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University University of Auckland (UOA)
Subject Nursing 742 Biological Science for Practice

Here is the information about Assignment 1:

Written Assignment 1

Aim

The aim of this assignment is for you to review one of the selected pathologies outlined below and present two randomised controlled trials (RCTs) relating to and supporting the use of a commonly used health intervention to manage this disease. This will enable you to expand your knowledge in one area of applied science. You will gain the skills required to access current literature, and thus facilitate the underpinning of practice by current scientific research.

First, choose one of the following pathologies for your assignment: cardiovascular disease (this includes cardiac pathologies, stroke and peripheral vascular disease); type 1 or type 2 diabetes, cancer, or a pathology associated with one of the following body systems – central nervous system, immune, renal, gastrointestinal or respiratory. You may choose a rare pathology (but please check with the course lecturers that it is a suitable topic.
Second, choose a widely used intervention for managing this pathology. Examples of suitable interventions include: a drug (such as flixotide); an immunisation programme (i.e. the meningococcal vaccine); a screening programme (mammography) or a comparison of different interventions. Review the literature to ensure there are suitable RCTs before you decide on an intervention.
Third, identify and present two well designed RCTs that support the use of this intervention. Outline the characteristics of the study and participants, the major findings and their relevance within a New Zealand setting (including ‘numbers needed to treat’). Explain the biological (or mechanism of) action of intervention and how it improves the underlying pathophysiological process or health outcome. In your discussion comment on how good the evidence is. For example, have there been additional RCTs conducted that also support the intervention or perhaps findings have been mixed (positive, neutral or negative)? Have there been other types of other epidemiological studies carried out (case-control, cohort or cross-sectional studies) that support the intervention.

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Topic

Here is the information about the Title and Introduction from the Assignment Brief:

  1. Choose one of the research topics listed above that includes a pathology and an intervention that has been tested in RCTs.
  2. Write an informative title by introducing your topic in the title of your assignment. The title should inform the reader of what your assignment is about. For example, it should include the participant or patient (participants/patients with asthma), the intervention (flixotide), and the measured or measurable outcome (decreased hospitalization and / or decreased mortality). This approach informs the reader of your topic and will help you focus while researching and writing your assignment.
  1. Write a 300 to 400 word introduction. This should be the introduction you submitted at the end of week 2. The introduction should include: a brief overview of your topic or chosen disease or pathology (i.e. why is it important), some basic epidemiological facts such as the incidence or prevalence and mortality (nationally and internationally). If appropriate, note differences across ethnic groups, age and gender. Remember to reference all data or numbers (this includes percentages). Following this, outline the risk factors and/or causes of this pathology. Write a final short paragraph outlining the contents of your assignment content. For example, this assignment will discuss the pathophysiology of asthma and two RCTs will be presented that provide evidence for flixotide in reducing acute episodes of asthma requiring hospitalisation. The findings from two RCTs will be reviewed in the context of managing children and adolescents with asthma, in New Zealand.

Here is the information about the RCT Summary from the Assignment Brief:

Present or review, ONE of your two RCTs (including a table with just this ONE trial summarised) that supports the use of the intervention. Write about 300 words.

Your RCT needs to be described as outlined below.

Main points to be included in the RCT presentation include:

    • The main aim of each RCT
    • Study characteristics (country, authors and/or name of study, year published)
    • Participant characteristics (size, number of participants in each arm (if an RCT), gender, age, health status etc.)
    • Intervention/s being compared
    • Exclusion (or inclusion) criteria for participants
    • Results of the RCT. For example, in an RCT, be precise in stating the difference between outcome/s measured in the group receiving the active intervention compared with the placebo or control group. State the p-value and 95% confidence intervals (CI), as these provide proof as to whether the intervention was more effective than the placebo or control treatment. You also need to convey to the reader that you understand the findings (either when you write up each RCT or in your discussion). Please read the extra material provided regarding these statistical tests or ask your lecturer for help.

You are also required to summarise the most important information from your RCTs in a small table.

Method suggested in writing your assignment

Follow each of the steps below in the preparation of your assignment and incorporate the feedback you receive from your introduction and RCT presentation into your final assignment.

  1. Choose one of the research topics listed above that includes a pathology and an intervention that has been tested in RCTs.
  2. Write an informative title by introducing your topic in the title of your assignment. The title should inform the reader of what your assignment is about. For example, it should include the participant or patient (participants/patients with asthma), the intervention (flixotide), and the measured or measurable outcome (decreased hospitalisation and / or decreased mortality). This approach informs the reader of your topic and will help you focus while researching and writing your assignment.
  3. Write a 300 to 400 word introduction. This should be the introduction you submitted at the end of week 2. The introduction should include: a brief overview of your topic or chosen disease or pathology (i.e. why is it important), some basic epidemiological facts such as the incidence or prevalence and mortality (nationally and internationally). If appropriate, note differences across ethnic groups, age and gender. Remember to reference all data or numbers (this includes percentages). Following this, outline the risk factors and/or causes of this pathology. Write a final short paragraph outlining the contents of your assignment content. For example, this assignment will discuss the pathophysiology of asthma and two RCTs will be presented that provide evidence for flixotide in reducing acute episodes of asthma requiring hospitalisation. The findings from two RCTs will be reviewed in the context of managing children and adolescents with asthma, in New Zealand.
  4. For the main content of your assignment, divide your assignment into two broad areas. Initially, discuss the pathophysiology of your chosen health condition and the biological action of the intervention. Second, present your two RCTs that show the intervention is more effective than the control treatment or equally effective compared with another intervention. For example, a new drug is often trialled against an old traditional drug to see if the new drug is more effective or at least as effective.
  • In the first part of this section describe the general pathophysiology of the condition and the biological action of your selected intervention. For example, if you choose asthma explain the pathology of asthma and link this to the main effects of asthma or signs and symptoms. Where possible relate the pathology to identified risk factors (outlined in your introduction), and the biological action of flixotide. Another example would be to review an immunization program. This would involve an explanation of how the infectious agent causes disease and how the associated vaccine stimulates the immune system to protect the vaccinated person from subsequent exposure to the same pathogen. (Write about 900 words for this section.)
  • In the second part of this section, present or review, two RCTs (including a table with each trial summarised) that support the use of the intervention. In order to identify two RCTs and familiarise yourself with the issues around your chosen topic it is best to identify and read a meta-analysis or review on your chosen topic. To do this, conduct an electronic search using key words from your chosen topic. You may need to change or modify these words as you carry out your search depending on how many published papers or reviews are identified in your search. If you choose a drug for your intervention, you may use a phase 3 trial (conducted before and for the purpose of approval) in place of a post-approval RCT, provided the drug is now approved or registered, on the market and being used clinically. If there are two suitable post-approval RCTs, you should use these. (Write about 350 – 400 words for each trial).

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  1. For your discussion, summarise the combined results from your two trials in the context of patient care (benefits and risks) and/or population health within the New Zealand setting. If appropriate explore economic and political influences on the use of the intervention.
  1. *Excludes table in assignment 1, in-text referencing and the reference list.
  2. Rubric
N742 Ass 1 Grading Form
Criteria Ratings Pts
This criterion is linked to a learning outcomeScope

All sections completed and conceptual understanding shown.
• Introduction
• Pathophysiology
• RCTs
• Discussion

50 pts
This criterion is linked to a learning outcomeStructure

Ideas presented succinctly, with excellent flow.

15 pts
This criterion is linked to a learning outcomeReading and Evidence

Relevant research presented, suitable randomised controlled trials and synthesis of evidence and its applicability within the New Zealand setting.

25 pts
This criterion is linked to a learning outcomePresentation

Includes layout of text and table, academic integrity and application of referencing conventions.

10 pts
  1. N742 Ass 1 Grading Form
  2. Total points: 100

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Nursing 742 RCT-Based Assignment 1: Flixotide Intervention for Asthma Management in New Zealand Children

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