Dr. D. E. Masini
Research in Allied Health ALHE4060
Exam for Bailey Workbook.  This is an Open Book exam, and you may use any tools or documents to complete this exam.  No team testing or assistance from peers is allowed, the tenets of the ETSU Honor Code covers your taking this exam.    Directions: Complete this exam contextually, in that all questions should refer to Bailey's Workbook and to your study that you are handing in for credit.  You may refer to your bibliography or practical examples if the question is not addressed in your study.  This semester (as an experiment) you will post Bailey's Exam to the Student webpage.  Let me know how I can assist you...dr. m

1. Your instructor has reviewed several strategies to conduct and report on scientific research.  Discuss the procedures in the positivistic, scientific method and the components of this research paper. List two reasons why you agree or disagree with this worldview and how you might utilize it for your future research agenda.

Positivist looks for universal laws or “truths”.  This is a quantitative type study. It deals with numbers and calculations that can represent known values. The studies are divided by design type. Experimental design, is the classic style with random selection, control groups, pre and post testing, and allows for manipulation of the independent variable. Quasi-experimental design does not require randomization. Non experimental design cannot prove causation because the damage has already been done, it can merely show correlation. The studies are generally longitudinal and the time frame varies. Case studies are often exploratory, with one researcher gathering data in a natural setting. I agree with this type of study because it is best to keep subject lives a normal as possible. It is important to the validity of the study, and also for the comfort of the subject. It is the best type of study with people, and I wish to help people be healthy with minimal invasive procedures.

2. We have stated that the researcher must remember the equation [dependent variables = independent variables]. Discuss the differences between independent and dependent variables and the influence one exerts upon the other.  How was this theorum influential in your study or project?

 Independent variable is the variable that is being manipulated. The dependent variable is effected variable, which determines the extent of effectiveness of the manipulation. The dependent variable is examined in the beginning and end of the study. There were two independent variables in my study diet and exercise, the dependent variable was the areas of brain lesions symptomatic of Alzheimer’s disease that were affected by both diet and exercise.

3. Create a list of the independent variables you identified in your study (Hint: these
are important client, institutional, environmental, or patient characteristics). Give one example of a variable you could change or 'fix' in a departmental, governmental, or organizational policy.

Diet (Low Cholesterol, high cholesterol, high fat, low fat), exercise, age, illness level, willingness to change diet exercise habits, gender. Governmental funding for economical exploration of healthcare options, example fitness programs for all ages, more dieticians and nutritionist, less drugs and surgeons. Put Physical education back in school and emphasize the importance. Also mandate environmental friendly energy sources, example hydrogen fuel cells, solar, wind, and methane heat from composted waste. Alternative housing materials like straw bale, mud brick, etc. Save the trees they cool our planet and prevent mudslides and floods. Let the gators have the swamps back. Need I go on????

4. When creating a study, one must address the operational definitions for individual studies.  Give 3 examples of operational definitions you encountered in your project.  How does this process help or hinder the researcher?

Hyperphosphorylation – too much phosphorylation, which disrupts normal brain function. Tau – brain tissue, Cytoskeleton – external cell wall. It can hinder the researcher because it makes the studies hard to decipher. It can also be a point of misconception for the reader. It is necessary for the writer to explain terms.

5. Define the different scales of measurement (i.e. Ordinal, Nominal, Interval, Ratio). In each of these scales of measure, how would the researcher decide on which statistical analysis to use?  How did you decide what methodology to use (theoretically, you told me in METHODS chapter what you decided to do with all of the datum).

    Ordinal is classified as nonparametric therefore it represents only tendencies or preferences. You can use a Likert scale to determine degrees of preferences. Then inferential statistic tests like the Mann-Whitney test, or median test.

    Nominal data is nonparametric data that can determine preferences such as yes/no response or never/sometimes/always. The inferential tests are the Chi-square Goodness of Fit test, Chi-square test of Independence, Contingency coefficient, Cramer’s V, Phi, or Lambda tes.

    Interval data is continuous, considered parametric, and is tested by t-tests or variance analysis such as the t-tests for Independent or Related samples, or the Reported Measures Analysis of Variance, or Analysis of Covariance. I used an Analysis of covariance in my study to determine that gender was not an effecting factor. I also used this test in relation to the diet and exercise variables. The progression of degeneration was compared with a t-test. MRI tests were evaluated using the SAS statistical package. Data concerning caloric intake and exercise were analyzed using statistical parametric mapping.

   Ratio data is continuous and has equal intervals between numbers. It is considered parametric, and can be tested by Product Moment Correlation, Brivariate Linear Regression, Multiple Regression, or Multiple or Canonical Correlation. .

6. Discuss the types of reliability. Why does a researcher in health care consider reliability an important component of their study?

 Reliability in a qualitative study is concerned with the chances of replication of the study. A study needs to be able to be replicated in order for it to be accepted. External reliability can be protected by identifying the research status position, descriptive informant choices, understand the pressure from social situations, define analytic constructs and premises, standardize techniques for data collection and analysis. Internal reliability can be protected by use of low inference descriptions, the use of multiple researchers, participants to correspond on research, peer examination of information, and mechanically recorded data.

 Reliability in a quantitative study has to take into account the effect of the study itself. Subject fatigue, subject motivation, subject learning, ability, tester skill, different testers, and environment all can have an effect on reliability of results.

7. Define validity. Examine internal and external validities and list attributes or problems associated with validity issues (think from the perspective of a potential patient or an informed peer reviewer of your study).

   Validity in a qualitative study is the believability of the assumptions of the study. There are many ways to test this. One is to examine rival causes such as other explanations for the observations. In my test you would ask if the changes in the scans were in fact a result of the treatments or other causes. Examination of negative cases, this would be the question of why some did not like the exercise as the study continued. Triangulation is the process of using data collection techniques to study the same program. This can be established by asking participants if they have noticed a difference in their memory since they began the study, or if they feel any different. Design checks can be eliminated by not generalizing results. The results in my study were only significant to the participants that met my criteria, not all patients who suffer from Alzheimer’s disease. Researcher effect can be eliminated by having patients be evaluated by someone they already know. I have eliminated this by having the patients nursing staff make the notations and findings. I personally do not come in contact with the patients, and the CT and MRI scans do not allow for bias as well. Researcher competence is also a non issue because the medical staff is doing the work I am simply compiling the data as a researcher. Participant reactions give a real perspective to what has been noted, and they can clarify any misconceptions. Intellectual rigor is the ability to stick to the data and report it just as it comes in, not to jump to conclusions. This is difficult not to do in our instance because we do not actually do the study.

  Validity in a quantitative study examines if the observing and measuring is actually observing and measuring what they wish to measure. Internal validity can be affected by history which can be eliminated in my study due to the stringent eliminations for other health problems. Maturation would not affect my study, as it is on mature people. The testing will not be an issue because of the MRI and Ct scans. Subject selection is eliminated because of the random assignment. Subject mortality is always an unavoidable issue.  Measures for precision of instrumentation were addressed by using the same CT scanner and MRI. External validity can be affected by the hawthorn effect it should not be an issue due to the exam techniques. Replication could be done at any facility. Generalizability should be possible and multitreatments were accounted for and researcher effect is not an issue because the researcher does not interact with the participants. All the issues need to be taken into account to ensure the study is measuring what it is supposed to as my study has. I could also triangulate my study with a qualitative study

8. Discuss the characteristics of a quantitative research design. Name and discuss at least two designs from this worldview or viewpoint.  Why would you decide to use this worldview or research methodology (instead of qualitative)?

Quantitative research uses three criteria in different orientations. Manipulation is the treatment given to the subject. Control is an attempt to eliminate doubts about the effect of the manipulation. The control is given no treatment when ethically possible or given old treatment in the study of a new treatment. Randomization is a way to keep from having selection bias in a study. All subjects meeting criteria have equal chance of being selected.

   True experimental design uses all three criteria. This design allows for the researcher to compare different types of treatment and to determine which type is most likely to be the most effective.

  Quasi – experimental design lacks control or randomization, although it does have a manipulation that is given to an independent variable to see the effect on the dependant variable. There is a pre and post test. Often there is a period of no treatment to the same group. This time acts as the control.

  This world view gives a more scientific expression of the events that take place in the study. Qualitative studies are all from a outside perspective or opinion of subject. This is good for judging resultant actions, or opinions of the subjects, but it does not account for scientific calculations of correct findings.

9. Discuss the characteristics of a qualitative research design. Name and discuss at least two designs from this worldview or viewpoint. Why would you decide to use this worldview or research methodology (instead of quantitative)?

   Qualitative design uses thick description and subjects in a naturalistic setting, meaning in their own opinions. It also uses local groundedness to keep outer influences from affecting the results. Phenomenological perspective places validity in the perceptions, assumptions, judgments, of the subjects and the world around them. Thick description is vivid and has a strong impact on the reader. Lived experiences of the subject are included in their judgments, perceptions and assumptions.

   Ethnography is a study that attempts to describe a people or culture. This would be used to give a new understanding to the researcher.

  Unobtrusive Researcher and Observer studies the researcher attempts to remain distant from the subject. The distance is an attempt to keep from influencing the subjects.

Qualitative design is good for sociological, educational, or anthropological studies. It is also being used to give a humanistic approach to medical studies. I could use qualitative technique to triangulate my results.

10. Your instructor has stated that “…the best positivistic (quantitative) studies often arise from a relativist study or (qualitative) framework of inquiry.” Discuss advantages and disadvantages of qualitative and quantitative research designs.  If you had it to do over, would you change the methodology you used in your study?

   Qualitative advantages are for society and humanity. Disadvantages are exact results. Quantitative advantages are for science and medicine. Disadvantages are lack of human understanding.

   Qualitative give ideas and opinions that can lead to the ideas of quantitative study. Once the quantitative study results are in it is good to reexamine from a qualitative perspective to triangulate the results and ask more questions for future studies.