Nutrition/Dietary Paper

Question

Critique Assignment = 25 points

Approximately 3 (MAX) pages in length (you can submit it any time before the deadline)

You will choose 1 article from a peer reviewed journal related to a topic that aligns with the course objectives. Please review the posted link in the project tab on Blackboard to determine where to locate peer reviewed journal articles.  You may want to avoid systematic reviews, literature reviews, meta-analyses or qualitative studies as these will not lend well to the critique process. 

You will critically only 1 article  = 25 points.

You will find a drop off link in Blackboard.

Critique Instructions:

Address all points clearly and concisely.   When submitting this you will also need to attach the original article that you are reviewing.   Use the drop off link to attach both files. 

At minimum your critique should address these elements:

0.5 pt – APA citation of article

Section 1 – Elements influencing the believability of the research:

0.5 pt – Writing Style – describe the writing style

0.5 pt – Author(s), credibility of the author(s)

0.5 pt – Report title – does the title match the report? length? attracting?

1.5 pts – Abstract – does the abstract summarize the research question, methods, data analysis, results and conclusion?

Section 2 – Elements influencing the robustness of the research:

2.5 pts – Purpose/research problem – What is the research problem or research hypothesis?  Is the problem clearly identified? Is the significance of the problem noted and described?  Does the paper clarify the aim of the study?  Is there a clear link between the conceptual theory and the research question? Is the study practical?  

1 pts – Logical consistency – is there good flow? Organization? Are ideas presented clearly and well defined? 

2.5 pts – Literature review – Describe the review of the literature.   Are the references up to date? How is the literature organized?  Do previous studies lead toward the study or research question? Is the rationale and direction for the study indicated in the lit review? 

1.5 pts – Theoretical Framework – Are any models, theories, constructs used or presented in the development of the framework for this study? Is it logical?  

1.5 pts – Aims/objectives – are the aims of the study well established? Does this align with the theoretical framework?

2 pts – Sample – who, sample size, exclusion criteria, inclusion criteria, generalizability to the population

2 pts – Ethical Consideration – does the study describe ethical concerns? IRB approval, steps described?

1 pts – Operational Definitions – are new terms, definitions clearly defined in a logical manner for the reader?

3 pts – Methodology – what were the methods? Can you reproduce this study? Are there any concerns with the methods? 

2 pts – Data analysis/results – describe the data analysis procedures and results – were any results significant?

2 pts – Discussion/Conclusion – does the discussion add to the topic and the results section? Does this include implications for further research? Does the conclusion discuss limitations of the study? 

0.5 pt – References – were references up to date, from credible source

Answer

Article Critique: “Understanding Nutritional Gaps in the Elderly”

Understanding Nutritional Gaps in the Elderly

Mudge, A. M., Ross, L. J., Young, A. M., Isenring, E. A., & Banks, M. D. (2011)

                The journal article was published in the Clinical Nutrition Journal and was authored and published in 2011. All of the authors of this article are not only qualified scholars, they are also highly respected authorities in the field of medicine with specialization on nutritional issues. The writing style that they adopted that of an exposition. Firstly, the idea behind the experiment is well laid-out, then the justification for this idea has been provided. On the other hand, the process of experiment and data to answer the research problem has been specified. Bias does not seem to be a major issue whatsoever in this journal article. It seems to have been written in a completely impartial manner with empirical evidence presented and expounded on explicitly. The title, though rather long, matches the contents of the text as it states precisely what the paper aims to do. The abstract adequately describes the methods, data analysis, results and conclusions of the study. However, it does not clearly outline the research questions that the authors were attempting to answer.

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In this study, the authors of performed a retrospective cohort study, and the chosen location was the Michael E. DeBakey Veterans Affairs Medical Center (MEDVAMC). Besides, the hypothesis was clearly spell out: to describe the prevalence of inadequate energy and protein intake among older medical in-patients within the first week of hospital (Mudge, Ross, Young, Isenring, & Banks, 2011). This hypothesis stipulates that lack of adequate energy and protein intake leads to susceptibility to infections and worsening health conditions among the elderly.

The study appears satisfactorily practical in nature, with the authors examining patient records from July 2007 through July 2010, and follow-up observations continuing through July 2012. Moreover, it has been laid out in a logical sequence with well-organized points and ideas. To begin with, Mudge et al. (2011) searched the MEDVAMC database for veterans with protein intake between 100 and 125 mg/dL or energy between 5.7% and 6.4%. Of the 134 patients whose mean age was 80 years, 51% of whom were female, only 41% fully fulfilled the estimated requirements in terms of resting energy. Researchers collected demographic and laboratory data, including age, sex, height, weight, BMI, glucose, and HbA1c. They were also interested in weight change, visits to nutrition clinics and dates of no-shows. The factors that were found to be associated with several health-related problems, including inadequate intake of energy through multivariate analysis include higher BMI, poor appetite, delirium, diagnosis of cancer and infectious diseases, and the need for assistance particularly in terms of feeding. Inadequate nutritional intake was found to be a common problem. For this reason, the authors argued that factors that predispose patients to poor intake need to be put in consideration in the design of nutritional interventions. I feel that the general layout of this study is acceptable, although there is an overwhelming lack of women used in this study, and this could possibly skew the results.

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The authors state that they used a Cox proportional hazards model to analyze the energy and protein intake of elderly patients within the first week of admission. They list the factors they used for this model, but fail to explain how this model actually works. While it makes sense that the authors would want to try to predict this, it would be helpful if they were to define how it is calculated. They do, however, clearly explain their objectives, and the above model seems to be directly related to these objectives. Meanwhile, it may have been better if definitions for key or new terms were provided. Because of this omission, readers are compelled to conduct their own independent research to understanding the meaning of the unknown terms.

The discussion and conclusion sections do provide additional commentary relating to the study and its findings. They explain that the study focuses on elderly patients and therefore may not be applicable to the other demographics within the larger population. It is also important to note that as with any experiment, the sample selected may not necessarily be an accurate representation of the state of the art within the actual population on the ground. The authors also mention their lack of female participants in the study, as well as the fact that they did not look at any diet change or physical activity conducted by participants. Moreover, they have indicated that they did not include those taking medications. In their view, all these are crucial factors that should be considered in future studies relating to this topic.

There may possibly be a conflict of interest for two of the authors, as they are both employed by the facility at which the study was conducted. On the larger part, though, no ethical issues were cited. Of importance to note, however, is that there is no mention of efforts by the authors to obtain approval from the Institutional Review Board (IRB). Lastly, the references used by appear to be relatively up to date (within the past 10 years or so), credible and relevant to the research conducted and the topic chosen.

References

Mudge, A. M., Ross, L. J., Young, A. M., Isenring, E. A., & Banks, M. D. (2011). Helping understand nutritional gaps in the elderly (HUNGER): A prospective study of patient factors associated with inadequate nutritional intake in older medical inpatients. Clinical Nutrition30(3), 320-325.

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