NR 503 Week 3 Discussion<\/figcaption><\/figure>\nThe Centers for Disease Control and Prevention (CDC). (2018). 2018 Democratic Republic of the Congo, Bikoro. Retrieved from https:\/\/www.cdc.gov\/vhf\/ebola\/outbreaks\/drc\/2018-may.html<\/span><\/p>\nThank you for opening up the discussion this week! You’ve selected a great study for discussion. Generally speaking, case control study designs, as well as cohort studies\u202fare good for understanding\u202fcausation of\u202fdisease (<\/span>if the exposure is associated with the outcome<\/span><\/i>).\u202fAs you mention, case control studies\u202fare considered observational and researchers use this study design to compare persons with a disease to those without the disease when both groups have a history or exposure (e.g., vaccinated people who developed the flu compared to vaccinated peopled who did not develop the flu). This is an interesting study, especially since case control designs are often used in rare disease or outbreaks compared to cohort studies, which are more ideal for comparing exposure and disease.<\/span>\u00a0<\/span><\/p>\nA 2005 study published in Nature and directed by Eric Leroy tested more than 1,000 small vertebrates in central Africa and found evidence of asymptomatic Ebola infection in three species of frugivorous bats, which led him to believe that perhaps these animals that sometimes they hunt to consume their meat, were the reservoir of the virus (Kupferschmidt,\u202f2017). Humans can become infected by hunting and eating infected meat or by direct contact with bats. Once infected, the human can transmit the virus to others.\u202f<\/span><\/p>\nMoreover, Ebola has an incredible ability to take over the body fluids of men who have survived the disease long after they have healed. In fact, one study found that more than half of men who survived the West African epidemic tested positive for Ebola in semen a year or more after recovery\u202f(CDC, 2016). In one case, the analysis yielded a positive result no less than 565 days after the cure (CDC, 2016). Because of the risk of the disease spreading, survivors are advised to avoid having unprotected sex until their semen has twice tested negative for the presence of the virus. It is estimated that each infected person infects an average of two other people (Doucleff, 2014).<\/span><\/p>\n The bodies of deceased people remain highly infectious for about seven days. Although Ebola has often been classified as a hemorrhagic fever, WHO and other experts begin to avoid the term as not all individuals present with visible hemorrhages (WHO,\u202f2014). In fact, the evolution is as follows: the first symptoms (tiredness, nausea, fever, headache) are similar to those of diseases such as influenza and malaria, which makes early diagnosis difficult. As the infection progresses, muscle aches, fever and headache become more pronounced and diarrhea and vomiting appear. Often, there is bleeding from the nose or gums. Death occurs within two weeks after the onset of the first symptoms (WHO, 2014).\u202f<\/span>\u00a0<\/span><\/p>\nThe\u202frVSV-ZEBOV vaccine, specific for the Zaire strain and not yet approved, was developed by the National Microbiology Laboratory of Canada, tested in Guinea and Sierra Leone during the 2014-2016 epidemic and then purchased by the company. Pharmaceutical Merck, which holds the rights. 100% of the people vaccinated did not develop the\u202fdisease. However, it was the end of the outbreak and the actual efficacy of this compound must still be proven\u202f(Medaglini\u202f& Siegrist, 2017).\u202fThe first trials with the candidate vaccines show that they are safe and that they induce an immune response. What is not yet known is the level of protection and the duration of it. Even if the vaccines do not confer lasting protection, they can be used in\u202ffuture outbreaks to protect the most exposed populations (health workers, among others). Moreover, there is currently no approve vaccine or specific treatments for Ebola. For now, the most effective way to limit in part the mortality caused by the virus is to provide intensive support care, which consists in restoring liquids and electrolytes lost by diarrhea and vomiting.\u202f<\/span>\u00a0<\/span><\/p>\nCDC (2016). Virus Linger Longer than Expected in Semen. Retrieved on July 8, 2018 from\u202fhttps:\/\/www.cdc.gov\/media\/releases\/2016\/p0830-ebola-virus-semen.html\u202f<\/span>\u00a0<\/span><\/p>\nDoucleff, M. (2014).\u202fNo, Seriously, How Contagious Is Ebola?. Public Health. Retrieved on July 12, 2018 from https:\/\/www.npr.org\/sections\/health-shots\/2014\/10\/02\/352983774\/no-seriously-how-contagious-is-ebola\u202f<\/span>\u00a0<\/span><\/p>\nKupferschmidt, K. (2017).Hunting for Ebola among the bats of the Congo. Since AAAS.\u202f (361)6398. doi:10.1126\/science. Aan6907\u202f<\/span>\u00a0<\/span><\/p>\nWHO (2014). Ebola Response Team. Ebola virus disease in West Africa \u2014 the first 9 months of the epidemic and forward projections. N\u202fEngl\u202fJ Med.371:1481-1495\u202f<\/span>\u00a0<\/span><\/p>\nAs future APNs, you will need to be able to identify best practices, which will\u202finclude evaluating and incorporating published research into your practice.\u202f<\/span>\u00a0<\/span><\/p>\nI’ve listed below some guidelines that you may find useful when\u202fcritiquing research studies.\u202f<\/span>\u00a0<\/span><\/p>\nArticle Title<\/span><\/b>\u00a0<\/span><\/h3>\n\n- Is the title concisely stated?<\/span>\u00a0<\/span><\/li>\n
- Does the title convey the content of the study?<\/span>\u00a0<\/span><\/li>\n<\/ul>\n
\n- Introduction<\/span><\/b><\/li>\n
- Statement of the Problem<\/span><\/li>\n<\/ol>\n
\n- Is the problem significant?<\/span>\u00a0<\/span><\/li>\n
- Is the problem clearly and completely formulated?<\/span>\u00a0<\/span><\/li>\n
- Is the general scope of the study adequately presented?<\/span>\u00a0<\/span><\/li>\n
- Is the purpose of the study precisely stated?<\/span>\u00a0<\/span><\/li>\n<\/ul>\n
\n- Related Research<\/span><\/li>\n<\/ol>\n
\n- Is previous research related to the study presented?<\/span>\u00a0<\/span><\/li>\n
- Is the cited research relevant to the study presented?<\/span>\u00a0<\/span><\/li>\n
- Is a succinct and meaningful summary presented?<\/span>\u00a0<\/span><\/li>\n<\/ul>\n
\n- Hypotheses or Questions<\/span><\/li>\n<\/ol>\n
\n- Are the hypotheses to be tested or the questions to be answered clearly stated?<\/span>\u00a0<\/span><\/li>\n<\/ul>\n
\n- Assumptions and Delimitations<\/span><\/li>\n<\/ol>\n
\n- Are the assumptions underlying the study made explicit?<\/span>\u00a0<\/span><\/li>\n
- Are these assumptions reasonable?<\/span>\u00a0<\/span><\/li>\n<\/ul>\n
\n- Operational Definitions<\/span><\/li>\n<\/ol>\n
\n- Are essential concepts or terms clearly defined or explained?<\/span>\u00a0<\/span><\/li>\n<\/ul>\n
\n- Are the definitions or explanations meaningful?<\/span>\u00a0<\/span><\/li>\n<\/ul>\n
\n- Method<\/span><\/b><\/li>\n
- Population and Sample<\/span><\/li>\n<\/ol>\n
\n- Are the characteristics of the selected population and sample (size, source, nature,\u202fetc.) fully presented?\u202f<\/span>\u00a0<\/span><\/li>\n
- Is the sampling method indicated?<\/span>\u00a0<\/span><\/li>\n<\/ul>\n
\n- Research, Instruments and\/or Apparatus<\/span><\/li>\n<\/ol>\n
\n- Are the techniques employed (e.g. interview, questionnaire, apparatus, tests, etc.)\u202fclearly and fully described?\u202f<\/span>\u00a0<\/span><\/li>\n<\/ol>\n
\n- Are the instruments or techniques appropriate for collecting the data?<\/span>\u00a0<\/span><\/li>\n<\/ol>\n
\n- If tests were used, what evidence is presented regarding their rationale, reliability,\u202fand validity?\u202f<\/span>\u00a0<\/span><\/li>\n<\/ol>\n
\n- Procedure<\/span><\/li>\n<\/ol>\n
\n- Is the design or procedure clearly and fully reported?<\/span>\u00a0<\/span><\/li>\n<\/ol>\n
\n- Are appropriate statistical methods used in analyzing the data?<\/span>\u00a0<\/span><\/li>\n<\/ol>\n
\n- Can the study be replicated?<\/span>\u00a0<\/span><\/li>\n<\/ol>\n
III. Results and Conclusions\u202f<\/span><\/b>\u00a0<\/span><\/h3>\n\n- Are the findings intelligibly reported in textual presentation?<\/span>\u00a0<\/span><\/li>\n<\/ol>\n
\n- Are the conclusions logically drawn (i.e. based on the data presented)?<\/span>\u00a0<\/span><\/li>\n<\/ol>\n
\n- Are tables and figures used appropriately?<\/span>\u00a0<\/span><\/li>\n<\/ol>\n
\n- Discussion<\/span><\/b><\/li>\n<\/ol>\n
\n- Are the findings discussed adequately and meaningfully?<\/span>\u00a0<\/span><\/li>\n<\/ol>\n
\n- Does the investigator indicate the possible implications of the study?<\/span>\u00a0<\/span><\/li>\n<\/ol>\n
\n- Are these implications meaningful?<\/span>\u00a0<\/span><\/li>\n<\/ol>\n
\n- Are limitations of the study recognized?<\/span>\u00a0<\/span><\/li>\n<\/ol>\n
\n- What are some other limitations that were not mentioned?<\/span>\u00a0<\/span><\/li>\n<\/ol>\n
\n- Are any suggestions offered regarding avenues for further research?<\/span>\u00a0<\/span><\/li>\n<\/ol>\n
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