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REAP

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Research, Ethics And Publications; Overview

REAP

  1. 1. AIIMS-REAPAIIMS-REAP Workshop on Research, Ethics and Publication
  2. 2. Introduction  Nurses are the backbone of any hospital and can greatly contribute to improving patient outcome by doing research on their day-to- day clinical activities thus not only proving professional gain but also personal satisfaction.
  3. 3. What Is Research?  Systematic inquiry using disciplined methods to solve problem Nursing research  Systematic inquiry to develop knowledge about issues of importance to the nursing profession Research
  4. 4. Research  Basic: Extend information for sake of knowledge  Applied: Discovering solutions to immediate problems
  5. 5. Consumer–Producer Continuum Consumers: Nurses who read and evaluate research reports or summaries Producers: Nurses who design and undertake research studies
  6. 6. Sources of Evidence for Nursing Practice  Tradition  Authority  Clinical experience, trial and error, intuition  Logical reasoning (inductive and deductive)
  7. 7. Key Evidence-Based Practice  Treatment/therapy/intervention  Assessment and diagnosis  Prognosis  Harm and etiology  Meaning and process
  8. 8. Research Utilization (RU) Versus Evidence-Based Practice (EBP)  Research utilization (RU) The use of study findings in a practical application unrelated to the original research  Evidence-based practice (EBP) Basing clinical decisions on best possible evidence—especially high-quality research
  9. 9. Resources for Evidence- Based Practice  Systematic reviews  Clinical practice guidelines  Care bundles  Other preappraised evidence
  10. 10. Research Integration and Synthesis Forms of integrative reviews:  Narrative, qualitative integration (traditional review of quantitative or qualitative results)  Meta-analysis (statistical integration of results)  Metasynthesis (theoretical integration of qualitative findings)
  11. 11. Key Challenges of Doing Research  Conceptual  Financial  Administrative  Practical  Ethical  Clinical  Methodologic
  12. 12. Barriers to Using Research in Nursing Practice Quality and nature of the research Characteristics of nurses Organizational factors
  13. 13. Why Research is Essential? • Writing for publication in nursing is essential to disseminate evidence, share initiatives and innovations with others, provide new information to keep nurses up-to-date, communicate the findings of research studies, and develop the science base of the profession. • Writing an effective scientific paper is not easy, but the process can be simplified by understanding how to develop a manuscript and submit it for publication
  14. 14. How Will REAP -AIIMS Help You?  A major goal of this course is the ability to conduct research and development of effective technical writing skills.  After the course, you will be better motivated to conduct research, write the research into a paper and have it presented at conference.
  15. 15. AIIMSONIAN OF AMERICA AWARD Ms. Anjusha Thomas Best Research Nurse 2009 Ms. Metilda Robin- Best Nurse 2009 Ms Sonia Chauhan Best Research Nurse 2010 Ms Anu Susan Best Nurse In Community Health 2010
  16. 16. Mrs. Jacintha Gunjiyal (HICN) NATIONAL FLORENCE NIGHTINGALE AWARD 2011
  17. 17. Nurses’ Role in Using Research Evidence  Read widely and critically  Attend professional conferences  Learn to expect evidence that a procedure is effective  Become involved in a journal club  Pursue and participate in Research Utilization/Evidence Based Practice projects
  18. 18. If its not published, it didn’t happen
  19. 19. Why do research? • Curiosity • Question in day to day life • Build upon previous work • Do good
  20. 20. Why Do Research? • Promotion? • Fame? (Desire to be known among peers) • Altruistic?
  21. 21. Tell Others?  Desire to inform  Basic instinct  Ideas- Communicate
  22. 22. Communication  Why?  Tell others, learn from others  2-way process  Exchange information
  23. 23. Scientific Communication  Purpose same, Style different
  24. 24. Types of Research  Written  Research paper, review, letter, comment, editorial….  Oral  Research, Oration…  Poster  Research
  25. 25. Written Communication  Most Important  For posterity: factual, comprehensive  Can be referred to repeatedly  Change not possible  Writing skills  Limited interaction, delayed  Demanding: write and re- write
  26. 26. Communicate  Do it all the time:  informal, unstructured, on the job  Not taught
  27. 27. Importance • Necessary : inform, educate • Unending process • Learn ground rules • Get past ‘gatekeepers’ • Build on a strong base • Creative
  28. 28. Quality Communication • Get Noticed : Recognition • Effective • Accurate, brief, complete, ‘story’ • Poor communication • Criticism, hurts ego
  29. 29. Why Publish?
  30. 30. IMRAD Format, Introduction
  31. 31. Parts of a Paper  Beginning  Main Body  End
  32. 32. Parts of a Paper I Introduction M Methods R Results A And D Discussion
  33. 33. Bradford Hill’s Questions Introduction Why did you start?  Methods What did you do? Results What did you find?  And Discussion What does it all mean?
  34. 34. Introduction (Why did you start)  Rationale of the study  Supply sufficient background information to allow a reader to understand and evaluate the results of present study without referring to previous publications on the topic  Concise, adequate, not a detailed review.
  35. 35. Introduction  Review pertinent literature to orient the reader.  Define lacunae and shortcomings in current state of knowledge.  Provide rationale for the current study  What gap in knowledge did you try to fill?  What controversy did you try to resolve?  State the aim of the study.
  36. 36. Introduction Brief, clear, to the point Written in present tense Clearly defines nature and scope of the problem investigated May state the study group, study design and methods used ( How and why are these better than those of previous studies) May state the principal result/conclusion
  37. 37. Introduction  Key references to support the background information provided  Refer to your  Previous preliminary work  Closely related papers appearing elsewhere  Define any specialized terms, definitions or abbreviations you intend to use
  38. 38. Introduction: Common problems  Historical details  Frequently too long  Too general and vague  Contains ‘discussion’ material  Imitative
  39. 39. Summary  Why did you start?  4 sentences  Background  Gap in knowledge  Question  Study design  Be brief and focused
  40. 40. LANGUAGE AND WRITING STYLE
  41. 41. Scientific Writing: Orwell’s Rules  Never use a metaphor, simile or figure of speech  Never use a long word, if a short one will do  If you can cut a word out, do it  Never use the passive, when you can use the active  Never use a foreign phrase, a scientific word or a jargon word if you can think of an everyday English equivalent
  42. 42. Language  Precise One and only one interpretation  Familiar Easier to read  Concise Short, brief  Fluid Smooth and logical flow of thoughts
  43. 43. Writing Style: Elements  Structure Uniformity Placement and emphasis Brevity and simplicity  Language Spellings Grammar  Illustrations
  44. 44. Structure : Uniformity  Formerly, hemoglobin was measured by colorimetry, but now an automated analyzer is employed.  Formerly, hemoglobin was measured by colorimetry, but now it is done using an automated analyzer.
  45. 45. Structure : Placement Place the most important elements at the start or the end  Word(s) in sentence  Sentence in paragraph  Paragraphs in composition
  46. 46. Structure: Emphasis and Placement The currently available vaccine for disease X is ineffective when used post-exposure. However, it is not safe enough for universal pre-exposure prophylaxis. In the current study, we found that the new polysaccharide vaccine -------------------------------------------------------------------------- ----. The vaccine was useful even when administered up to 10 days after exposure. The efficacy of the vaccine in this situation was ------------------------------------------------. Our findings are thus likely to have a major impact on the prevention and epidemiology of disease X.
  47. 47. Paragraphs  Divide a written piece into logical segments  Make text less intimidating and easier to read  Each deals with one topic/thought  Need transitions to connect thoughts or separate them logically  Avoid one sentence paragraphs except as transition  Begin with a sentence that either suggests the topic or helps the transition  Logical mind + Good eye
  48. 48. Paragraphs And Transitions Essential hypertension is associated with renal retention of salt. The salt retention is due to a disturbed renin-angiotensin- aldosterone axis. This disturbance may be due to several causes. The most important cause of this distubance is------------. This has been studied in detail and -----------
  49. 49. Sentence Parts The jailor beat him hard with an iron rod Subject Verb Object Adverb Adjective Noun Tense Pomposity Pronoun Voice Verbosity Dangling modifiers Split infinitives
  50. 50. Grammar: Noun- Pronoun Which noun does the pronoun substitute? The Prime Minister’s emissary talked to Mr. Amarinder Singh. Mr Singh admitted that he had not consulted the Prime Minister before he got the new act about river water passed in the state assembly. The emissary told him that he was very upset about it. Gender neutral language (plural form helps)
  51. 51. Nouns: Expressions To Avoid  Colloquialism Mom, kid, lab, minilap  Contrived long words Maternal parent, pediatric patient, liquid imbibitions  Long string of nouns Doctor workload reduction program (Program to reduce the workload of doctors)
  52. 52. Missing (‘Understood’) verbs  Polly loves cake more than me  Polly loves cake more than I  Polly loves cake more than she loves me  Polly loves cake more than I do
  53. 53. The Voice: Active Or Passive  We discussed the therapeutic potential of fish oil.  The therapeutic potential of fish oil was discussed
  54. 54. Dangling Modifiers Dr Young treated the patients using antidepressants.  Dr Y treated patients who were using antidepressants.  By using antidepressants Dr Y treated the patients.  She told me that he was dead on the phone. She told me on the phone that he was dead.
  55. 55. Dangling Participles  Having a temperature of 42o C, we gave patient a cold bath.  After being whipped fiercely, the cook boiled the egg.
  56. 56. ‘Only’ I hit him in the eye Only I hit him in the eye I only hit him in the eye I hit only him in the eye I hit him only in the eye I hit him in the only eye
  57. 57. Redundancy  already existing alternative choices  at the present time basic fundamentals  completely cured currently underway  first began introduced a new  mix together never before  none at all still persisted
  58. 58. Redundancy  The question as to whether Whether  In spite of the fact that Though  In almost all cases Nearly always  Due to the fact that Because  In only a small number of cases Rarely  With the possible exception of Except  As compared to Than
  59. 59. Pompous Words Accomplish Do Performed Done Visualize See Initiate Begin, start Prior to Before Quantitation Measurement
  60. 60. Fewer vs. lesser  The patient undergoing laproscopic surgery had less pain than those undergoing open surgery  The patient undergoing laparoscopic surgery spent fewer days in hospital than those undergoing open surgery.
  61. 61. Grandiloquence  Abstract words(juxta, sphericity)  Vague words(of the order of)  Foreign words(circa, vide supra)  Fancy words(beauteous)  Offbeat words(upright, hep)  Non-words(aspirinize, normalized, electrophoresed)
  62. 62. Grandstanding  Pre-eminence claims  Precede claims  Prejudice  Superlatives  Unindicated italics, underline  Exclamation(’shriek’)marks
  63. 63. Verbosity  At this moment of time, it is believed that X is the major causative factor for disease Y  Currently, it is believed that…….
  64. 64. Spelling: common errors  Vomitting Vomiting  Inflamation Inflammation  Occuring Occurring  Upto Up to  Principal Principle  Mucus Mucous  Illium Ileum  Ilitis Ileitis  Coastal Costal
  65. 65. Emphasis : Illustration  When the infusion of drug A was started, blood levels of substance C initially fell to reach a nadir at 12 hours; however, thereafter,the levels again increased to close to the pre- infusion levels and remained so for the remaining of the infusion.
  66. 66. Other Common Errors  ‘And’ and ‘but’ to join unconnected thoughts  Overuse of indirect speech  Overuse of passive voice  Switching tenses  Switching persons  Improper punctuation
  67. 67. Miscellaneous Issues  Abbreviations and acronyms  Group names vs labels  Numbers: numerals vs words  Punctuation
  68. 68. One should not aim at being possible to understand but at being impossible to misunderstand - Quintilian
  69. 69. ‘The greatest invention of the nineteenth century was the invention of the method of invention.’ -AN Whitehead Material & Methods
  70. 70. Basic Terminology Research problem An enigmatic, perplexing, or troubling condition Problem statement A statement articulating the research problem and indicating the need for a study
  71. 71. Basic Terminology (cont’d) Research questions The specific queries the researcher wants to answer in addressing the research problem Hypotheses The researcher’s predictions about relationships among variables
  72. 72. Basic Terminology (cont’d) Statement of purpose The researcher’s summary of the overall study goal Research aims or objectives The specific accomplishments to be achieved by conducting the study
  73. 73. Methods: Goal The purpose of the methods section is to describe in sufficient detail what you did to answer your research question so that another researcher can replicate the study
  74. 74. Methods  What all was done ?  How was it done?  When was it done?  Who did it?  How were the results analysed?  Did you have ethical clearance to do so?
  75. 75. Major Classes of Quantitative Research Experimental research Researchers actively introduce an intervention or treatment Nonexperimental research Researchers collect data without intervening or introducing treatments
  76. 76. Methods: Types of Studies  Primary research studies -clinical trials -surveys -laboratory experiments -evaluation of a new test  Secondary research studies -reviews -meta-analyses -Cost -efficacy analyses
  77. 77. Method : Study Design  Randomized  Controlled: placebo/active drug  Open/blinded  Cohort/case control  Prospective/retrospective
  78. 78. Phases in a Quantitative Study  Phase 1: Conceptual Phase  Phase 2: Design and Planning Phase  Phase 3: Empirical Phase  Phase 4: Analytic Phase  Phase 5: Dissemination Phase
  79. 79. Major Steps in a Quantitative Study  Phase 1: Conceptual Phase 1. Formulating the problem 2. Reviewing related literature 3. Undertaking clinical fieldwork 4. Defining the framework and developing conceptual definitions 5. Formulating hypotheses
  80. 80. Major Steps in a Quantitative Study (cont.)  Phase 2: Design and Planning Phase 6. Selecting a research design 7. Developing intervention protocols 8. Identifying the population 9. Designing the sample plan
  81. 81. Major Steps in a Quantitative Study (cont.)  Phase 2: Design and Planning Phase (cont.) 10. Specifying methods to measure research variables and collect data 11. Developing methods to protect human/animal rights 12. Finalizing and reviewing the research plan
  82. 82. Major Steps in a Quantitative Study (cont.)  Phase 3: Empirical Phase 13. Collecting data 14. Preparing data for analysis
  83. 83. Major Steps in a Quantitative Study (cont.)  Phase 4: Analytic Phase 15. Analyzing the data 16. Interpreting results
  84. 84. Major Steps in a Quantitative Study (cont.)  Phase 5: Dissemination Phase 17. Communicating the findings 18. Utilizing findings in practice
  85. 85. Criteria for Evaluating Quantitative Research  Reliability The accuracy and consistency of obtained information  Validity The soundness of the evidence—whether findings are convincing, well-grounded
  86. 86. Activities in a Qualitative Study 1. Conceptualizing and planning the study 2. Conducting the study 3. Disseminating the findings
  87. 87. Research Journal Articles Summarize the context, design, and results of a study; the primary method of disseminating research evidence
  88. 88. Material: Reviews/Meta- analysis  Information on searches -source -time period -selection: exclusion criteria  Validity assessment  Data abstraction  Additional data from authors
  89. 89. Methods: Intervention  Details of procedure  Mention the special circumstances  After fasting  Indoor/outdoor procedure  Time of the day
  90. 90. Methods Provide sufficient details New method  Provide all details Previously described  Provide reference  Describe in brief  Don’t cite an abstract/obscure journal  Describe any modifications Inter and intra-assay variability, sensitivity
  91. 91. Define outcome  Intervention trials  Primary outcomes  Secondary outcomes  Toxicity  Parameters used  Follow up  Frequency  Method  Duration  Laboratory experiments  Define cut-off for positive  Sensitivity and specificity of assay tested  Define significant change
  92. 92. Methods : Analysis of Data  Sample size calculation  Estimate of power: β error  Exact tests used for analysis  Chosen a priority  Common tests: give name  Advanced/unusual test: provide reference  Details of software used  p value to disprove the null hypothesis
  93. 93. Methods: Ethical considerations  Approve of ethics committee  Human subjects  Animals  Consent
  94. 94. Methods  Present methods in chronological order  Subheadings should match those in results ‘internal consistency’  In past tense  Be precise
  95. 95. Methods : language  ‘Employing a straight platinum wire rabbit, sheep and human blood agar plates were inoculated’  ‘Blood samples were taken from 48 patients aged 6 months to 22 years; all patients gave informed consent.’  ‘After standing in boiling water for an hour, examine the flask’  ‘All endoscopic procedures were done by an experienced endoscopist, after intravenous sedations’
  96. 96. Methods  Do not mix results and methods  ‘Colleague treatment ’
  97. 97. Methods: Checklist  Does it describe  What questions was asked?  What was being tested?  How reliable was the measurement?  Were the parameters recorded and analyzed correctly?  Would a reader be able to repeat the same experiment?
  98. 98. GROUP EXERCISE
  99. 99. Materials and Methods- Rough Draft  The study was conducted in two phases. The first phase was before the introduction of Vibrators from the month of January 2011 to March 2011 and the second phase was from April 2011 to June 2011 after the introduction of Vibrators.
  100. 100. Materials & methods- Final  This retro-prospective study was carried out in all ventilated head & spinal injured patients over 6 months in Neurosurgery ICU. The clinical (demographics, admission GCS & in hospital mortality) & microbiological data (Modified Tracheal Culture) was collected over the two time periods.
  101. 101.  The ‘control’ group consisted of patients in whom data was retrospectively collected from January 2011 to March 2011 (before the introduction of Vibrators). The ‘test’ group consisted of patients in whom data was prospectively collected from April 2011 to June 2011 (following introduction of Vibrators). All chest physiotherapy using mechanical vibrators was done by bedside nurses every 2 hourly.
  102. 102. RESULTS
  103. 103. Results: Before Writing  Collect data  List variables mentioned in Methods  Place data for each under them  Avoid missing information  Are there any additional data?  Are these relevant to the study?  Matrix plan
  104. 104. Results: Before Writing  Recheck tables for accuracy  Analyze  List all findings, study their relationships  Identify the important ones  Think and plan  Sequence  Identify subheadings  Tables/text/figure
  105. 105. Measurements  Science is measurement!  Report the who, what, when, where  How (in methods)  Why (in discussion)  Precision, reliability and validity of measurements
  106. 106. Statistics  Use % if n>100  Restrict decimal points to 1 or 2  No adjectives (most, some, often..)
  107. 107. p Values  Nothing like significant, highly significant or very highly significant  All p<0.05 are significant; give value of p  Give exact p values: p=0.02 vs p<0.05  Smallest p value that need be reported is p<0.001  Many journals require 95% CIs
  108. 108. Report Study Findings- Follow Methods Who Patients / controls / rats / age / gender / weight What Procedure / Measurements When Time period / morning Where Hospital / Clinic
  109. 109. Results of Clinical Studies  Schematic summary of study  Show study design  Indicate flow of subjects through the study  Account for all subjects or observations
  110. 110. Participants / Controls  Age/ gender distribution  Whether matched for baseline characteristics (usually as table)  If different, whether correction applied
  111. 111. Order in Results  Report results of primary comparisons first
  112. 112. Evaluation  Compliance with therapy/protocol  Response with respect to outcome measures  All evaluated parameters  Adverse reactions  Follow up data  Correlations / differences between parameters / groups
  113. 113. Results  Give numerators and denominators of all percentages  (“In all, 33% of the rats lived, 33% died, and the last one got away.”)  What does 12% of 6 patients mean?  What is normal/abnormal? raised/high/low?  Cite all tables/figures in text
  114. 114. Results: Do not  Omit unexpected findings  Give results to a greater degree of accuracy than each measurement  Make groups/patients appear/disappear  Use abbreviations??
  115. 115. Results  What did you find?  Should answer all the points raised in the methods  No new parameters  Text / tables / figures  No mismatch in numbers
  116. 116. Results: Study Specific?  Variations: depends on type of study  Drug trial  Animal experiment  Clinical trial  Cohort, case-control  Randomised controlled trial  Meta-analysis
  117. 117. Length of Manuscript  Typical scientific manuscript:  Text pages(double space) 12 (10-15)  References 23 (15-32)  Tables 3 (1-4)  Figures 4 (2-6.5)  Total pages 20 (16-27)
  118. 118.  Shortest sections  Title  Results
  119. 119. “The fool collects facts, the wise selects them”
  120. 120. Text or Tables  Number of items  Few variabes: Text  Many variables: Table
  121. 121. Example Bacteria N Stool Urine Blood Strep aureus 12 6 0 6 Str viridans 4 1 1 2 Str faecalis 2 2 0 0 Pseudom onas 8 1 7 0 E coli 9 3 4 2 S typhi 0 0 0 0
  122. 122. Tables : Common errors  Title: none, too long, too brief  Effect of adrenaline on cirrhotic and non-cirrhotic rats at 20,40 and 60 days Effect of adrenaline on cirrhotic and non-cirrhotic rats  Adrenaline and rats
  123. 123. Figures  Types  Graphs  Photographs  Flowcharts  Location in relation to IMRAD structure  Results  Methods: technique, study design
  124. 124. Figures  Purpose-specific  Graphs  Line : usually event in relation to time  Bar : comparisons  Pie : parts of a whole  Histogram : frequency distribution  Scatter : associations between variables
  125. 125. Figures  What do I want to say?  Is there a better method?  Type of figure?  Less better than more  Only if necessary
  126. 126. Figures  Photographs, pictures  Technique  Before and after  Show an event  Flow charts  Process, sequence, systems  Algorithms
  127. 127. Table or figure  Prefer tables  Use figures only for illustrative  Bar, histogram, pie: ?table Difference in written and oral communication
  128. 128. Figure : Guidelines  2 axes : 2 types of information  Curves : not more than 5 lines, thick  Label axes : quantity, units  Simple symbols (,) not ,  Crossing curve : show break
  129. 129. Figure : Guides  Good contrast  Label  Stain used  Mask identity  Magnification and scale  No clips or staples  Use colour, if absolutely essential
  130. 130. Figure : Legend  Brief but complete  Explain label  Full form of abbreviations  Write separately (Journal instructions)  Usually not with the figure
  131. 131. Figure : Details  Indicate the TOP of the figure  Place a mark   Name of the author  Brief title of article  Figure number  Not within the figure
  132. 132. Summary  Illustrations : adjuncts  Convey a message  Various types: use appropriately  Ask: Is it needed?  Simple, consistent, clear, focussed, visually effective
  133. 133. Recommend  Look at recent issue of journal  Use a similar published table/figure as a template  Read journal instuctions  Read Vancouver style (www.icmje.org)
  134. 134. GROUP EXERCISE
  135. 135. WRITING THE ‘DISCUSSION’ SECTION
  136. 136. Discussion of a Paper What does it all mean? ‘ IMPLICATIONS’ ‘SIGNIFICANCE’ vs. ‘RELEVANCE’
  137. 137. Discussion: Purpose  Brings together all the pieces of the puzzle  What was known before  What we learned  This interpretation through inter-relation bridges the data with the conclusion
  138. 138. Discussion: Problems  Difficult to write  Tend to be verbose, too long  Issues not addressed by the study  Sequence: does not flow  Introduce new information  Harp on trivial or obvious points  Ignore difficult to explain results
  139. 139. Discussion: Structure  State major findings  Strengths: design, technique, results  Discuss  Findings re: existing information  “important” minor findings  Implications: of findings, for practice/future research  Limitations  Summary(conclusion)
  140. 140. Discussion  Summary of findings without quantitative results WHAT WAS FOUND  Making points  First point  Second point WHAT CAN BE FOUND  (Potentially a third point)  Limitations WHAT ONE CANNOT SAY  Last paragraph of conclusion and recommendations WHAT YOU MAKE OF IT
  141. 141. First Paragraph Of The Discussion  DO  Announce the points that will be discussed  Summarize the results in big picture terms  Avoid Interpreting Repeating results in great details Initiating the discussion of the results per se
  142. 142. Last paragraph of the discussion  DO Summarise conclusion points Propose recommendations  Add action points  Future studies  Implications for patient evaluation and care  Avoid Proposing recommendations disconnected from conclusions Repeating results without adding a layerof interpretation
  143. 143. Middle Part: Interpretation  Starting from the results, bridge to conclusions through interpretation  Describing and interpreting  Before you interpret, describe  imagine you are talking on the phone  the person you talk to has not seen the evidence  Interpreting in light of initial hypotheses
  144. 144. Strengths  Study design  Sample size, controls, variables assessed  Duration of follow up  Technique  New, established but not previously used in subset  Better standardization
  145. 145. Comparison with Others  Check that the comparison is valid e.g. comparable methods, study groups  Build arguments around consistency  If differences, provide posssible explanations  Discuss opposing views equally well  A must: good grasp of information  Do not hesitate to criticize  Reasoned, logical arguments  Avoid rhetoric, be diplomatic
  146. 146. Unexpected Findings  Do not ignore  Explain; if no explanation, state so.
  147. 147. Limitations  Selection bias  Generalizable, applicable  Drop outs  Discuss unexpected findings  Do not ignore, offer explanation  If none plausible:say so
  148. 148. Place of the ‘limitations’ section  Recommended location  After summarizing the results in the discussion  Before the conclusions  Location to avoid  After the conclusions We want to conclude after we have taken the limitations into account
  149. 149. For each limitation, specify:  What is the limitation  What are the consequences of the limitation  What did you do to control/address the limitation  How do you interpret the data in view of the limitation
  150. 150. Example of a “limitations” section  Limitation  We could not isolate the pathogen  Consequence  We cannot rule out another diagnosis  Address the limitation  The serology that is specific (ref) was positive  signs/symptoms were compatible(ref)  The disease is endemic in our region(ref)  Interpret in view of the limitation  Our diagnosis is the most probable hypothesis(despite the limitation)
  151. 151. Focus the Discussion  Begin with the most important point, then move to less important points  Confine to the subject studied  Focus on key issues  Provide link sentences between paragraphs: ensure flow
  152. 152. Implications  Alteration in clinical practice, public policy  Understanding of pathogenesis, mechanism of disease  Geographical  Financial  Consider alternative explanations  Speculate, but intelligently correlation≠causation
  153. 153. Discussion DO NOT  Start with history  Repeat all your results  Provide new data  Extrapolate results  Superlatives
  154. 154. Conclusions  Answer  So what?  Who cares?  Only those supported by data  Avoid sweeping statements
  155. 155. Is the job done?  Ask a colleague to read  Get feedback from ‘worst enemy’  Re-work
  156. 156. Summary  Difficult to write  Break into sections  Provide link sentences : ensures continuity  Short, clear, key issues
  157. 157. GROUP EXERCISE
  158. 158. DEEPAK AGRAWAL Assoc Prof Neurosurgery, JPNATC,AIIMS HANDWASHING
  159. 159. How to handwash…
  160. 160. Handwash with…
  161. 161. Why to handwash…
  162. 162. PaniPuri (Gol guppa) Vendor
  163. 163. Comments on Youtube:  येः इंिडयन दुिनया मे जहाँ भी जाते है गंद फै लाते है  अपना घर तो साफ़ रखते है और कचरा बहार डालते है
  164. 164. Comments on Youtube:  it is gross for sure. but it does look like a setup. Why on earth was this female ankitha rane filming a pani puri vendor at that time. Now they will politicize this matter against some communities .  Already over 300 vendors were beaten black 'n blue 'n their stalls were broken.
  165. 165. Comments on Youtube:  They need to be educated about sanitation and its our responsibility to secure their livelihood...  These videos are good if it gonna make people think that these poor people need training and if it is going to divert people to Mc.Donald sort of shops then its sad...
  166. 166. Why? (Panipuri vendor)  Normal ‘guy’  Nobody watching  No concern/ empathy with the people who come to him (Haves & have nots)  Just earn his livelihood & go home
  167. 167. Why? (Healthcare professional)  Normal ‘guy/ girl’  Nobody watching  No concern/ empathy with the patients who depend on them completely  Just earn his livelihood & go home
  168. 168. Consequences of the Act- unsuspecting people Eating contaminated Panipuri 99.9% of times- Nothing If vendor has UTI- then maybe infection???
  169. 169. Consequences of the Act- unsuspecting people Not handwashing/ not handwashing properly Extremely dangerous Patients- Resistant infection- death Loved ones- resistant infection- death
  170. 170. Incidence  Roadside vendors :1% ?? (No data available)  Healthcare professionals: >50% (data on file)
  171. 171. Be the change you want to see in the world
  172. 172. THANK YOU
  • manishparihar17

    Apr. 25, 2020

Research, Ethics And Publications; Overview

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