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Variables/measurement cited, reliability of measurement data is included
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4
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Statistical test used for quantitative Qualitative may use pain score, survey, depression rating scale
N320W Calendar 8 week
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Module2
Weeks 3-4
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Topic
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Assigned Content/Readings
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Assignments/Due Dates
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Week 3
Models to Guide Implementation and Sustainability of EBP
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Evidence-Based Practice
Models
Critically appraising the evidence
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Read Melnyk & Fineout-Overholt Ch. 14
Review APA Chapters 1-8
Assignment: Chose a EBP model that aligns with your PICO(T) and Complete Research Model Worksheet
Instructions : After reading Chapter 14 in Melnyk & Fineout-Overholt. Review the following models and choose one that best fits your PICO(T), the organization where you work or where you would implement the PICO(T):
IOWA Model of EBP, John Hopkins Nursing Process for EBP, Stetler Model of EBP, Stevens Start Model, Clinical Scholar Model, PARIHS Elements and Sub-elements, and ARCC Model
Once you have chosen your EBP model complete the Research Model worksheet found in this module. This will guide your EBP study based on your specific PICO(T) ( and will be included in your Research Paper) Please complete this worksheet using APA 7th ed format .
Review the following in Module 2 to provide guidance and examples in further detail:
Research Model Worksheet
Research Model Example
Submit Research Model Worksheet to the drop box Sunday by 11:59pm
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Quizzes Due:
No quiz due this week
Discussion:
No discussion due this week
Assignment: Submit Research Model worksheet to drop box Sunday by 11:59
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Week 4
Quantitative and Qualitative Evidence
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Critically appraising the evidence
Technical Writing
Professional Writing
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Read Melnyk & Fineout- Overholt Chapters 5, 6, 17. 18
Review: Literature Review Content found in Module 2
Read: Differences between qualitative and quantitative articles handout found in the content area of Module 2.
<
Differences between Quantitative and Qualitative Methods
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Quantitative
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Qualitative
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Objective
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Subjective
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Design
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Longitudinal, Clinical trials, Cohort, Cross-sectional, Correlational, Quasi-experimental, Experimental, Pre-Post Test, Chart audits, Case Study
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Historical, Observations, Philosophical, Ethnography, Case Study, Grounded theory, Lived Experiences
*Be sure if you identify a case study it is the right design category
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Sample
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Large (N=)
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Small
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Data Collection
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Mailings, Scales, Questionnaires, Surveys, Polls,
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Interviews, semi-structured, focus groups, open ended questions,
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Tools
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Setting
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Controlled (outcome oriented)
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Flexible natural (process oriented)
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Analysis
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Statistics, SPPS, SAS, numbers
Some basic stats: Chi squares, t-tests, factor analysis, ANOVA, logistic regression,
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Thematic or content analysis, rich descriptions, narrative statements, patterns, constant comparative, coding, categories, conversation analysis, photo voice. Or they may use software for qualitative studies
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Strives to generalize
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Strives for transferability
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All research is descriptive, exploratory, or explanatory; however, quasi-experimental and experimental are usually quantitative studies striving for control and prediction.
Some studies are mixed methods and they combine quantitative and qualitative methods. If you identify a mixed methods critique only the parts that are necessary for the critique.
Week 4 Part A Critically Appraising Quantitative EBP
You are gaining confidence in searching articles for your PICO(T). Find one quantitative article to support your PICO(T). This will be your first article for your literature review table due in Week 4. Refer back to the Boolean search and database in Week 2 to demonstrate a simple search with the specific types of research format. Complete a literature review table :N320 Literature Review Template
1) Discuss the fundamental meaning of quantitative research in Melnyk and Fineout-Overholt (Chapter 5 & 17).
2) Utilize the strength-of-evidence pyramid (Melnyk & Fineout-Overholt, pg 116,Figure 4.2) and determine where qualitative and quantitative research sits within the pyramid using a compare and contrast methodology.
3) Attach your first article literature review table to your discussion post and cite your article in APA reference style at the end of your post.
4) Respond to two peers on the strengths/weaknesses of the articles selected.
Part B: Critically Appraising Qualitative EBP
You are gaining confidence in searching articles for your PICO(T). Find one qualitative article to support your PICO(T). This will be your second article in your literature review table due in Week 7. Refer back to the Boolean search and database in Week 2 to demonstrate a simple search with the specific types of research format. Complete a literature review table :N320 Literature Review Template
1) Discuss the fundamental meaning of quantitative research in Melnyk and Fineout-Overholt (Chapter 6 & 18).
2) Utilize the strength-of-evidence pyramid (Melnyk & Fineout-Overholt, pg 116, Figure 4.2) and determine where qualitative and quantitative research sits within the pyramid using a compare and contrast methodology.
3) Attach your first article literature review table to your discussion post and cite your article in APA reference style at the end of your post.
4) Respond to two peers on the strengths/weaknesses of the articles selected.
Advanced maternal age increases the risk of very
preterm birth, irrespective of parity: a
population-based register study
U Waldenstr€om,a S Cnattingius,b L Vixner,c M Normand,e
a Division of Reproductive Health, Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden b Clinical
Epidemiology Unit, Department of Medicine Solna, Karolinska University Hospital, Stockholm, Sweden c School of Health and Social Studies,
Dalarna University, Falun, Sweden
d
Division of Paediatrics, Department of Clinical Science, Intervention and Technology, Karolinska
Institutet, Stockholm, Sweden e Department of Neonatal Medicine K78, Karolinska University Hospital, Stockholm, Sweden
Correspondence: Professor U Waldenstr€om, Division of Reproductive Health, Department of Women’s and Children’s Health, Karolinska
Institutet, Bastugatan 42, 118 25 Stockholm, Sweden. Email [email protected]
Accepted 20 August 2016. Published Online 21 October 2016.
Objective To investigate whether advanced maternal age is
associated with preterm birth, irrespective of parity.
Design Population-based registry study.
Setting Swedish Medical Birth Register.
Population First, second, and third live singleton births to
women aged 20 years or older in Sweden, from 1990 to 2011
(n = 2 009 068).
Methods Logistic regression analysis was used in each parity group
to estimate risks of very and moderately preterm births to women
at 20–24, 25–29, 30–34, 35–39, and 40 years or older, using 25–
29 years as the reference group. Odds ratios (ORs) were adjusted for
year of birth, education, country of birth, smoking, body mass index,
and history of preterm birth. Age-related risks of spontaneous and
medically indicated preterm births were also investigated.
Main outcome measures Very preterm (22–31 weeks of gestation)
and moderately preterm (32–36 weeks) births.
Results Risks of very preterm birth increased with maternal age,
irrespective of parity: adjusted ORs in first, second, and third
births ranged from 1.18 to 1.28 at 30–34 years, from 1.59 to 1.70
at 35–39 years, and from 1.97 to 2.40 at ≥40 years. In moderately
preterm births, age-related associations were weaker, but were
statistically significant from 35–39 years in all parity groups.
Advanced maternal age increased the risks of both spontaneous
and medically indicated preterm births.
Conclusions Advanced maternal age is associated with an
increased risk of preterm birth, irrespective of parity, especially
very preterm birth. Women aged 35 years and older, expecting
their first, second, or third births, should be reg
Health Care for Women International, 28:534–555, 2007
Copyright © Taylor & Francis Group, LLC
ISSN: 0739-9332 print / 1096-4665 online
DOI: 10.1080/07399330701334356
First Mothering Over 35 Years: Questioning the
Association of Maternal Age
and Pregnancy Risk
M. CAROLAN
School of Nursing and Midwifery, Victoria University, Melbourne, Australia
S. NELSON
School of Nursing, University of Toronto, Toronto, Canada
Women having a first baby at 35+ years are commonly considered
to be “at risk” for pregnancy complications. This understanding
appears to be based primarily on age, and curerntly many healthy
women are included in this category. There is clear evidence to
suggest that, for these women, being considered “at risk” is anxiety
provoking.
In this Australian qualitative study of first mothering over
35 years, we found four risk-related themes, “realizing I was at
risk,” “hoping for reassurance,” “dealing with uncertainty,” and
“getting through it/negotiating risk.” We concluded that successful
adjustment to motherhood related principally to participants
negotiating risk and also to the infant growing and becoming
more responsive. Attitudes of health professionals were found to
contribute to rather than ameliorate participant dilemmas.
Understanding how healthy women over 35 years engage with
and negotiate notions of risk may assist health professionals in the
provision of more meaningful maternal support for this growing
group of women.
BACKGROUND
In the past four decades, there have been many changes to childbearing
trends in the advanced industrial world. Those changes include fewer
Received 1 September 2005; accepted 26 August 2006.
Address correspondence to Dr. Mary Carolan, School of Nursing and Midwifery,
Victoria University, St. Albans Campus, P.O.Box 14428, Melbourne 8001, Australia. E-mail:
[email protected]
534
Questioning the Risk 535
children, born closer together, to older mothers. This “graying” of maternity
gives rise to many concerns and dilemmas, not the least of which is the asso-
ciation of maternal age and pregnancy risk among healthy mature women.
First-time mothers over 35 years are often labeled as “elderly primigravidae”
and as “at risk,” which is an issue of concern to a wide range of health
professionals and to a growing group of parturient women and their families.
Historically, the term “Elderly primigravida” was first coined in the 1950s
to describe women of 35 years and above embarking on their first pregnancy
(International Council of Obstetricians, 1958; as cited by Barkan & Bracken,
1987, p. 101 Waters & Wager, 1950). At that time, obstetric outcomes for “el-
derly” mothers were considered to
ORIGINAL ARTICLE Infertility
‘Inconvenient biology:’ advantages and
disadvantages of first-time parenting
after age 40 using in vitro fertilization
K. Mac Dougall1, Y. Beyene1, and R.D. Nachtigall1,2,*
1Institute for Health and Aging, University of California, San Francisco, 3333 California Street, Suite 340, San Francisco, CA 94114, USA
2Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, CA, USA
*Correspondence address. Tel: +1-415-661-3913; E-mail: [email protected]
Submitted on August 19, 2011; resubmitted on December 19, 2011; accepted on January 5, 2012
background: As ages at first birth have steadily risen in the industrial west over the last several decades, the phenomenon of ‘delayed
childbearing’ has come under research scrutiny by demographers, medical specialists and social scientists. In this study, we specifically explore
the perceived advantages and disadvantages of postponed conception as well as participants’ retrospective opinions on the ‘optimal age’ for
parenting.
methods: To this end, we examined a cohort purposely chosen to epitomize delayed childbearing, i.e. men and women who used IVF to
conceive at the very end of their reproductive capability. In-depth qualitative interviews were conducted between 2009 and 2011 with 46
couples and 15 individual self-selected US women and men who had used IVF to conceive their first child when the woman was aged 40 or
older at the time of delivery. Although the demographics of this cohort were consistent with others who use IVF in the USA, their median
income was 3 – 4 times higher than that of the average US family, which may bias their largely positive parenting experiences.
results: Most women and men believed that childbearing later in life resulted in advantages for themselves and their families. These
included having established careers with financial security and career-time flexibility, enhanced emotional preparedness, committed co-par-
enting relationships and a positive overall family experience. The main disadvantage was the unexpected difficulty in conceiving that culmi-
nated in the use of IVF and resulted in a smaller family than desired, although many expressed feeling ‘lucky’ to have children at all. Other
disadvantages were lack of energy for parenting, less available lifetime to spend with children and anticipated stigma as older parents.
conclusions: These disadvantages appear to have influenced conception and parenting experiences so that in hindsight the majority of
participants identified the optimal age for first-time parenting as 5 – 10 years earlier than they had conceived. This age range was imagined to
maximize the financial and emotional advantages of later parenting while minimizi
original article
ANN SAUDI MED 2021 SEPTEMBER-OCTOBER WWW.ANNSAUDIMED.NET274
Correspondence: Dr. Taghreed
Shams · Department of Obstetrics
and Gynecology, King Saud bin
Abdulaziz University for Health
Sciences, Jeddah 22384, Saudi
Arabia · [email protected]
· ORCID: https://orcid.org/0000-
0002-0454-406X
Citation: Shams T, Gazzaz T,
Althobiti K, Alghamdi N, Bamarouf
W, Almarhoumi L, et al. Comparison
of pregnancy outcomes between
women of advanced maternal
age (≥35 years) versus younger
women in a tertiary care center in
Saudi Arabia. Ann Saudi Med 2021;
41(5): 274-279. DOI: 10.5144/0256-
4947.2021.274
Received: June 18, 2021
Accepted: July 2, 2021
Published: October 7, 2021
Copyright: Copyright © 2021,
Annals of Saudi Medicine, Saudi
Arabia. This is an open access
article under the Creative Commons
Attribution-NonCommercial-
NoDerivatives 4.0 International
License (CC BY-NC-ND). The details
of which can be accessed at http://
creativecommons. org/licenses/by-
nc-nd/4.0/
Funding: None.
Comparison of pregnancy outcomes
between women of advanced maternal
age (≥35 years) versus younger women in a
tertiary care center in Saudi Arabia
BACKGROUND: Pregnancy in women aged 35 years or above is gen-
erally considered an advanced maternal age (AMA). AMA is associated
with an increased rate of maternal and neonatal complications.
OBJECTIVES: Assess the effect of AMA on maternal and neonatal out-
comes.
DESIGN: Analytical cross-sectional study of medical records.
SETTINGS: In-patient hospital tertiary care setting in Jeddah.
PATIENTS AND METHODS: All women who attended antenatal care
and delivered at King Abdulaziz Medical City in Jeddah in the first half
of 2018 were included in the study. Outcomes for women 35 years of
age or older were compared with younger women. Significant factors in
a univariate analysis were entered in a multiple logistic regression model
to assess the association between AMA and outcomes.
MAIN OUTCOME MEASURES: Rates of maternal neonatal complica-
tions, analysis of factors associated with advanced maternal, gestational
diabetes mellitus (GDM), cesarean delivery.
SAMPLE SIZE: 1586 women.
RESULTS: Of the 1586 women, 406 were 35 years of age or older
(25.6%), and 1180 were younger than 35 years. The AMA group had a
significantly higher proportion of GDM (32.0% versus 13.2%, P<.001).
The adjusted odds ratio (OR) for GDM was 2.6 (95% CI 2-3.5, P<.001.)
compared with younger women in the multivariate logistic regression
analysis. Older women had a higher rate of cesarean delivery (43.6%
versus 30.8%, P<.001). The adjusted OR for cesarean vs. vaginal delivery
was 1.5 (CI 1.2-1.9, P=.002).
CONCLUSION: Pregnancy in women 35 years or older was associ
Acta Obstet Gynecol Scand. 2020;99:459–468. wileyonlinelibrary.com/journal/aogs | 459© 2019 Nordic Federation of Societies
of Obstetrics and Gynecology
Received: 19 May 2019 | Revised: 4 November 2019 | Accepted: 6 November 2019
DOI: 10.1111/aogs.13769
O R I G I N A L R E S E A R C H A R T I C L E
Pregnancy complications and risk of preterm birth according
to maternal age: A population-based study of delivery
hospitalizations in Alberta
Natalie V. Scime1 | Katie H. Chaput1,2,3 | Peter D. Faris1 | Hude Quan1 |
Suzanne C. Tough1,3 | Amy Metcalfe1,2,4
Abbreviations: aRD, adjusted risk difference; aRR, adjusted risk ratio; DAD, discharge abstract database; iPTB, iatrogenic preterm birth; PAF, population-attributable fraction; PTB,
preterm birth; RD, risk difference; RERI, relative excess risk due to interaction; RR, risk ratio; sPTB, spontaneous preterm birth.
1Department of Community Health
Sciences, Cumming School of Medicine,
University of Calgary, Calgary, AB, Canada
2Department of Obstetrics & Gynecology,
Cumming School of Medicine, University of
Calgary, Calgary, AB, Canada
3Department of Pediatrics, Cumming School
of Medicine, University of Calgary, Calgary,
AB, Canada
4Department of Medicine, Cumming School
of Medicine, University of Calgary, Calgary,
AB, Canada
Correspondence
Natalie V. Scime, University of Calgary,
Owerko Center in the Child Development
Center, 2500 University Drive NW, Calgary,
T2N 1N4 Alberta, Canada.
Email: [email protected]
Funding information
No external funding was sought for this
research. NVS is supported by a Canadian
Institutes of Health Research Canada
Graduate Scholarship Doctoral Award. AM is
supported by a Canadian Institutes of Health
Research New Investigator Award.
Abstract
Introduction: Pregnancy-related medical complications are associated with a 2- to
5-fold increased risk of preterm birth (PTB), but the nature of this etiologic relation in
context with maternal factors remains poorly understood. Previous studies have gen-
erally treated maternal age as a confounder but overlooked its potential as an effect
modifier, whereby the magnitude of the effect of complications on PTB could dif-
fer significantly across age groups. We investigated whether advanced maternal age
(≥35 years) modified the association between pregnancy complications and PTB, and
compared population-attributable fractions of PTB from complications in women
older vs younger than 35 years.
Material and methods: We analyzed population-based, cross-sectional data from the
Alberta Discharge Abstract Database for women aged 18-50 years with singleton live
births in hospital between 2014 and 2017 (n = 152 246). Complications were preec-
Literature Review Table
|
APA reference of article
|
Roou, B., Park, E., Perez, G., Rabin, J., Quain, K., Dizon, D., Post, K., Chinn, G., McDonough, .Jimenz, R., van de Poll-Franse, L. & Ppercron, J. (2018). Cluster analysis demonstrates the need to individualize care for cancer survivors. The Oncologist:Health Outcomes and Economics of Cancer Care, 23, 1474-1481. www.TheOncologist.com
|
|
|
Purpose of article
|
Researchers sought to identify and characterize subgroups based on client cancer survivors self-report and assessing of sociodemographics
|
|
|
Sample size
(N= total sample size
n= portion of sample size)
|
N= 292
(n= 123.42%) had low unmet needs
(n=46, 16%) physical unmet needs
(n=57, 20%) psychological unmet needs
(n=66, 23%) – both psychological and physical unmet needs
Two groups of clusters had p values of <0..05 for psychological and fatigue. These low p values are significant because this means the effect is likely real and not a result of other variables
|
|
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Research design
(explain the definition of the research design) and
level of evidence
(Melnyk Figure 4.2, page 116)
|
Cross sectional assessment survey – this give type of study design give a snapshot at one particular time and measures the participants at one specific time – when they questionnaire/survey is completed
This would be categorized under non-experimental study – we are not changing variables we are gathering data at a particular time or event
|
|
|
Variables (independent and dependent variables)
measurement
|
Sociodemographic variables included age, gender, race, marital status, employment, internet access, educational level, and income.
Clinical variables include cancer type, years since diagnosis, treatment, and comorbidities
|
|
|
Results, findings
(identify percentages or p values< 0.05)
|
Two groups of clusters had p values of <0..05 for psychological and fatigue. These low p values are significant because this means the effect is likely real and not a result of other variables
|
|
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