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Critique of LiteratureMarcie Chenette NURS 531A Randomized Trial of the Efficacy of Hand Disinfection for Prevention of Rhinovirus InfectionSource Credibility: Turner is a medical doctor affiliated with the Department of Pediatrics, University of Virginia, Charlottesville. Fuls, Rogers, Lockhart, and Aust are associated with Henkel, and Goldfarb is affiliated with Statistics and Data Corporation, Tempe, Arizona. A few conflicts of interest arise from this research. The study is funded by the Dial Corporation, which is owned by Henkel. Turner is a consultant for Henkel and received grant funding for the study. Additionally all of the authors are employed or have been employed by Henkel. Peer reviewed: I searched the website and could not find that it was peer reviewed, but did completed a search on Ferris State University website and found it to be peer reviewed in that search.Well-written/referenced: Study is well written and references are of good quality.Purpose and problemSubject clarity: Does hand disinfection prevent rhinovirus (RV) infection and RV associated common colds in a natural setting?Identification of independent/dependent variables: Independent variables are disinfecting hands with antiviral hand treatment (I) and no treatment (C). Dependent variable prevention of RV infection or RV-associated common cold illnesses (O).Hypothesis, question, aim: In a natural setting, do adults who use hand sanitizer have a lower incidence of RV related infections?Literature and backgroundConsistent with purpose: Studies have been completed on the experimental side, but wanted to conduct a study in a natural setting.Identifies why this study is necessary: Successful prevention of RV related infections would be important for both medical morbidity and economic cost.Theory or sub-theory used to guide study: Hand to hand transfer of RV has been proven to be a likely transmission of RV, would inactivating the RV on the hand be an effective method of prevention?DesignExperimental/non-experimental/applied: This would be an experimental study since they are introducing an intervention that being utilizing hand sanitizerQuantitative, qualitative, or mixed: QuantitativeSpecific design: Randomized controlled trial that lasted 9 weeks in duration. Level of evidence: Level II Randomized controlled trialMethodsSubject recruitment: Adult volunteers age >18 years were recruited from the University of Virginia community. Those with skin conditions that could impact the study or those whose occupation required frequent hand washing were excluded from the study. They were compensated for participation.Sample description: Volunteers were assigned a randomized subject number and based off of that number they were placed in either the active hand treatment (lotion containing 62% ethanol, 2% citric acid, and 2% malic acid) which was applied every 3 hours while subject was awake or the no treatment control group. 212 subjects were enrolled (116 in the treatment group and 96 in the control group).Method for gathering data: Volunteers kept a daily diary of application of product and common cold symptoms. All volunteers gave weekly nasal lavage samples which were assayed by polymerase chain reaction for the presence of RV.Ethical consideration: Written informed consent was obtained and volunteers were compensated for participating.Validity and ReliabilityPotential threats: Compliance with the hand treatmentHow addressed/determined: Volunteers using the hand treatment came for an additional visit each week for the first 5 weeks to access and reinforce compliance with the study.Analysis Level of measurement and consistency with statistical methods used: Primary efficacy was assessed by a Poisson regression (log linear model). Secondary analysis compared the common cold and RV infections in each treatment group using x2 testsAnalysis: Analysis was performed on both the intent to treat (ITT) and per protocol (PP) populations. ITT included all the available data from the randomized. PP populations were those who completed the hand treatment expected 90% of the time.Statistical and/or clinical significance: ITT analysis showed 45 of the 116 treated subjects had at least 1 RV infection compared with 47 of the 96 control subjects (p=.3). 26 of the treated subjects had at least 1 RV-associated illness compared with 23 in the control group (p>.5). Findings Interpretation of the results consistent with the findings: The interpretation of the results that hand treatment in a natural setting did not significantly reduce RV infection or RV-related common cold was consistent with the findings reported. However it did reduce the number of common cold illnessesClarity of findings: The findings were clear and easy to read.Appropriateness and relevancy of visuals used (tables/graphs/plots): Study used a flow diagram to show the passage of the participants through the study. A plot graph was also used to compare the first rhinovirus-associated illness in the treatment and no-treatment (control) groups.Results of this study: Use of virucidal hand treatment had no significant impact on the incidence of RV infection or RV-associated illness.Casual claims and are they justified: They make a possible claim that the virus in the nasal secretions possibly protects it from the hand treatment, but that further investigation would be needed.Consistency with existing literature on topic. Does this study make a contribution to evidence? Most of the studies on this subject have been completed in an experimental setting. A previous study that did find beneficial was focused on preventing infection in mothers in contact with children in the home. The results from this study may vary from the previous study because they subjects were outside the home. I believe this makes a contribution to petitive explanations provided: Evaluation What are your doubts about the validity of the study findings? At first I thought that because all of the authors were employed by the company that makes anti-bacterial soap and that the funding also was provided by Dial that this study would be swayed. How might this study be improved? They could have used different types of hand treatment.How might this study be translated into practice? Since this study did not include individuals whose job included washing their hands several time or in a hospital setting I would not incorporate this into nursing practice.Turner, R.B., Fuls, J.L., Rodgers, N.D., Goldfarb, H.B., Lockhart, L.K., & Aust, L.B. (2012). A randomized trial of the efficacy of hand disinfection for prevention of rhinovirus infection. Clinical infectious diseases : An official publication of the Infectious Diseases Society of America, 54(10), p.1422-6.Effects of a Mindful Meditation Course on Learning and Cognitive Performance among University Students inTaiwanSource Credibility: No credentials were listed. Ching is associated with the Department of Natural Biotechnology, Nanhua University, Dalin, Chaiyi, Taiwan. Koo is associated with Department of Medical Research, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Dalin, Chiayi, Taiwan and Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada. Tsai is affiliated with Department of Psychiatry, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundatio, Dali, Chiayi, Taiwan. Chen is associated with the Department of Natural Biology list under Ching and Research and Extension Center of Natural Healing Sciences, Nanhua University, Dalin, Chiayi, Taiwan. Peer reviewed: I searched the website and could not find that it was peer reviewed, but did completed a search on Ferris State University website and found it to be peer reviewed in that search. It does classify as an evidence-based website and does list a Publication Ethics.Well-written/referenced: Study is well written and references are of good quality.Purpose and problemSubject clarity: Does the effects of a curriculum-based mindfulness meditation course improve learning performances in Asian students?Identification of independent/dependent variables: Independent variables are mindfulness meditation course (I) and not taking the meditation course (C). Dependent variable benefits for both mental and physical health (O).Hypothesis, question, aim: In Asian students does curriculum-based mindfulness compared to no curriculum benefit the students mental and physical health?Literature and backgroundConsistent with purpose: Studies have been completed on mindfulness training, but few have addressed this with Asian students.Identifies why this study is necessary: To study the effects of mindfulness training on Asian students.Theory or sub-theory used to guide study: Mindfulness meditation practice promotes present moment awareness. Mindfullness meditation has been shown to help many mental and physical issues. Will it help improve attention, cognition, and academic performance?DesignExperimental/non-experimental/applied: This would be an experimental study since they are introducing an intervention, that being a one-semester mindfulness meditation course.Quantitative, qualitative, or mixed: QuantitativeSpecific design: Quasi-experimental pre/posttest. Level of evidence: Level II Single Non-Randomized Trial (Quasi-Experiment)MethodsSubject recruitment: A new curriculum added at a university in Taiwan which mandated a credited course for all first-year students. The study used the first semester students as the study group and those signed up for the second semester as the control.Sample description: A total of 359 students, 204 in the intervention group and 155 in the control group. During the study 52 dropped out of the intervention group and 25 dropped from the control group. Method for gathering data: The College Learning Effectiveness Inventory and computer cognitive tasks were used. The pretest was given at 3 weeks and the posttest at 15 weeks.Ethical consideration: Study was approved by the Institutional Review Board of the Buddhist Dalin Tzu Chi Hospital, Taiwan and approval was obtained from the course instructor.Validity and ReliabilityPotential threats: Motivation of the students may have been engaged since this was a mandated class. Also stress levels may be higher at the beginning of the school year as opposed to the end.How addressed/determined: None.Analysis Level of measurement and consistency with statistical methods used: Chi-square test was used to compare the variables sex, religious affiliations, perceived health status, experience practicing mindfulness mediation and college of study. Chi-squared test was used to compare the variables in the intervention group and the control. Independent t-test was used to compare the posttest minus pretest. Analysis of covariance was used to compare scores from the CLEI.Analysis: All analysis were conducted using IBM SPSS Statistics software package, version 21.0 A p<0.05 was considered statistically significant. Statistical and/or clinical significance: xxITT analysis showed 45 of the 116 treated subjects had at least 1 RV infection compared with 47 of the 96 control subjects (p=0.3). 26 of the treated subjects had at least 1 RV-associated illness compared with 23 in the control group (p>.5). Findings Interpretation of the results consistent with the findings: The interpretation of the results that one semester of mindfulness meditation improved learning performance was shown by the least squats mean scores of the full CLEI scale (P=0.022). Computer cognitive tasks showed better performance in the accuracy of digital vigilance task (P=0.48), choice reaction time (P=0.004), and spatial working memory (P=0.042).Clarity of findings: The findings were clear and easy to read.Appropriateness and relevancy of visuals used (tables/graphs/plots): Tables were used to show the characteristics, CLEI, and ANCOVA.Results of this study: One semester mindfulness meditation course did show it improved learning performance. However, of the nine subscales none showed a significant difference was not noticed between the intervention group and the control. It improved the accuracy of digital vigilance task, choice reaction time, and spatial working memory.Casual claims and are they justified: Based off of some of the limitations to the study further research would be needed.Consistency with existing literature on topic. Does this study make a contribution to evidence? The literature review showed that mindfulness meditation should decrease stress and improve classroom behavior. I think this study has some variances that decrease the petitive explanations provided: NoneEvaluation What are your doubts about the validity of the study findings? One thing mentioned in the study that may affect the study include a lack of randomization. How might this study be improved? Offering the class as an elective and studying it versus a mandatory class.How might this study be translated into practice? The study shows that mindfulness training may increase participant’s cognitive performance and mood. This could benefit nurses and patients in stressful situations.Ching, H., Koo, M., Tsai, T., & Chen, C. (2015). Effects of a mindfulness meditation course on learning and cognitive performance among university students in Taiwan. Evidence-Based Complementary and Alternative Medicine, Vol. 2015. doi:10.1155/2015/254358Mindfullness-Based Stress Reduction for Long-term Physical Conditions: A systematic ReviewSource Credibility: No credentials were listed. Crowe and Jordan are associated with the Department of Psychological Medicine, University of Otago-Christchurch, New Zealand. Crowe, Jordan, Burrell, Jones, Gillon, and Harris are associated with the Centre for Postgraduate Nursing, University of Otago-Christchurch, New Zealand. Peer reviewed: Is a peer-reviewed journal.Well-written/referenced: Study is well written and references are of good quality.Purpose and problemSubject clarity: Identify whether mindfulness-based stress reduction (MBSR) is effective in improving physical health outcomes for long-term physical conditions.Identification of independent/dependent variables: Independent variable is mindfulness stress reduction (I). Dependent variable is effective improved benefits for both mental and physical health (O).Hypothesis, question, aim: Is MBSR an effective intervention for improving physical outcomes for people with long-term physical conditions?Literature and backgroundConsistent with purpose: Studies have shown that mindfulness interventions are clinically effective for depression and anxiety. Since depression and anxiety co-occur with physical health conditions would MBSR be effective for physical health conditions as well. Identifies why this study is necessary: To study the effects of MBSR on long-term physical conditions.Theory or sub-theory used to guide study: MBSR has been shown to improve anxiety and depression symptoms. Based of the co-occurrence of depression and anxiety and physical health conditions. MBSR should improve physical health conditions also. DesignExperimental/non-experimental/applied: This would be an experimental study since they are introducing an intervention, that being MBSR.Quantitative, qualitative, or mixed: QuantitativeSpecific design: Systematic review of randomized controlled trials and pre/post-tests.Level of evidence: Level I Systematic ReviewMethodsSubject recruitment: Databases searched for Chronic disease, mindfulness, long-term conditions, and intervention studies/or interventions.Sample description: Criteria for consideration included intervention studies, adult participation (aged>18), community-based, MBSR intervention, participants have long-term physical symptoms and/or condition, physical health outcomes measured, published before August 2014. Method for gathering data: Database search found 3821 articles based of search criteria, of those 499 title and abstract were screened and 452 were excluded, full text was reviewed and 27 were excluded. The remaing15 studies met quality appraisal and were included in the review.Ethical consideration: None noted.Validity and ReliabilityPotential threats: Motivation of the students may have been engaged since this was a mandated class. Also stress levels may be higher at the beginning of the school year as opposed to the end.How addressed/determined: None.Analysis Level of measurement and consistency with statistical methods used: Chi-square test was used to compare the variables sex, religious affiliations, perceived health status, experience practicing mindfulness mediation and college of study. Chi-squared test was used to compare the variables in the intervention group and the control. Independent t-test was used to compare the posttest minus pretest. Analysis of covariance was used to compare scores from the CLEI.Analysis: All analysis were conducted using IBM SPSS Statistics software package, version 21.0 A p<0.05 was considered statistically significant. Statistical and/or clinical significance: xxITT analysis showed 45 of the 116 treated subjects had at least 1 RV infection compared with 47 of the 96 control subjects (p=0.3). 26 of the treated subjects had at least 1 RV-associated illness compared with 23 in the control group (p>.5). Findings Interpretation of the results consistent with the findings: The interpretation of the results that one semester of mindfulness meditation improved learning performance was shown by the least squats mean scores of the full CLEI scale (P=0.022). Computer cognitive tasks showed better performance in the accuracy of digital vigilance task (P=0.48), choice reaction time (P=0.004), and spatial working memory (P=0.042).Clarity of findings: The findings were clear and easy to read.Appropriateness and relevancy of visuals used (tables/graphs/plots): Tables were used to show the characteristics, CLEI, and ANCOVA.Results of this study: One semester mindfulness meditation course did show it improved learning performance. However, of the nine subscales none showed a significant difference was not noticed between the intervention group and the control. It improved the accuracy of digital vigilance task, choice reaction time, and spatial working memory.Casual claims and are they justified: Based off of some of the limitations to the study further research would be needed.Consistency with existing literature on topic. Does this study make a contribution to evidence? The literature review showed that mindfulness meditation should decrease stress and improve classroom behavior. I think this study has some variances that decrease the petitive explanations provided: NoneEvaluation What are your doubts about the validity of the study findings? One thing mentioned in the study that may affect the study include a lack of randomization. How might this study be improved? Offering the class as an elective and studying it versus a mandatory class.How might this study be translated into practice? The study shows that mindfulness training may increase participant’s cognitive performance and mood. This could benefit nurses and patients in stressful situations.Ching, H., Koo, M., Tsai, T., & Chen, C. (2015). Effects of a mindfulness meditation course on learning and cognitive performance among university students in Taiwan. Evidence-Based Complementary and Alternative Medicine, Vol. 2015. doi:10.1155/2015/254358 ................
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