Importance of Statistical Research in Medicine

Importance of Statistical Research in Medicine The Nepal Journal of Epidemiology is the first journal of its kind in Nepal. Our main objective in pioneering this journal is to attempt to provide a common platform for all researchers, particularly those doing epidemiological studies on prevailing public health problems in the community. We wish to make this journal one that follows standard criteria of scientific article writing with sound technical knowhow. We have introduced several initiatives to improve the quality, reporting, and transparency of research in general, and randomised trials in particular, by emphasising the importance of protocols. We offer to review protocols to improve trial quality and reduce publication bias. We consider submissions of randomised trials only if registered and accompanied by a protocol, which is sent with the manuscript to peer reviewers. All who use, receive, or pay for health-care interventions depend on guidance from reliable research findings and will want reassurance that medical researc h is credible. Essentially, Nepals research output is still small. More collaboration and partnerships between countries in different regions of Asia and externally must be fostered. Lack of investment in research should also be addressed by nations that are capable of investing more. Research in Nepal can and should flourish over the next decade. A brief review through almost any recently published medical journal will show that statistical methods play an increasingly important role in modern medical research. Many research papers quote at least one p-value to communicate their results while some present the results and the statistical analysis of medical data in relatively sophisticated and complex sets1-8. After extensive study of the available literature and from the personal experience in this domain, I would like to venture a few recommendations for the improvement of various aspects in medical research and its application. I believe that this brief discussion will be of great value to all professionals involved in medical research and its application. Medicine is a science of uncertainty and an art of probability, mused William Osler. Medical journals are a confluence of medicine, science and journalism-and are expected to have the values of all three. The science that underpins medicine is presented in journals, and most journals can point to landmark studies that changed medicine. Medical journals differ from scientific journals in that they are mainly read, not by scientists, but by practicing doctors. Medical journals will continue to be the main vehicle of scientific information for years to come, particularly where access to computer and internet facilities are relatively limited. Currently, the output-and rewards-of research are based almost entirely on published papers in scientific journals. Scientists in low-income and middle-income settings want an opportunity to analyze data for their populations according to their own priorities. They want to be in the frontlines of national and global conversations about their countr ys experiences. Evidence-based medicine provides several ways to quantify and communicate uncertainty, but does so from a probabilistic rather than a human perspective. We can divide Evidence based medicine/clinical epidemiology into two major methodological themes: statistical and implementation. The use and analysis of large trials, meta-analyses, systematic reviews, evidence hierarchies, cost-effectiveness analyses, and number needed to treat would come under the statistical while the improved access to evidence through literature searching, library and critical appraisal tools, guideline development, risk framing, etc. would be implementation. Researchers welcome clinical uncertainty as a source of knowledge gaps, whose answers will be meaningful to clinicians and patients. Clinical epidemiology bridges clinical practice and public health. Policies notwithstanding, despite suggestions to detect and eliminate research misconduct, training in research ethics, standards and responsible conduct is often minimal or absent in academia. The quality of medical journals depends on several factors involving three groups of people: namely the authors, the reviewers and the editors. Deciding who should be listed as an author is not simple, and too often the decision is made on the basis of power. The powerful are included, even when they have done nothing, and the weak are excluded, even though they have done most of the work. This unethical behaviour can become a major problem if the study proves to be fraudulent, as has happened many times. Sometimes journals receive coverage in the media that makes them squirm, particularly when they are exposed as having published research that is fraudulent. I worry that journals are being polluted by misconduct and that editors are not responding adequately. Scientific reading will enhance the quality of scientific writing. Critical reading and thinking will provide a relevant, interesting, feasible, ethical and novel research hypothesis. The author or researcher planning on a research study and publication should search in Medline, PubMed and other search engines for relevant reviews and literature of similar studies in world and national scenario. These studies must be examined for strengths and weaknesses, and the researcher must apply required modifications for new knowledge. It will help the author tremendously in the writing of the introduction, discussion and conclusion part of the manuscript. Before starting data collection, the researcher should decide upon the study design, target population, sample size and sampling method, inclusion exclusion criteria, study period, study variable, outcome measures and units of measurement, definition of all the terms and variables and their classification. After careful consideration, the methodology of data collection and the method of data analysis, including the computer packages and statistical methods, should be chosen. The instruments or questionnaire used to measure the variables should be described correctly and if others have developed them, referenced properly. A researcher should be well aware of the concepts of different types of data and variables, two types of errors (type I and type II errors), calculation of sample size, significance level, confidence interval, testing of hypothesis and power of the test1-11. Once these criteria are followed, the authors should allot paragraphs for each one of them in the material and methods part of the manuscript, thereby increasing the quality of the study. This meticulous planning and execution will be useful to new researchers in this area. The editorial management is a crucial part of the publishing process. The editors begin action with the receipt of the manuscript by directing the various steps of evaluation, correction and re-submission, until an editorial decision is taken to accept the paper as is, accept it after modification or reject it if it is unacceptable. They then make necessary text and layout editing. Due consideration is given to the statistical, multilingual and ethical aspects as well as to the overall uniformity of the terminology, nomenclature and style throughout the volume as a whole. Experts review plays a pivotal role on maintaining the quality of a medical journal. A reviewer is required to address a number of important aspects of the paper and to make recommendation concerning the acceptability of the paper. Findings of good research deserve to be presented well, and a good presentation is as much a part of the research as the painstaking collection and analysis of the data. Critical appraisal of 150 articles published in a reputed medical journal in Nepal reveals that in more than 70% articles experienced biostatisticians were not involved or substantially contributed (not co authored), more than 65% studies sample size calculation were wrong and 80% of the article with inadequate statistical details and wrong statistical tests. Critical reviewers of the biomedical literature have consistently found that more than half of the published articles (including scientific articles, published even in the best journals) that used statistical methods contained unacceptable errors 1-11. The term statistics here in this context, has a wider meaning and includes the methodology of research, study design, or epidemiological methodology etc 1-8. The major applications of biostatistics started in the middle of the 17th century in the analysis of vital statistics. After the early developments in vital statistics, the field of genetics was the next area that benefited most from the new statistical ideas emerging in the works of Charles Darwin (1809-1882), Francis Galton (1822-1910), Karl Pearson (1857-1936), and Ronald A. Fisher (1890-1962). Now, the fields of application and areas of concern of biostatistics include evidence based medicine, bioassays, public health, health service research, nutrition, environmental health, demography, epidemiology, surveys of human populations, community diagnosis, bio-mathematical modelling, clinical trials, brain imaging, genomics and proteomics. Computer-based statistical packages have not yet been given expertise to decide the correct method although they sometimes generate a warning message when the data are not adequate. The user of the package decides the method9. The real solution to poor statistical reporting will come when authors learn more about the statistical methods in research design and when statisticians are able to convey the importance of the methods used in the study to authors, editors, and readers; when researchers begin to involve statisticians from the beginning of research, not at its end; when manuscript editors begin to understand and to apply statistical reporting and editing guidelines; when the journals are able to screen the articles containing statistical analyses more carefully; and when readers learn more about how to interpret statistics and begin to expect and demand, adequate statistical reporting7. A researcher should never hesitate to ask for professional assistance from a biostatistician to plan the study or experiment. There may be valuable research going on in developing and financially less-privileged countries, but it usually does not reach international visibility, in spite of a large number of scientific journals in these countries. Such journals are not only invisible but by perpetuating a vicious circle of inadequacy, may be directly damaging to the local science and research culture. Journals should prevent this by constructing an editorial board including qualified editors from developed and developing countries in the editorial board. I recommend biostatisticians to join as editors and reviewers in order to help formulate journal policy, audit the quality of statistics in published papers, help produce statistical guidelines or checklists for authors, educate editors, provide explanatory statistical comments on published papers, and write expository articles about statistical matters in journals.

Craddock Cup Essay

Background: The Craddock Cup is a regional soccer tournament held by the Craddock Youth Soccer League (CYSL) and managed by Joe Rivaldo every year. The cup brings in around 32 premier high school soccer teams (both boys and girls teams) from throughout the region to compete. Each year the cup is considered a great success by players, their families and the local community and is now widely considered as the premier tournament for high school soccer players. Over the past few years the cup has developed into a showcase event for high school soccer players and has been able to attract the region’s best teams due to the fact that on average 25 college scouts attend the cup each year for recruiting purposes. Main Issue or Problem: The main problem is that of the Craddock Cup being cancelled and Jose Rivaldo the manger of CYSL losing his job. This is due to the issue that, CYSL who fund the Craddock Cup, do so in part to fund a field acquisition program for the league with the expectation the cup will generate at least $6,000 annually towards this goal. However the cups profits are averaging a loss of around $4,000 a year and the board of CYSL is becoming impatient with the lack of profits being generated. Therefore Joe needs to find a solution to increase the cups profitability and by doing so save his job. Three Possible Mutually Exclusive Alternatives that Might be used to Solve the Problem (these must not include the status quo (current practice) and should include at least one alternative that is not mentioned in the case): Alternative| Quantitative Techniques to Use + Reason| Qualitative Issues to Discuss + Reason| Suggested reading (pages) in HDR (2012)| 1. Make changes to the overhead expenses allocated to the tournament including salaries, rent, utilities and field rental.| Relevant cost and relevant revenue analysis. If the cup was to be cancelled then CYSL would still incur the sunk costs of rent, utilities, field rental and Rivaldo’s salary meaning they should not be allocated to the cup. However the cost of Jansten’s salary would be saved if the cup was cancelled.| If the cup was to be cancelled then it would result in the loss of Jansten’s job as his/her employment is solely related to the cup. This could affect the moral of fellow employees.| 415-416, 430-434| 2. Organize a deal with a hotel/s where you arrange accommodation for all the players. In return for the extra business the hotel/s offer you free or discounted accommodation for the college scouts. | Breakeven analysis and contribution margin. If the variable cost of putting the college scouts in hotels (which is a large cost of $4,000) could be eliminated or reduced significantly it would greatly affect the contribution margin of the cup (CM = Sales – VC) as variable costs would decrease significantly. It would also decrease the breakeven point in revenue. | Issues could include the problem of finding a hotel or hotels that will be able to provide enough accommodation for the large amount of players and that will agree to the proposal as the hotel or hotels may feel they will be able to attract the players on their own accord and do not need to avoid losing the additional profit of the scouts by doing so. | 86-88, 90-91, 94| 3. Increase the tournament size from 32 teams to 64 teams. | Incremental profit and costs. If the cup was to increase its size to 64 teams it would bring in additional revenue from the new teams registration fees. Other revenue would also likely increase. While most expenses such as registration fees, face books, hotels and marketing would remain the same as the scouts are only looking for high school players, where the new teams introduced would be from middle schools.| Issues include finding enough teams to be able to expand the tournament along with making sure the suppliers of things such as t-shirts and food can provide enough goods to match the extra demand. Also whether or not the staff can cope with the increased work load or whether another employee will need to be hired.| 421, 579-80, 584-86|

Foundations of Human Development in the Social Environment Essay

Write a 700- to 1,050-word paper in which you examine the foundations of human development in the social environment. Address the following in your paper: Describe the interactions between the bio-psycho-social dimensions of development. Explain the concept of human diversity and cultural competence. Explain the connection between general systems theory and social order. The bio-psycho-social dimensions of human behavior are made up of biological, psychological and, social factors that explain human behavior. The biological dimension refers to the role of biological systems—meaning our bodies. The psychological dimension refers to the role of thoughts, emotion, and behavior on others. The social dimension refers to how individuals relate to various groups and institutions in society–and how groups and institutions relate to individuals, or classes of individuals. Social workers can understand a person’s behavior through subjective development. Viewing problems through a bio-psycho-social lens allows a social worker to help clients solve problems and learn coping skills through an understanding of behaviors and how biological, psychological and social aspects of ones life plays a role in behavior. When a Social worker has a better understanding of a client and the relationships in which the client is incorporated in, the social worker can set up a plan of action and the healing process can begin (Dale, Smith, Norlin,, Chess, ,2009).. The strengths perspective is a tool that helps aids in the understanding of people from different ethnic and cultural backgrounds; diversity. Different segments of society interpret things such as hand motion, eye contact and, other non-verbal communications in different ways. When a social worker can become proficient in cross cultural interaction, they will be much better  able to help clients that are from different cultures and ethnic backgrounds. This proficiency requires intense observation, superior listening skills, and a true desire to learn about different cultures, beliefs and traditions. The concept of human diversity can be described as a person or organization clearly understanding different cultures, languages, and beliefs of people and families from all around the world. Cultural competence can be described as skills, behaviors, attitudes, and policies implemented that assist social workers and organizations to efficiently deal with cross-cultural (socialworker.org, 2014). â€Å"Culture refers to integrated patterns of human behavior that include the language, thoughts, communications, actions, customs, beliefs, values, and institutions of racial, ethnic, religious, or social groups. ‘Competence’ implies having the capacity to function effectively as an individual and an organization within the context of the cultural beliefs, behaviors, and needs presented by consumers and their communities. (Minorityhealth.hhs.gov ,Adapted from Cross, 1989).† According to NAACP.org, cultural competence also focuses on population specific issues such as health related beliefs, cultural values, disease prevalence, and treatment efficiency. A culturally proficient social worker can make the difference in the success and failure of their clients. In the human service field when a social worker has an understanding of human diversity and cultural competence he or she can better understand clients from diverse backgrounds such as those with disabilities, the elderly, and the gay and lesbian community (NAACP.org, 2014). General systems theory is comparable to business and industry in the manner in which it is structured. In the business world, inputs are managed by organizational systems to produce outputs. In the field of social work, social workers use resources (inputs) to develop processes and procedures to produce services (outputs). Systems theory can help social work professionals comprehend how systems establish and the order of that social system. When explaining the connection between general systems theory and social order one must describe the two individually. General systems theory can be defined as components, which are in transaction and bounded. The components complement a system that functions within an environment. A component can be anything and exchanges are any relationship that exists between the components. A person is able to be aware of the boundaries  because it is what he or she can see, hear, feel, or sense. Social order is described as the demeanor in which a culture is organized and the standards that are required to manage the organization. Looking at what general systems theory and social order are separately one can see that both deal with groups and environments when working in human services both can work hand in hand when trying to find help and create goals for clients. The general systems theory is used in all aspects of social work, such as children and families, policymaking, and advocacy. Social order refers to a relatively stable system; institution, pattern of interactions, customs, and facts regarding society. To have a systems theory there must be social order. Without social order, one cannot determine the causes and factors within an environment that are causing a problem. Without social order we cannot provide proper treatment. Social order gives us a set of norms within a system. Without social order one cannot use systems theory (Mosby, 2009). In social services, bio-psycho-social dimensions, human diversity, cultural competence, general systems theory, and social order all work together to create a better environment for their clients, and enable social work professionals to better serve their clients. References Dale, O., Smith, R., Norlin, J., & Chess, W. (2009). Human behavior and the social environment: Social systems theory. (6th ed.). Boston: Pearson/Allyn and Bacon Zastrow, C., & Ashman, K. (1990). Understanding human behavior and the social environment (2nd ed.). Chicago: Nelson-Hall. Naacp.org, 2014

University of Mississippi Acceptance Rate, SAT/ACT Scores, GPA

The University of Mississippi is a public research university with an acceptance rate of 88%. Located in Oxford and better known as Ole Miss, University of Mississippi is part of the state of Mississippi university system. Ole Miss was the first publicly funded university in the state to be awarded a chapter of  Phi Beta Kappa, the prestigious undergraduate honor society. The campus houses 30 different research centers, and high achieving students may want to consider the  Sally McDonnell Barksdale Honors College. In athletics, the Ole Miss Rebels compete in the NCAA Division I  Southeastern Conference. Popular sports include football, basketball, soccer, tennis, track and field, and golf.   Considering applying to Ole Miss? Here are the admissions statistics you should know, including average SAT/ACT scores and GPAs of admitted students. Acceptance Rate During the 2017-18 admissions cycle, the University of Mississippi had an acceptance rate of 88%. This means that for every 100 students who applied, 88 students were admitted, making Ole Miss admissions process less competitive. Admissions Statistics (2017-18) Number of Applicants 15,371 Percent Admitted 88% Percent Admitted Who Enrolled (Yield) 25% SAT Scores and Requirements Ole Miss requires that all applicants submit either SAT or ACT scores. During the 2017-18 admissions cycle, 25% of admitted students submitted SAT scores. SAT Range (Admitted Students) Section 25th Percentile 75th Percentile ERW 530 640 Math 520 630 ERW=Evidence-Based Reading and Writing This admissions data tells us that most of University of Mississippis admitted students fall within the top 35% nationally on the SAT. For the evidence-based reading and writing section, 50% of students admitted to Ole Miss scored between 530 and 640, while 25% scored below 530 and 25% scored above 640. On the math section, 50% of admitted students scored between 520 and 630, while 25% scored below 520 and 25% scored above 630. Applicants with a composite SAT score of 1270 or higher will have particularly competitive chances at Ole Miss. Requirements Ole Miss does not require the SAT writing section. Note that University of Mississippi does not superscore SAT results, your highest composite score will be considered. ACT Scores and Requirements Ole Miss requires that all applicants submit either SAT or ACT scores. During the 2017-18 admissions cycle, 86% of admitted students submitted ACT scores. ACT Range (Admitted Students) Section 25th Percentile 75th Percentile English 22 32 Math 20 27 Composite 21 29 This admissions data tells us that most of University of Mississippis admitted students fall within the top 42% nationally on the ACT. The middle 50% of students admitted to Ole Miss received a composite ACT score between 21 and 29, while 25% scored above 29 and 25% scored below 21. Requirements Note that Ole Miss does not superscore ACT results; your highest composite ACT score will be considered. The University of Mississippi does not require the ACT writing section. GPA In 2018, the average high school GPA for incoming University of Mississippi freshman was 3.58. This data suggests that most successful applicants to Ole Miss have primarily A and B grades. Self-Reported GPA/SAT/ACT Graph University of Mississippi Applicants Self-Reported GPA/SAT/ACT Graph. Data courtesy of Cappex. The admissions data in the graph is self-reported by applicants to the University of Mississippi. GPAs are unweighted. Find out how you compare to accepted students, see the real-time graph, and calculate your chances of getting in  with a free Cappex account. Admissions Chances The University of Mississippi, which accepts nearly ninety percent of applicants, has a slightly selective admissions process. If your SAT/ACT scores and GPA fall within the schools average ranges, you have a strong chance of being accepted. In the graph above, the blue and green dots represent accepted students. The majority of admitted students had high school GPAs of B- or higher, SAT scores (ERWM) of 950 or above, and ACT composite scores over 19. Numbers a little higher than this lower range can improve your chances of getting in. Youll notice a few red dots (rejected students) and yellow dots (waitlisted students) hidden behind the blue and green on the left side of the graph. Some students with grades and standardized test scores on target for Ole Miss did not get in. On the flip side, quite a few students were accepted with test scores and grades a bit below the norm. This is because the University of Mississippi admissions process is not entirely quantitative. Grades and test scores play the largest role in the process, but Ole Miss is also looking for students who completed a challenging college preparatory curriculum. Admission standards vary for in-state and out-of-state applicants. In some situations, Ole Miss will take into consideration a students extracurricular activities, community service, work experiences, and special life circumstances. If You Like Ole Miss, You May Also Like These Schools Auburn University, University of Florida, Florida State University, University of Kentucky, and Clemson University All admissions data has been sourced from the National Center for Education Statistics and University of Mississippi Undergraduate Admissions Office.