Work Stress and Coronary Heart Disease Assignment Sample
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Subject Name : Nursing
Cohort Profile - Part 1
The Whitehall Study is a landmark study which was conducted to understand the relationship between social status and health determinants (Marmot, Shipley & Hamilton, 1978). It was conducted in two parts – the first part consisted of 1800 males aged 20-64 and the second part had 10308 participants who were civil servants aged 35-55. The sample predominantly consisted of men – only one-third of the sample had female participants. The participants in this study were graded according to their professional status and an association of their job status with the occurrence of cardiovascular diseases was being established.
In the Whitehall studies and the follow-up to the study (Breeze et al., 2001), the risk factors were assessed with respect to the occupational grades and socioeconomic factors of the participants. For instance, if the employees at the higher grades were more vulnerable to coronary heart disease because they had more money to buy cigarettes, thereby smoking more than those in the lower pay grades. In the study on work stress and coronary heart disease (Chandola et al., 2008), the disease risks were assessed based on behavioural factors and biological factors.
The Whitehall studies and its subsequent follow-up studies have helped clear two misconceptions. The first being that people with high-status jobs have are at a higher risk for heart disease. The second misconception being that health can be analysed on the basis of rich and poor – with the poor being disadvantaged and hence experiencing poor health, whereas the others experiencing good health. Having said this, this study can be replicated and conducted taking other populations into consideration, where there is a hierarchy being adhered to at the workplace. Examples of such populations include manual labourers and factory workers.
The 45 and Up cohort study as well as the longitudinal cohort study on the health of Australian women have similar characteristics as the Whitehall studies. They are all prospective longitudinal cohort studies, meaning they are all studies involving a sample consisting of individuals who share similar characteristics, but have some differentiating factors and compares these people, checking for specific outcomes. In the Whitehall Studies, the association between occupational status and cardiovascular disease was being explored. Similarly, in the 45 and Up Cohort Study, health determinants concerning ageing are being examined and in the Australian Women’s Longitudinal Study, the relationship between health and wellbeing of women pertaining to their access to healthcare services is being established.
Cohort Profile - Part 2
The best design to understand the causal relationship between smoking and lung cancer is a cohort study. In a cohort study, individuals in the sample have certain similarities as well as some differences, and this can be used to study specific outcomes. To determine the relationship between smoking and lung cancer, a sample consisting of smokers as well as non-smokers can be observed over time to see if any of them develop lung cancer due to smoking or, in the case of non-smokers, due to other factors. The advantage of conducting cohort studies is that multiple exposures and outcomes can be studied at one go. Also, results obtained from cohort studies are reliable.
A prospective cohort study would be an appropriate design to study the association between depression and binge eating among obese adolescents and adults. A prospective cohort study is a longitudinal study which examines a group of cohorts (individuals with similar characteristics), differing in terms of certain factors and how they affect the occurrence of an outcome, over time. Prospective cohort studies are observations made over time and help determine risk factors related to outcomes, thus helping with minimizing them.
To study the long-term effects on the mental and physical health of asylum seekers, a systematic review would be the ideal design. Since there are many factors to consider when we talk of mental and physical health, a summary reviewing the individual effect of all these factors can be cumulated and presented in the form of a study. Systematic research is also known as secondary research and helps combine relevant aspects of previous studies to answer the given question. They deliver a detailed and clear outline of the available research evidence and help develop better insight into the factors being studied.
To examine whether consumption of folate supplement during pregnancy has an impact on the development of autism, a child cohort study would be an appropriate design. Child cohort studies are birth cohort studies, which follow the development of a child from before its birth to adolescence. They are also longitudinal as they are conducted over a long period of time, spanning through years. Child cohort studies help understand factors leading to childhood disorders, such as autism, better and come up with possible solutions and preventive measures for them.
Testing of drugs for the use of elderly patients with Alzheimer’s should be carried out using a Clinical trial. Testing the effectiveness of drugs and vaccines are commonly carried out through the various stages of a clinical trial. Clinical trials usually have 5 phases. Phase 0 is the first set of trials, which are conducted to understand the effect of the drug on the body. Phase 1 tries to improve the drug by minimizing the side effects observed initially. Phase 2 assesses further issues related to the safety and function of the drug. Phase 3 is conducted to understand the effect of the new drug to a pre-existing standard drug. It is usually carried out for the purpose of obtaining approval from the FDA. Finally, phase 4 is conducted once the FDA approval is obtained. The purpose of this phase to develop a better understanding of the new drug, study the duration of its effects as well as its side effects. Clinical trials are important to understand and judge how beneficial the administration of a drug can be on the affected population and to minimise the risks and side effects of using them.
References for Work Stress and Coronary Heart Disease
Chandola, T., Britton, A., Brunner, E., Hemingway, H., Malik, M., Kumari, M., Badrick, E., Kivimaki, M., & Marmot, M. (2008). Work stress and coronary heart disease: what are the mechanisms? European Heart Journal, 29(5), 640–648. https://doi.org/10.1093/eurheartj/ehm584
Cohort Profile: The 45 and Up Study. (2007). International Journal of Epidemiology, 37(5), 941–947. https://doi.org/10.1093/ije/dym184
Do socioeconomic disadvantages persist into old age? Self-reported morbidity in a 29-year follow-up of the Whitehall Study. (2001). American Journal of Public Health, 91(2), 277–283. https://doi.org/10.2105/ajph.91.2.277
Loxton, D., Tooth, L., Harris, M. L., Forder, P. M., Dobson, A., Powers, J., Brown, W., Byles, J., & Mishra, G. (2017). Cohort Profile: The Australian Longitudinal Study on Women’s Health (ALSWH) 1989–95 cohort. International Journal of Epidemiology, 47(2), 391–392e. https://doi.org/10.1093/ije/dyx133
Marmot, M. G., Rose, G., Shipley, M., & Hamilton, P. J. (1978). Employment grade and coronary heart disease in British civil servants. Journal of Epidemiology & Community Health, 32(4), 244–249. https://doi.org/10.1136/jech.32.4.244
Phases of clinical trials. (2020). National Comprehensive Cancer Network. https://www.nccn.org/patients/resources/clinical_trials/phases.aspx
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