effective in reducing falls. The ethics committees of AUT University, University of Otago and ACC approved the research protocol and written informed consent was obtained from participants prior to the study. The mean age of participants was 74.5 with a standard deviation of 6.5. The participants ages ranged from 55 to 95. The participants were divided into three random groups, TaiChi 1 time/wk, Tai Chi 2 times/wk, and low-level exercise, the low level exercise group was the control group. The groups each contained 228 participants. The participants kept a monthly log of falls. Each group reported an equal reduction in falls during the intervention time period and at the 17 month follow up with a mean fall rate reduction of 58%. The secondary outcome was to determine an increase in strength and endurance, again all three groups showed an equal increase in strength and endurance.

Taylor, D., Hale, L., Schluter, P., Waters, D., Binns, E., McCracken, H., McPherson, K., & Wolf, S. (2012). Effectiveness of Tai Chi
as a community-based falls prevention intervention: a randomized controlled trial. JAGS, 60, 841-848.
doi: 10.1111/j.1532-5415.2012.03928.x

2. The topic of my research question is: Can music therapy decrease or alleviate anxiety in pediatric patients? The article I researched is a quantitative study on the emotional responses to music applying a scientific perspective on music therapy (Suda, Morimoto, Obata, Koizumi, & Maki, 2008).

Demographic data: Ten participants: 5 women and 5 men. Ages between 25 and 35 five years old. All participants were postgraduates or University graduates.

Survey data done: A 28- item General Health Questionnaire was given to determine the emotional status of the participants. Also a self-rating depression scale was given to the participants.

In this study, ethical principals were addressed. None of the participants had a high-risk emotional state that was determined by the results of the two surveys done (GHQ28 score <8 and a self-rating depression score< 42) (Suda et al., 2008). ?The design of the study was approved by the Ethical Committee of Hitachi Ltd, Central Research Laboratory. ? (Sudi et al., 2008, p. 76).

Knowing the demographics of a research article helps generate a knowledge base about the study and helps to form hypotheses for conducting correlational and quasi-experimental and experimental studies (Melnyk & Fineout-Overholt, 2011).

Melnyk,B. M. & Fineout-Overholt, E. (2011). Evidence-based practice in nursing and healthcare: A guide to best practice (2nd ed.). Philadelphia, PA: Wolters Kluwer/Lippincott.

Suda, M., Morimoto, K., Obata, A., Koizumi, H., & Maki, A. (2008). Emotional responses to music: towards scientific perspectives on music therapy. Neuro Report, 19(1), 75-78.

3. The study I chose to evaluate used Chi-square tests for the purposes of bivariate analysis (Kaye et al., 2011). According to the literature, the Chi-square ?can provide information not only on the significance of any observed differences, but also provides detailed information on exactly which categories account for any differences found? (McHugh, 2013, p. 143). The study cited that subjects who were male, married, obese, admitted from institutional settings, and had a worse prognosis based on co-morbidities were more likely to develop a catheter associated bacteremia (P <.05). The small P-value indicates statistical significance. The likeliness of these characteristics being predictive of development of a nosocomial bloodstream infection was expressed as an odds ratio:
Characteristics Odds Ratio (CI 95%)
male 1.23
married .84
obese 1.39
admit from institutional setting 1.2
McCabe score (comorbidities) 1.39
The research question sought to identify predictors for the development of nosocomial bloodstream infections. Through Chi-square testing, the authors were able to establish that certain variables were associated with an increased likelihood of developing this type of infection. In light of the increased odds of developing infections when certain characteristics were present, the authors inferred that these characteristics were predictive for development of a bloodstream infection. I believe these study results could have been strengthened had they included the current diagnosis or disease process the subject was being hospitalized for. It would have been helpful to see if there were certain diagnoses or disease processes that accounted for the development of a nosocomial bloodstream infection.

4. In the article by Christopher Tompkins and John Orwat (2010) titled ?A randomized trial of telemonitoring health failure patients?, all hypotheses regarding the effectiveness and efficiency of telemonitoring were tested against a one- sided alternative or t-test. The article did not include all the p-values related to the tests, but noted that increased urgent care visits in the telemonitored group was highly significant with p<0.01 and the lower average of hospital days in telemonitored group was marginally significant with p <0.1. The only p-value (p=0.14) included was chi-squared tested was showed the total cost was lower in the intervention group( by 12%), controlling multiple demographic characteristics. The article provided a chart with incidence rate ratio bases on demographic characteristics and different types utilization. I was unable to provide alternate explanation for the results of the study without the p-values.

Tompkins, C. & Orwat, J. (2010). A randomized trial of telemonitoring heart failure patients. Journal of Healthcare Management, 55(5), 312-322.