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D/508/0491 PICOT Questions Regent College Level 4

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Pico: Are children under the age of 6(p) with early onset eczema and a history of croup (i) more likely to develop asthma (o) as opposed to those with no history of respiratory infections?

PART A

Database

In addition to this, it can be said that content was searched on the basis of key aspects which are covered under Pico. It was essential for me to have understanding of topic is essential in order to have sustainable development and ensure that standards are being well maintained. Number of online sources are being accessed in respect to Pico keywords. By having an effective acknowledgement about the subject the issues can be resolved and ensure that goals and objectives are being accomplished so I have considered the same (Maniezzo, 2011). It has been witnessed with an analysis of database that paying close monitoring to the patient can cut down the risk factor. In addition to this, it can be said that data is being collected in desired manner with appropriate reference of standards.

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Sources

In order to have data collection, it is necessary for me to have consideration of primary and secondary sources as per the significance of topic. In present study as per analysis of Pico, the secondary collection of data is being taken into account by me. By having an appropriate consideration of secondary sources the information in respect to children’s issues in terms of eczema and asthma are being identified and evaluated (Shojania and Bero, 2011). It has been noticed by me that selection of secondary sources was effective which has allowed to attain better opportunities in terms of subject. The use of secondary sources of data collection supports in gathering data which has been already collected by someone else. In addition to this, I have also noticed that valid and reliable information has been collected from the secondary sources. Every researcher needs to select appropriate data collection sources as per the nature of their respective studies. It assist in meeting standards and ensure about objectives accomplishment.

Article data range

For effective and valid collection of data, I have focused on secondary data collection in which number of sources are being accessed and evaluated. I have also witnessed that time frame has been taken into account by me to accomplish objective. Sources are accessed only published between 2010 - 2018. It means the recent articles and sources are being accessed to have effective collection of data (Greenhalgh and Peacock, 2015). In addition to this, it can be said that this, data range has been selected by me because it allows to attain recent and valid information so I have considered the same as a standard in search. Along with this, reliability of information has also been advanced by setting out the data range between 2010 – 2018. With an assistance of such measures the information can also be presented in reliable manner which assist in understanding the topic more effectively.

Subject headings and key words

In order to have consideration of Pico, initially the relevancy of keywords has been taken into account. In this, it has been noticed by me that children’s are facing issues in terms of eczema and asthma. It also indicates that earlier it was identified that by setting out keywords on the basis of Pico the articles selection can be taken into account in standardised manner (Shojania and Bero, 2011). I have witnessed that keywords which are accessed during article selection are as children, 6 years old, eczema, croup, respiratory infection, asthma, etc.

Search Strategy

It has been witnessed that at the initial level the content was searched with a single keyword like asthma. It has allowed me to provide a detailed description of study and ensure that work to refine the results is being considered as critical section. Along with this, I have also accessed the content with a help of multiple keywords like children, 6 years old and asthma. Along with this, I have decided that sources are being searched with limited scale like year 2010 -2018. Using proper keywords the searching has been accomplished and ensure that specific results about the subject is being taken into account.

Google Scholar

In addition to this, it can be said that using google scholar the information in regard to the topic has also being searched. By having an easy access to search engine the content has been searched by me so that overall learning can be developed in significant manner. Effective consideration of google scholar the Pico questions has been addressed. Although google has also helped in accessing number of articles issues by medical authorities in respect to concern subject (Greenhalgh and Peacock, 2015). With an effective evaluation of key measures I have developed an evidence based practice. Along with this, additional information has also been accessed in respect to the subject so that overall information can be accessed.

Library

It has also been witnessed that for effective collection of information in respect to the Pico the authorities has also focused on library access. It has allowed me to collect the data in respect to eczema, croup and asthma. By having an access to the library the different books and articles are being reviewed in order to have appropriate consideration of subject.

Sources

In present research the information has been gathered in respect to Pico question by having search of secondary sources and literature. It has been noticed by me that publications which has been identified to have selection of answer provides a detailing in respect to Pico question. In this, number of journals has been accessed by me which provides an original information about subject with detailing of the authors. Systematic review and summary evolution has also been taken into account by the manager for sustainable development. Along with this, I can state that nursing database has also been accessed and evaluated in respect to have effective collection of information regarding early children, eczema, croup and asthma. By having a detailed evaluation of standards the issues in terms of data collection has been reviewed so that article selection activity can be accomplished properly.

Selection of the final articles for review

On the basis of several criteria and standards the selection of final articles has been taken into account. Along with this, it has been noticed that initially I have ensure that selected articles must provide a specific information about the subject. In this respect the consideration of abstract has been taken into account. By having an analysis of summary and abstract the significance of article has been reviewed. It has also been considered by me that mythology information has also been shared properly in the article so that outcome can be accomplished. In addition to this, observing all standards and key values of article I have selected the articles. One of key aspect considered during selection was focus on analysis of content presented in article.

  • Article 1: Vermeulen, E. M., Koplin, J. J., Dharmage, S. C., Gurrin, L. C., Peters, R. L., McWilliam, V., ... & Allen, K. J. (2017). Food Allergy Is an Important Risk Factor for Childhood Asthma, Irrespective of Whether It Resolves.The Journal of Allergy and Clinical Immunology: In Practice.
  • Article 2: Wolsk, H. M., Chawes, B. L., Litonjua, A. A., Hollis, B. W., Waage, J., Stokholm, J., ... & Weiss, S. T. (2017). Prenatal vitamin D supplementation reduces risk of asthma/recurrent wheeze in early childhood: A combined analysis of two randomized controlled trials.PLOS one,12(10), e0186657.
  • Article 3: Saunes, M., Øien, T., Dotterud, C. K., Romundstad, P. R., Storrø, O., Holmen, T. L., & Johnsen, R. (2012). Early eczema and the risk of childhood asthma: a prospective, population-based study. BMC paediatrics. 12(1). 168

PART B

Article 1

PICO question: Are children under the age of 6(p) with early onset eczema and a history of croup (i) more likely to develop asthma (o) as opposed to those with no history of respiratory infections?

Author(s), Date, Article Title, Journal, Volume, issues (APA)

Primary Author Credentials

Journal Ranking, Bias, Reliability

Vermeulen, E. M., Koplin, J. J., Dharmage, S. C., Gurrin, L. C., Peters, R. L., McWilliam, V., ... & Allen, K. J. (2017). Food Allergy Is an Important Risk Factor for Childhood Asthma, Irrespective of Whether It Resolves.The Journal of Allergy and Clinical Immunology: In Practice.

Evelien M. Vermeulen, BSc, Jennifer J. Koplin, PhD, Shyamali C. Dharmage, MBBS, MSc, MD, PhD, Lyle C. Gurrin, PhD, Rachel L. Peters, PhD, Vicki McWilliam, BSc, MND, Anne-Louise Ponsonby, MBBS, FAFPHM, FRACP, PhD, Terence Dwyer, PhD, Adrian J. Lowe, PhD, Mimi L.K. Tang, MBBS, PhD, FRACP, FRCPA, FAAAAI, Katrina J. Allen, MBBS, BMedSC, FRACP, FAAAAI, PhD.

This is interdisciplinary journal publishes high quality peer that is focused on variation that are identified asthma due to croup in children.

Research Question and Purpose

To understand whether challenge-proven food allergy in infancy increases the risk of asthma at age 4 years, using data from a population-based cohort.

Main purpose of this research is to determine the risk that is faced by children due to food allergy. A child gets affected due to changes in trends in type of food that are provided to them and when they get allergic, then it causes serious health related issues. Different strategies are determined that enable to make child overcome these type of conditions.

Research Method: Approach, sample, setting, Data Collection, Analysis

In accordance with the type of method that is implemented, there are in total 5376 infants were recruited and this is was done by making use of population based sampling frame. Infants underwent skin prick test to egg, peanut, and sesame and those with a detectable skin prick test result had oral food challenges. At the age of 4 repetition of food challenges in order to determine resolution and persistence of food allergy. The association between food allergy and doctor-diagnosed asthma was examined using binomial regression in 2,789 participants.

Research Findings

In accordance with the findings made it is being identified that Children with food allergy at age 1 year had an increased risk of asthma. Further, The risk of asthma was highest in children with food allergy and coexistent eczema in infancy. In addition to this, Transient food allergy and persistent food allergy were both associated with an increased risk of asthma.

Applicability to Clinical PICOT question Details why and how the article relates to the clinical PICOT questions

Are children under the age of 6(p) with early onset eczema and a history of croup (i) more likely to develop asthma (o) as opposed to those with no history of respiratory infections?

This article is related with PICO questions and rate of asthma can increase with growth in body and this can cause serious problem and can also give raise to other health problems and it requires to take up appropriate steps so that the rate of issues faced be reduced.

Article 2:

Author(s), Date, Article Title, Journal, Volume, issues (APA)

Primary Author Credentials

Journal Ranking, Bias, Reliability

Wolsk, H. M., Chawes, B. L., Litonjua, A. A., Hollis, B. W., Waage, J., Stokholm, J., ... & Weiss, S. T. (2017). Prenatal vitamin D supplementation reduces risk of asthma/recurrent wheeze in early childhood: A combined analysis of two randomized controlled trials.PLOS one,12(10), e0186657.

Helene M. Wolsk (COPSAC), Bo L. Chawes (COPSAC), Augusto A. Litonjua (Department of Medicine), Bruce W. Hollis, Johannes Waage, Jakob Stokholm, Klaus Bønnelykke, Hans Bisgaard, Scott T. Wei.

This is interdisciplinary journal publishes high quality peer that is focused on emergency departmental care for children with asthma and croup.

Research Question and Purpose

To perform a combined analysis of the two trials and investigate whether maternal 25-hydroxy-vitamin D (25(OH)D) level at trial entry modified the intervention effect.

Main focus of this research is to provide the benefit of Vitamin D in reducing the rate of issues that are faced by children with Asthma. This is possible when women are conscious and taken up initiatives to taken high rate of vitamin D.

Research Method: Approach, sample, setting, Data Collection, Analysis

VDAART (N = 806) and COPSAC2010. (N = 581) randomized pregnant women to daily high-dose vitamin D3 (4,000 IU/d and 2,400 IU/d, respectively) or placebo. All women also received a prenatal vitamin containing 400 IU/d vitamin D3. The primary outcome was asthma/recurrent wheeze from 0-3yrs. Secondary end-points were specific IgE, total IgE, eczema and lower respiratory tract infections (LRTI). We conducted random effects combined analyses of the treatment effect, individual patient data (IPD) meta-analyses, and analyses stratified by 25(OH)D level at study entry

Research Findings

The analysis showed a 25% reduced risk of asthma/recurrent wheeze at 0-3yrs: adjusted odds ratio. The effect was strongest among women with 25(OH)D level ≥30ng/ml at study entry: aOR = 0.54 (0.33–0.88), p = 0.01, whereas no significant effect was observed among women with 25

Applicability to Clinical PICOT question Details why and how the article relates to the clinical PICOT questions

Are children under the age of 6(p) with early onset eczema and a history of croup (i) more likely to develop asthma (o) as opposed to those with no history of respiratory infections?

This article is related with PICO questions as it focus on proving women with Vitamin D so that the rate of issues that are faced by asthma can be reduced.

Article 3:

Author(s), Date, Article Title, Journal, Volume, issues (APA)

Primary Author Credentials

Journal Ranking, Bias, Reliability

Saunes, M., Øien, T., Dotterud, C. K., Romundstad, P. R., Storrø, O., Holmen, T. L., & Johnsen, R. (2012). Early eczema and the risk of childhood asthma: a prospective, population-based study. BMC pediatrics, 12(1), 168.

Marit Saunes, Torbjørn Øien, Christian K Dotterud, Pål R Romundstad, Ola Storrø, Turid L Holmen and Roar Johnsen

 

This is interdisciplinary journal publishes high quality peer that covers early eczema and the risk of childhood asthma

Research Question and Purpose

  • What are the risks involved in early eczema for children?
  • What is the impact of early eczema of children with asthma?

Main purpose of the research is to determine early eczema and the risk of childhood asthma.

Research Method: Approach, sample, setting, Data Collection, Analysis

Questions related with health variables and environmental exposures were administered at 2 years of age.

Research Findings

The estimate for the association between eczema at 2 years and current asthma at 6 years was OR=1.80. Four of ten children with eczema at 6 years had the onset of eczema after the age of 2 years, but the co-existence of different allergy-related diseases at 6 years was higher among those with the onset of eczema before 2 years of age.

Applicability to Clinical PICOT question Details why and how the article relates to the clinical PICOT questions

Are children under the age of 6(p) with early onset eczema and a history of croup (i) more likely to develop asthma (o) as opposed to those with no history of respiratory infections?

This article is related with PICO questions as it is focused on early eczema and the risk of childhood asthma which similar.

SUMMARY

In accordance with the above given articles, it can be stated that all three were highly effective and these were helpful to consider the PICOT questions. From the analysis made from all the other articles, it is identified that at early stages when a child has eczema and croup, then it increases the risk of asthma. Further, it is also identified that child face serious issue when any of the diseases are caught. Apart from this, there are different types of risk that are faced by people who have asthma, croup or eczema. In all these aspects, it is important for professionals to convey information and take up steps so that they are able to support with the help of which the rate of negative impact can be reduced in effective manner. When a child grows, then the problem faced increases tremendously and causes other problems as well.

REFERENCES

  • Greenhalgh, T. and Peacock, R., 2015. Effectiveness and efficiency of search methods in systematic reviews of complex evidence: audit of sources.Bmj.331(7524). pp.1064-1065.
  • Maniezzo, V., 2011. Positive feedback as a search strategy. Sage.
  • Saunes, M., Øien, T., Dotterud, C. K., Romundstad, P. R., Storrø, O., Holmen, T. L., & Johnsen, R. (2012). Early eczema and the risk of childhood asthma: a prospective, population-based study. BMC pediatrics, 12(1), 168.
  • Shojania, K.G. and Bero, L.A., 2011. Taking advantage of the explosion of systematic reviews: an efficient MEDLINE search strategy.Effective clinical practice: ECP.4(4). pp.157-162.
  • Vermeulen, E. M., Koplin, J. J., Dharmage, S. C., Gurrin, L. C., Peters, R. L., McWilliam, V., ... & Allen, K. J. (2017). Food Allergy Is an Important Risk Factor for Childhood Asthma, Irrespective of Whether It Resolves.The Journal of Allergy and Clinical Immunology: In Practice.
  • Wolsk, H. M., Chawes, B. L., Litonjua, A. A., Hollis, B. W., Waage, J., Stokholm, J., ... & Weiss, S. T. (2017). Prenatal vitamin D supplementation reduces risk of asthma/recurrent wheeze in early childhood: A combined analysis of two randomized controlled trials.PLOS one,12(10), e0186657.
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