HPHY 212 midterm pt2

list the steps of the scientific method

1- observation

2- question

3- hypothesis

4- experiment

5- analyze results

6-conclusion

7- report results

hypothesis

predicts relationship between IV and DV; must be testable

theory

A hypothesis that has been tested with a significant amount of data

IV is _________________.

manipulated

DV _____________ on the _______________

depends / IV

identify the IV: Stretching prior to an exam will improve testing performance capabilities in cool conditions

stretching

identify the DV: Stretching prior to an exam will improve testing performance capabilities in cool conditions

test performance

Identify the IV: Oral ingestion of H(1)-and H(2)-receptor antagonists, known to attenuate the sustained postexercise vasodilatation, would reduce leg glucose uptake after a bout of cycling.

H(1)- and H(2)- receptor antagonists

Identify the DV: Oral ingestion of H(1)-and H(2)-receptor antagonists, known to attenuate the sustained postexercise vasodilatation, would reduce leg glucose uptake after a bout of cycling.

leg glucose uptake

Identify the IV: An excessively large alveolar to arterial oxygen difference (AaDO2) would contribute to reduced aerobic fitness in adults born very preterm with and without bronchopulmonary dysplasia.

arterial oxygen difference

Identify the DV: An excessively large alveolar to arterial oxygen difference (AaDO2) would contribute to reduced aerobic fitness in adults born very preterm with and without bronchopulmonary dysplasia.

aerobic fitness

Identify the DV: Deletion of MAFbx(knockout), a protein that helps initiate protein degradation, will prevent muscle atrophy in mice with spinal cord injury.

muscle atrophy

Ulcers

discontinuity in a bodily membrane; stomach ulcers are in the stomach lining

If the doctors treated ulcer patients with antibiotics to see if the ulcers stopped. What is missing from their study?

a control group

why do we need controls?

essential for measuring the effect of exposures

What results would you expect if the "excess

acid hypothesis" were supported?

C

What results would you expect if the "bacteria

causes ulcers hypothesis" were supported?

A

When is the peer-review process initiated?

report results

who publishes the work?

journals

who initiates the peer review process?

journals

journals are run by what type of organization?

profit or non-profit

reviewers are:

experts from other universities

reviewers are paid approximately _______ per hour.

$0

advantages in the peer review system?

- establishes the validity of research since it is reviewed by other experts in that field

- provides valuable feedback so the researchers can revise and improve their work

- widely an accpeted and understood process

disadvantages in the peer review system?

- lengthy delays in the spread of research findings

- time-consuming process

- difficult to protect the anonymity

- bias

- sometimes accused of protecting established opinions and not being open to genuinely new ideas

- may not prevent the publication of poor research as review standards may be lower in less prestigious journals

If a manuscript is rejected by one journal ....

it can be submitted to any other journal

List in order of strength of evidence the reviews:

1- meta-analysis

2- systematic review

3- review

List in order of strength of evidence the scientific studies:

1- randomized controlled trial

2- cohort

3- case control

list the strength of evidence in order:

1- meta-analysis

2- systematic review

3- review

4- randomized control

5- cohort

5- case-contol

6- case report

7- expert opinion

Meta-analysis

- NEEDS a new piece of review

- systematic review of the literature

- integrates findings from many published studies

- new statistical analysis using all the data

Systematic review

- systematic review of the literature

- integrates findings from many published studies

- NO NEW statistical analysis

review

- review of the literature (NOT systematic)

- integrates findings from many published studies

- NO NEW statistical analysis

level of evidence:

The purposes of this paper is to provide a broad perspective on the current treatments described in the literature with respect subacromial impingement syndrome, consider the role of the subacromial space in impingement syndrome, describe the intrinsic and extrinsic mechanisms considered to influence the subacromial space, and critique the level of evidence supporting these concepts.

review

level of evidence:

Randomized controlled trials were identified through an electronic literature search. Studies were considered eligible if they included interventions with resistive specific exercises. Six randomized controlled trials were included with 231 participants. Review of literature shows that in general, patients treated by Physical Therapists tended to do better than those who simply performed a home exercise program.

systematic review

level of evidence:

Randomized controlled trials were identified through an electronic literature search. Studies were considered eligible if they included interventions with resistive specific exercises. Six randomized controlled trials were included with 231 participants. No consistent statistical significant differences in outcomes between treatment groups were reported in the studies. Standardized mean difference (SMD) for pain was SMD - 0.19 (95% CI - 0.61, 0.22) and SMD 0.30 (95% CI - 0.16, 0.76) for function.

Meta-analysis

Random Controlled trial

- experimental process with a treatment/ intervention

- uses randomly assigned treatment and control groups

cohort study

- observational

- all subjects are from the same group and are linked by shared characteristics

- divided into subsets from the same group for comparisons

- can be prospective or retrospective

prospective

individuals are followed over time and data about them is collected as their characteristics or circumstances change

retrospective

individuals are sampled and information is collected about their past

Case- Control

- observational

- compares individuals with an existing condition / characteristic to group without

- always retrospective

- start with outcome and look back for exposure

level of evidence:

The charts of forty-six patients were reviewed. Half of the patients have impingement and half had no symptoms. Charts were reviewed for confounding factors.

case control

level of evidence:

Forty-six patients with impingement syndrome were recruited - half of whom were undergoing Physical Therapy and half of whom were not. After 4 weeks, strength, motion and pain were assessed.

cohort

level of evidence:

Forty - six patients were randomly assigned to 1 of 2 groups, one of which received a 4 - week intervention of strengthening exercises and the other the same intervention, supplemented by manual therapy. Outcome measures were strength, motion and pain.

random controlled trial

case report (case study)

- detailed characterization of few subjects

- observational

- often unique conditions

- no control

expert opinion

- direct knowledge obtained from an expert

- lowest level of scientific evidence

footnote chasing

the process of locating useful information by searching the reference sections of other papers

pearling

the reference lists of relevant articles are examined for articles that may have been missed by the database searches

boolean operators

AND, OR, NOT

identify boolean term:

concussion OR balance

identify boolean term:

concussion AND balance

identify boolean term:

concussion NOT balance

MeSH

- Medical Subject Headings

- predefined set of terms to connect you to the information you need

- hierarchical classification system with 16 main branches and lots of sub-branches

- revised annually to reflect changes in the literature and research

Benefits of Open access

- author's research is available to more people

- the public should have access to the research they fund

- smaller libraries and low-income economies benefit

- makes use of modern technology

When did the Tuskegee Study start?

1932

When did the Tuskegee Study end?

1972

problems with the Tuskegee study

- no informed consent

- cruel and inhuman treatment

- risks far outweigh any gain

- subject did not have an option to say no

Belmont report

- respect for persons

- beneficence

- justice

respect for persons

- protecting the autonomy of people

vulnerable populations

- pregnant women

- terminal patients

- disabilities

- mental illness

- children

- immigrants

- impoverished

- prisoners

- language barrier

- elderly

- education

- minority

beneficence

- to do good

- helping find a cure

- benefits outweigh the possible risks

- low risk to subjects

- known risks

- payment

justice

- fair distribution of costs and benefits

IRB

institutional review board

roles of IRB

- meet and review all research proposals

- make decisions regarding study

- follow up on studies

- implement policies, procedures, and documentation for review and follow up

Who sits on an IRB?

- faculty

- clinicians

- community members

what are the factors for IRB approval?

- scientific merit

- perceived competence of investigators

- who are the subjects? are they vulnerable?

- risk/ benefit ratio

- how is the subject being informed?

When can a subject withdraw from a research study?

anytime

consent elements

- voluntary

- "vulnerable" subjects

- free to withdraw at any time

- informed consent form

animal ethics

- describe human-animal relationships and how animals ought to be managed and treated

why do we use animals?

- gene similarities

- genetic modification can induce human-like diseases

- the similarities are greater than the differences

by law reserachers cannot use animals when _______________ is avaible

alternative

how are unnecessary or pointless animal experiments mitigated?

- strict control over animal use

- animals are expensive

- limited biomedical funds

- trivial, irrelevant, incremental, or repetitive work is not funded or permitted

3 R's

- Replace

- Reduce

- Refine

Replace

- replace animal studies with other methods

Reduce

- minimize the number of animals used

refine

- methods which minimize the suffering and improve the animal welfare

AWA

- animal welfare act

- 1966

- regulates treatment, exhibition, transport

- enforced by USDA (united states department of agriculture

OLAW

- Office of Laboratory Animal Welfare

- NIH (national institute of health)

- develops, monitors, exercises compliance

- consists of vets, researchers, member of the public

- assurance document

- guide for care and use of lab animals

AAALAC

Association for Assessment and Accreditation of Laboratory Animal Care

IACUC

- Institutional Animal Care and Use Committee

- review and approve/ reject all proposed activities involving animals

- inspect every 6 months

- monitor and investigate

statistical inference

the drawing of conclusions about a population based on what you see in a sample from that population

Biostatistics

the application of

statistics to a wide range of topics in

biology

What percent of data are contained between +/- 2 standard deviations from the mean?

95%

Probability

- Probability is the degree of certainty, the chance, or the likelihood that something will happen

- anumber between 0 and 1 or 0% and 100%

- independence of events