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Discuss the impact of changing technologies and social media on the distribution of tourism products and the role of the customer in the delivery of tourism services.

  • Discuss the impact of changing technologies and social media on the distribution of tourism products and the role of the customer in the delivery of tourism services.
  • Your essay must be theoretically informed and we would expect extensive use of academic literature within the essay. This literature should provide the foreground of the essay and be the basis for subsequent analysis.
  • Non-academic references (reports/websites) are permitted but these must be properly cited and referenced and be used primarily to illustrate issues derived from your review of academic literature.
  • Your word limit[1] for this assignment is 3,000 words. At least fifteen journal articles should be cited.

[1] The word limit does not include tables/figures/appendices/references

What do you see as the most significant or important issue or aspect of these social relations for women today, or our world as we understand it moving forward? Why? What do you see as the principal causal factor, or factors?  How or why? Do you see a way forward?

What do you see as the most significant or important issue or aspect of these social relations for women today, or our world as we understand it moving forward? Why? What do you see as the principal causal factor, or factors?  How or why? Do you see a way forward?

  • Feminism looks very different within other societies. This needs to be accepted my mainstream western feminist that (most of the time unknowingly) push their own views and narrative and setting back other feminist movements
  • Transnational Feminism
  • Yes to Intersectionality…BUT how should it be applied to help non-westren feminist movements?

READINGS

Kantola, J. (2010 [2006]) Gender and the State: Theories & Debates. Krook & Childs, 299-304.

  1. 312

Baldez, L. (2010 [2003]) Women’s Movements and Democratic Transition in Chile, Brazil, East German, and Poland. Krook & Childs, 37-45.

p.50

  • By comparing Chile, Brazil, East Germany, and Poland, Baldez offers a perspective on the nexus between women‟s movements and democratization. The author argues that women have tended to disregard individual differences within a movement in favor of unity based on their gender identity. Though general in theory, Baldez delves deeper into the argument by detailing each case study, which is helpful in defending the original thesis. The article is effective at providing a larger world-view of women and democratization without diminishing the experience in the individual country. Unfortunately, the argument is proven right only temporarily, as Baldez finds. An honest analysis reveals that while gender can unify initially, most women‟s movements separate into disparate groups based on conflicting interests.
  • Baldez contends that the success of women’s mobilization in East Germany, Brazil, and Chile led to better outcomes for women in comparison to Poland, where women were less successful.

Mohanty, C. (2013) Transnational Feminist Crossings: On Neoliberalism and Radical Critique. Signs 38(4) Intersectionality Theorizing Power, Empowering Theory, 967-991

Chandra Mohanty addresses the central question of how the neoliberalization of the academy affects feminist scholarship (2013). What is unique about Mohanty’s intervention is that she highlights the role of postmodern scholarship and the ways in which it distracts from structural forms of oppression. Mohanty sets out to address the dismissal of systemic analysis on the grounds that it cannot address internal conflicts within systems, and argues that “this particular postmodernist position converges with the proliferation of depoliticized multiplicities that is a hallmark of neoliberal intellectual landscapes,” (Ibid, 968). Postmodern scholarship has long been averse to grand narratives or a focus on structural analyses of power, seeing them as essentialist and reductionist. Mohanty writes of “the familiar postmodernist argument where ‘differences

within’ always trump critical analyses of dominant discourses, leading to a refusal to identify the existence of a hegemonic feminism that has systematic effects on marginalized communities,” (983). However, as Mohanty points out, by neglecting the structural or the universal, it becomes difficult to address questions of imperialism, national liberation, and capitalism. It has become commonplace to hear calls to not generalize, essentialize, or create binaries between East and West (for example). These calls perform a call to complexity and to abandon over-simplification. However, this has the parallel effect of emphasizing “internal differences” over hegemonic structures.

It is useful to bring together the critiques made by Mohanty about feminist studies in general with the critiques made by Bilge, Carbin, and Edenheim about intersectionality, in particular. All of these pieces focus on neoliberalism as a key factor in explaining the de-radicalizing of feminist scholarship. What is notable about Mohanty’s piece is that it brings in postmodernism as another part of the story: postmodernism, as an approach tied to the neoliberalization of the academy, is also responsible for this de-radicalizing, because it has taken attention (and validity) away from more structural understandings of oppression. This raises the question of how postmodernism and its increasing popularity have affected intersectionality, and vice versa.

The context of the academy has been central to diluting intersectionality. As Mohanty writes, postmodern skepticism of intersectionality “converts what originated as a compelling theory of the interwoven structures and inequities of power to an inert theory of identity that emphasizes difference over commonality, coalition, and contestation,” (2013, 974). This conversion is key, as it means we are back to identity politics minus power relations.

Karen Beckwith (2010) Beyond Compare? Women’s Movements in Comparative Perspective Krook & Childs, 29-36.

P.42

Strolovitch, D.Z (2010 [2006]) Do Interest Groups Represent the Disadvantaged? Advocacy at the Intersections of Race, Class, and Gender. Krook & Childs, 55-62.

P.68

– Strolovitch (2006) focusses on sub-groups within organizations advocating on behalf of the disadvantaged, she further problematizes this, when she finds that in cases where disadvantaged have organized a voice such as in the National Organization for Women, these mainly focus on issues of concern to relatively privileged constituents of the group.

–  Strolovitch highlights that interest groups often prioritize the interests of their most advantaged members, such as male rather than female racial minorities, or affluent rather than poor women.

– interest groups might still favour stronger members over weaker or deprived members in setting organizational goals.

– argued that the value of intersectionality is that it allows for one to study the least advantaged within uniaxial approaches. Research and advocacy tends to focus on members of the group that are by their nature better advantaged than other members of the group; women’s groups tend to focus on issues that impact white women more than they impact black women.

Chappell, L. (2010 [2000]) Interacting with the State: Feminist Strategies and Political Opportunities. Krook & Childs, 313-318.

p.326

Dahlerup, D. & Freidenvall, L. (2010 [2005]) Quotas as a “Fast Track” _to Equal Representation for women: Why Scandinavia is no Longer the Model. Krook & Childs, 175-184.

p.188

Identify and discuss two strengths and two weaknesses of this policy specifically related to this situation (not her initial hospitalization).

Paper 1 Health Policy Examination

Obtain a copy of your own health insurance policy (also referred to as the Schedule of Benefits) through your family or a copy of your B.U. Aetna Insurance Co. policy, if you carry that insurance.

Using your health care policy, write a paper to answer the questions below.

Scenario: Sara, a 21 year-old B.U. undergraduate student suffered a head injury over break. Sara is on the crew team. She has a part time job off campus as a waitress. After the injury, she has short- term memory problems, loss of appetite, and is feeling depressed. She has decreased coordination, mild left-sided weakness and mild expressive aphasia (word finding ability). Sara is determined to get back into full participation at school, and with her doctor’s agreement, begin the semester. She is home after spending one night in the hospital. Her physician clears her to return to school but recommends that she see several different health professionals as an outpatient when she returns to Boston to begin school again.

Write in the third person as if you are a professional explaining the policy coverage to someone else. You are role playing as “Sara” using your own policy.
Your paper will address all of the following questions:

  1. 1-  How much does the subscriber (you or your parents) pay annually? Briefly explain what type of policy this is (e.g. HMO,PPO, IPA, POS model). (Note: The true cost of insurance is often shielded from the consumer. The purpose of this information is to enlighten you as to the cost of insurance). You will need to get this information in most cases directly from your parent/guardian.
  1. 2-  How much will Sara pay for medications, (including in and out of network costs, co-payments, generic drugs, drug tiers, and mail order)?
  2. 3-  Sara’s physician recommends counseling, at least weekly for the next two months. What does the policy cover (including in and out of network costs)? How much will Sara pay out-of-pocket for counseling? Whom specifically can she see (i.e. a psychologist, psychiatrist, social worker, etc)

4- Sara needs to see a nutritionist, and an occupational therapist, physical therapy, and speech and language health professional and she may need ongoing treatment from each of these practitioners. Which of these services does her policy cover (including in and out of network costs) and how much will she pay for out of pocket for visits?

5- Identify and discuss two strengths and two weaknesses of this policy specifically related to this situation (not her initial hospitalization).

Paper Requirements:
§ See formatting requirements under Common Understandings.
§ 3-4 pages in length (not including title or reference page). Nothing beyond 4 pages will be read or graded.
§ In the text, reference the page numbers from your policy relevant to each question.
§ Follow APA style for referencing. See Quick reference for APA style
§ Highlight (in color) all pertinent information on the insurance policy
§ Attach the relevant plan information to your paper. You will receive this information back with your graded paper. § See grading criteria below.
§ Insurance Paper Grading Criteria Student Name__________________________________

  Max Pts.   Comments
    Ideas  
  4 Clearly discusses the type of policy and all costs to the subscriber.  
  5 Clearly and completely discusses cost of medications (including co- payments, generic drugs, drug tiers, and mail order).  
  5 Clearly and completely discusses coverage (3pt) and out of pocket cost (2 pt) of counseling (including in and out of network costs) and the providers (i.e. psychiatrist, social worker, psychologist, etc) that the subscriber can see under the policy.  
  8 Clearly and completely discusses coverage (including in and out of network costs) and out of pocket cost for nutrition (2pt), occupational therapy (2pt), physical therapy (2pt), and speech and language (2pt).  
  8 Clearly and thoughtfully discusses two strengths and two weaknesses (2 pts each) of the policy related to the situation (separate from the concluding paragraph).  
    Structure  
  3 Begins with a separate introductory paragraph, including a brief summary of the context for the paper.  

12

  3 Ends with a separate concluding paragraph, including a review of the key points of the paper.  
  3 Develops a logical, well-organized discussion of the material.  
    Mechanics  
  3 Follows APA style guidelines with regards to both format and citations.  
  2 Identifies policy page numbers next to cited text (1 pt); highlights pertinent information within the policy (1 pt).  
  3 Maintains a sophisticated and engaging academic tone.  
  3 Presents a college-level (relatively error-free) use of grammar.  
50 TOTAL SCORE (____) x2 = _____  

 

What does “shibboleth” mean and where did the term come from? Comment on the biblical origins of the term, including the narrative context and then discuss how it used by English speakers today.

Assignment Instructions

What does “shibboleth” mean and where did the term come from? Comment on the biblical origins of the term, including the narrative context and then discuss how it used by English speakers today using the following opinion pieces:

Safire, William. “Shattering Shibboleths.” New York Times, October 12, 1998. (This is an essay on the impeachment of President Clinton.)

O’Toole, Finian. “The Good Friday Agreement is so much more than a ‘Shibboleth.’” The Guardian, April 10, 2018. (This is an essay disputing the remarks of a British politician concerning the agreement that brought an end to armed conflict in Northern Ireland.)

Discuss a specific epidemiological study which measured the association between pregnant women’s exposure to the teratogen and adverse effects on the offspring (don’t forget to cite the study).

Assignment on Teratogens

Teratogens are exogenous agents, such as certain chemicals, drugs, or viruses, that disrupt the normal processes of development.  For this assignment you will choose a teratogen, which is known to cross the placental barrier, and cause damage or long-lasting adverse effects to the developing embryo or fetus.  You will do some research on the teratogen and then answer questions below.

Here are some examples of teratogens which cross the placental barrier:

Class of Teratogen Some Potential Choices*
Recreational Drugs Alcohol, Cocaine, Methamphetamine, Nicotine
Infectious Agents Toxoplasma Gondii, Rubella, Cytomegalovirus, Varicella Zoster Virus (chicken pox), Treponema pallidum (Syphilis), Herpes Simplex viruses, Zika virus, others
Prescription Drugs Retinoic Acid (Accutane), Anti-convulsants, Others
Environmental contaminants Mercury, Lead, Others

 

*Before you get too attached to a specific teratogen, be sure that there is sufficient literature on the effects of the teratogen.  To answer question 1, there have to be epidemiological studies that demonstrate an association between exposure of pregnant women to the teratogen and adverse outcomes in their children.  To answer question 2 on the underlying biological mechanisms, there should also be animal studies on the effects of the teratogen.  For example, I do not recommend choosing thalidomide since this was a drug mostly prescribed in Europe (Germany) in the 1940s, thus there would be few epidemiological studies and they would be fairly old and mostly in German.

You must do some research on your teratogen choice in order to answer the following questions.  Here are the parameters for the types of resources you are required to use.  You must actually cite these resources in your answers to the questions below using in-text citations and include them in your reference list at the end. citations should follow APA format:

  • At least 1 review article from published peer-reviewed literature. For example, the following is a review article published in the Journal Nature Reviews Neuroscience on the effects of prenatal exposure to drugs:

Thompson, B. L., Levitt, P., & Stanwood, G. D. (2009). Prenatal exposure to drugs: effects on brain development and implications for policy and education. Nature Reviews Neuroscience10(4), 303.  doi: 10.1038/nrn2598

  • At least 1 primary research article from published peer-reviewed literature: For example, you could find an article that is an epidemiological cohort study which measured the relative risk of infants being born with birth defects or having a developmental delay when the mother was using a specific prescription drug during her pregnancy. You could also find an experimental study that looks at the biological mechanisms for the effects of the teratogen using animals.  The references at the end of your review article (or on some websites) are a good starting point for finding primary research articles.
  • At least 1 Reputable Website (such as government websites (.gov), The Teratology Society, hospital websites, charitable organizations, etc.)
  • Charitable organizations that support Child and Maternal Health, such as the March of Dimes.

https://www.marchofdimes.org/complications/pregnancy-complications.aspx

 

  • You may also cite chapters in books if you wish. For example, the Teratology Primer (https://birthdefectsresearch.org/primer/) has chapters on teratogens such as Alcohol, Prescription drugs like Anti-depressant medications, Environmental Toxins, and Infectious Diseases.

 

You MUST answer the following questions in your own wordsDo NOT quote directly from your sources.  You must paraphrase instead.

  • If you copy from sources, you have committed plagiarism. Turn-it-in software will be used to detect plagiarism.
  • You must cite every new idea you discuss that is not your own (e.g. that came from other sources or is not general knowledge) using in-text citations and include a list of references at the end (in APA format).
  • You must submit a Word document (not pdf) with a title page and your answers to the questions to the LEARN Dropbox for Assignment 2
  • Do not include the actual questions in your Word document, just the question number and subpart (i.e. 1b, 2a, etc).
  • Use a title page for your Assignment with the following:
    • HLTH/KIN/GERON310 Assignment 2 – Winter 2020
    • Title that includes name of Teratogen
    • Your name and Student ID number
  • Use 1.0 spacing and 10 pt Times New Roman Font.

Questions to Answer

1) Epidemiology of the teratogen and risks to development. Vulnerable populations.

1-a) Discuss a specific epidemiological study which measured the association between pregnant women’s exposure to the teratogen and adverse effects on the offspring (don’t forget to cite the study). What type of study was it, how was the study carried out (e.g. describe study design and methods), and what were the main results of the study?  Report on specific statistics to help indicate the risk, such as the odds ratio or relative risk, or prevalence of adverse outcomes in the offspring that were exposed in utero.  You may have to give different statistics for different types of deficits associated with the same teratogen. (18-20 sentences)

Rubric: (5 points)              

Excellent and thorough description of an epidemiological study that measured association between teratogen exposure and adverse effects in the offspring. Your description clearly included the following:

–  thoroughly described study design and methods, including: the type of epidemiological study design; characteristics of the recruited participants, inclusion and exclusion criteria; description of what was measured and at what time points

– Thoroughly described the main results of the study.

– You included statistics to indicate the risk of deficits with exposure to the teratogen. (at least two different statistics to be Excellent)

– You cited the study and/or other relevant sources throughout in your description.

1-b. Which particular populations of pregnant women or regions of the world are most vulnerable or have higher prevalence of exposure to this teratogen?  Explain and cite your sources. (9-10 sentences)

Rubric: (2 points)

– Excellent description of particular populations or regions of the world with higher prevalence of exposure to the teratogen.  Must describe at least 2 vulnerable populations or regions to be excellent.

-You cited relevant sources.

2 Biological aspects of the teratogen effects:

2-a Describe the congenital defects, disorders, or neurobehavioral deficits associated with prenatal exposure to the teratogen.  What organs or tissues are mostly affected?  What are the most sensitive periods of prenatal development for the types of defects described above? (9-10 sentences)

Rubric: (3 points)

Excellent description that includes:

  1. a) Thorough description of the congenital defects, disorders, and/or neurobehavioral deficits.
  2. b) organs and organ systems most affected
  3. c) the most sensitive periods of prenatal development for exposure to the teratogen (note that the sensitive periods may differ for different defects/outcomes)

– You also cited relevant sources.

2-b. For one of the defects described above, describe a potential underlying biological mechanism for the teratogenic effects during development (usually these data come from animal studies).  Be specific in your description of the biological mechanism (e.g. death of cells in a certain part of the brain leading to severe mental retardation, decrease in nutrient transport across the placenta leading to very low birth weight).  (5-6 sentences)

Rubric: (2 points)

Excellent description of a potential underlying biological mechanism for one of the defects/disorders/deficits that is specific and cites a relevant source (such as an animal study).

3) Take on the role of a public health educator.  You need to get the word out to the public on the potential harmful effects of this teratogen.  Come up with a strategy to disseminate the information (public service announcement on TV? infographic signs in certain places?).  In your strategy, discuss how you will target those who are more likely to be exposed to the teratogen or the most vulnerable segments of society (i.e. from part 1b).  What are the most salient points to make about the harmful effects of the teratogen, based on your answers to the above questions?  Keep in mind that you can’t be too technical in your wording or you will confuse or lose the interest of your audience.  Be creative and describe your strategy in at least 13 sentences (but no longer than 15 sentences).

Rubric: (4 points)

Uses excellent strategy to disseminate information to the public that is thorough, clear, and logical.

Strategy efficiently targets the people most likely to be exposed or most vulnerable populations/regions (eg focus on 1 of the regions or populations discussed in Q1b).

Emphasizes the most salient points on the harmful effects of the teratogen

Presents information in an engaging and simplified manner to hold the attention of the public.

Research, references, and citations (be sure to use proper APA format).

Rubric: (3 points)

Excellent use of sources, citations, and proper formatting of references.

Used the three required types of sources (Review article, primary research article, and reputable website).

Cited sources extensively where appropriate in the answers to the questions.

Provided a complete list of references at the end with proper APA formatting.

What is the unstandardized beta coefficient for the education variable as shown on the SPSS printout? Explain what this unstandardized beta coefficient means?

Data analysis in criminal justice:
Input the data from the textbook (page 16) into SPSS.

Run descriptive statistics. What is the mean for the education variable? What is the mean for the income variable?

Run a regression analysis.

What is the coefficient for the intercept as shown on the SPSS printout? What does the coefficient for the intercept mean?

What is the unstandardized beta coefficient for the education variable as shown on the SPSS printout? Explain what this unstandardized beta coefficient means?

Turn in the SPSS printout and your answers to the questions. Keep in mind that your results and answers should mirror what is reported in the textbook.

Code the following variables into SPSS. The first variable is the individual’s sex [M = Male F = Female (Female is the reference category)] and the second variable is the individual’s religion [C = Catholic, P = Protestant, J = Jewish, and M = Muslim (Muslim is the reference category)].

1. M, C 2. M, P 3. M, J 4. M, M 5. M, C 6. F, P 7. F, J 8. F, M 9. F, C 10. F, P 11. M, J 12. M, M 13. M, C 14. M, P 15. M, J 16. F, M 17. F, C 18. F, P 19. F, J 20. F, M 21. M, C 22. M, P 23. M, J 24. M, M 25. M, C 26. F, P 27. F, J 28. F, M 29. F, C 30. F, P 31. M, J 32. M, M

Once the new variables are coded into SPSS, you need to run a regression analysis with the following independent variables: education, sex and religion. The dependent variable is income.
Interpret the unstandardized betas for all the independent variables and the intercept.

Interpret the R2 for the overall model.

What is the adjusted R2 for the model?

What variable has the greatest relative impact among the independent variables (the largest standardized beta coefficient)?

Run a regression equation with education as the independent variable. Then add the sex variable to the equation and check the change in R2. Why are there two changes in R2 reported in the SPSS output? What does the first reported change in R2 mean? What does the second reported change in R2 mean?

Run a regression equation with education as the independent variable. Then add the religion variables to the equation and check the change in R2. Why are there two changes in R2 reported in the SPSS output? What does the first reported change in R2 mean? What does the second reported change in R2 mean?

the whole paper should be consisting of 5 calculations + 1 page ( academic paper writing )

Discuss how the novel—and its characters—demonstrates elements of both humour and pathos.

English 12

Pale Fire: Analysis Guidelines and Essay Topics

Pale Fire is a very challenging novel. Listed below are some things to focus on/highlight/note as your read. You do not have to keep track of every reference to every item, but it will help you in your comprehension if you are able to keep track of at least a few of the more commonly occurring items. Be sure to provide direct quotations and page numbers as often as possible, as many of your observations early on may be useful for your eventual essay.

 

Literary and Historical Allusions

William Shakespeare (especially the passage from Timon of Athens, from which the poem gets its name)

Alexander Pope T.S. Eliot (“Four Quartets” and “The Waste Land) Alice in Wonderland (Lewis Carroll) Robert Browning John Keats Edgar Allan Poe King Charles II (England) fairy tales Nature  birds butterflies trees (and their symbolism) death and ghosts

Other  contrapuntal theme (i.e. poem versus Foreword, Commentary and Index) numbers (especially 3) colours alphabet mirrors (literal mirrors, as well as anything that “reflects”) jewels/crystals play(s) on names suicide insanity dates/birthdays

Essay Topicswrite a clear and thoughtful analytical research essay of 750-1000 words on one of the following topics. Be sure to include direct quotations (correctly integrated, with page numbers) from the book to support your ideas, and include citations from at least two outside sources. Please have an original title, and print your essay on the computer with 1.5 or double-spacing, with standard font and margin settings. (A separate handout on research essay guidelines will be provided later.)

1.) Select any topic from the list above, and discuss how that one item plays a significant role in Pale Fire. Your focus can be either narrow or more broad in scope. (For example, you could choose to focus on animal imagery and symbolism in general, or focus on the use/depiction of only one animal.)

2.) The poet Gregory Orr asserts that

[w]e often experience the world as confusing and chaotic…This confusion can be outside us…or it can be inside us, in the swiftly shifting world of emotions, thoughts and memories. Even as we recognize the power of disorder in our experience, we are likely to become aware of a strong need we have to feel there is some order in the world… [yet] in certain existential crises, disorder threatens to overwhelm us entirely…We are creatures whose volatile inner lives are both mysterious to us and beyond our control. How to respond to the strangeness and unpredictability of our own emotional being? One important answer to this question is [poetry]…dramatizing inner and outer experience. [Poetry is] a means of helping individuals survive existential crises represented by extremities of subjectivity and also by such outer circumstances as…suffering, pain, illness, violence, or loss of a loved one.” (Poetry as Survival, p.3-4)

Discuss how Orr’s claim applies to both John Shade and Charles Kinbote.

3.) Discuss how Pale Fire can be read as a satire of academic life at the college/university level.

4.) Discuss how the novel—and its characters—demonstrates elements of both humour and pathos.

5.) Post-modernists (namely Roland Barthes) speak of “the death of the author” – specifically, the intentions of an author are irrelevant, as it is the reader who finds (creates?) meaning as he/she reads a text. Discuss how this notion applies to Pale Fire, both in terms of the Shade-Kinbote relationship and the Nabokov-reader relationship.

Important note: As you are aware, other English 12 classes are studying this novel. Even though the book is the same, different teachers may have different approaches in both what and how they choose to teach Pale Fire. By all means, discuss the book with students from other classes and share your thoughts with them, if you feel that this will help you in your understanding and interpretation(s) of the novel. However, ALL work–discussions and essays–are expected to be your own thoughts, not those of another student or teacher. If necessary, you may be called upon to explain your insights, if it appears they may have come from a source other than your own head. Any copying of ideas and/or analyses will constitute plagiarism, and will result in a score of zero on the assignment in question. If you are unsure about anything, please ask.

How have your managerial responsibilities changed and progressed throughout your career?

Please respond to the following four questions in your essay:
Why do you want to apply to the MBA program?
How have your managerial responsibilities changed and progressed throughout your career?
In the positions you have held, what three experiences have had the most impact on the development of your managerial skills and abilities?
What do you expect the program to offer you in terms of personal development, career development and learning?

How can the sources of biases be reduced in observational studies for managing diabetes and obesity?

1) Proposed Research Title:

Reducing Bias in Observational (non-interventional) Studies for Obesity and Diabetes Management.

2) Introduction:

While in experimental trials a direct intervention can be made, observational studies only allow passive observation of the occurring events, making them susceptible to a high degree of bias. The high risk of bias associated with observational studies makes it difficult to establish a causal inference and may lead to inaccurate interpretation of results.

There is a need to reduce associated bias in observational studies being undertaken.

The reduction of bias should first identify the possible sources and types of bias that may be associated with a particular context [1].

The three main types of biases in observational studies include selection bias, confounding bias and information bias. A selection bias leads to the lack of inclusion of some participants into the study, therefore reducing the representativeness of the research. Confounding bias results when the statistical analysis does not consider all the relevant effects. Information bias arises from factors such as misclassification and false reporting of the findings [2].

 

3) Research Questions and Objectives: 

This research aims to identify ways that can be used to reduce the level of bias in observational studies, on the effectiveness of the lifestyle changes, in particular exercise, for the management of obesity in patients with type 2 diabetes.

  • How is the quality of research achieved in observational studies?
  • What are some sources of biases in observational studies relating to the management of diabetes and obesity?
  • How can the sources of biases be reduced in observational studies for managing diabetes and obesity?

The objectives that are pursued in the research questions include:

  • To determine ways for ensuring quality in observational studies.
  • To explore the sources of biases in observational studies relating to the management of diabetes and obesity.
  • To recommend measures that can be used in the reduction of the identified biases of the selected studies.

 

Justification and Rationale:

Regardless of the existence of numerous observational studies on the management and prevention of obesity and diabetes, the data presented may be biased due to the subjective nature of observational studies [3]. For instance, selection bias can occur when the researcher fails to include some participants in the research, therefore reducing the representativeness of the process.

Since obesity and diabetes are significantly affected by environmental and social factors, the biases from an observational study may lead to unreliable conclusions regarding the management measures adopted. This study is therefore justified in the identification of the errors in such studies. The findings of this study will contribute towards the improvement of the methodological processes in obesity and diabetes studies.

 

4) Short Literature Review:

According to the WHO the prevalence of obesity and diabetes has increased dramatically in the past three decades in all countries regardless of their income levels. The number of individuals with diabetes increased from 108 million in 1980 to 422 million in 2014. Similarly, the prevalence of diabetes in adults rose from 4.7% in 1980 to 8.5% in 2014. The prevalence of obesity has also increased in the past 50 years to pandemic levels globally [4]. Obesity presents a major health challenge leading to a substantial increase in the risk of diseases like type 2 diabetes, obstructive sleep apnoea, myocardial infarction and stroke.

Accordingly, the management of the two conditions is of the utmost importance in the global health sector. The reduction of obesity and diabetes burden is based on the combination of individual interventions and changes in the environment and society [5].

Therefore, an understanding of the influence of the personal behaviours on the management of the two conditions is critical in establishing the relative effectiveness of the appropriate strategies. Some of the lifestyle strategies that are used in the prevention and treatment for both diabetes and obesity include the maintenance of a healthy diet, regular physical activities, and avoiding tobacco and alcohol use.

5) Data Collection& Analysis by Systematic Review:

The proposed study involves a comparison of observational studies against randomised control trial (RCTs) regarding the measures of managing obesity via exercise and type 2 diabetes. Following a systematic review all relevant observational studies will be compared against  RCTs.

The inclusion and exclusion criteria will be based on factors such as year of publication (to be published within the last 5 years) and relevance to the topic of discussion.  Therefore the studies excluded will be those published more than five years ago and do not address the management of obesity and diabetes through changes in lifestyle.

Additionally, studies that focus on the changes in lifestyle habits towards the management of other diseases other than obesity and diabetes are excluded.

The study population is represented by adults over 35 years. The data collection is quantitative and qualitative, including questionnaires and statistical diagrams to represent the results of the study.

The main databases that will used for the search are Clintrials.gov, MEDLINE and PubMed with the search restricted to studies published in the last five years. The search strategy retrieves the studies that are then assessed for eligibility and inclusion.

The search terms used in the study include ‘observational studies’, ‘non-interventional studies’, ‘random clinical trials’, ‘interventional studies’, ‘diabetes’, ‘obesity’, ‘management’, ‘exercise’ and ‘lifestyle changes’.

6) Project Management Timetable:

Month Activity Completion
Mar 2020 Database Search, Systematic Review and Final Selection of Studies for Analyses
Mar 2020 Analyse Studies
Mar 2020 Draft Dissertation
Apr 2020 Finalise Dissertation
May 2020 Submit Final Draft for comment
Jun 2020 Revise and Submit Dissertation Project

 

7) Management of Risks to Project:

The main risk to this systematic review project is the risk of bias assessment of the validity of the included studies. The risk of bias entails the overestimation and underestimation of the effect of the intervention in the included studies.

The risk of bias will be ensured by enhancing the validity of the included studies through the adoption of the inclusion and exclusion criteria to enhance the quality of the evidence.

 

8) Ethical considerations:

No ethics submission is needed

The main ethical factors in the project relate to the considerations undertaken in the selected studies as the randomised control trials involve human subjects. Consequently, the included studies are those with ethical approvals.

9) Financial costs: NONE

10) Key References:

  1. Roglic G. WHO Global report on diabetes: A summary. International Journal of Non communicable Diseases. 2016 Apr 1; 1(1):3.
  2. Sharma M, Nazareth I, Petersen I. Observational studies of treatment effectiveness: worthwhile or worthless?. Clinical epidemiology. 2019; 11:35.
  3. Mokdad AH, Ford ES, Bowman BA, Dietz WH, Vinicor F, Bales VS, Marks JS. Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001. Jama. 2003 Jan 1; 289(1):76-9.
  4. Dietz WH, Baur LA, Hall K, Puhl RM, Taveras EM, Uauy R, Kopelman P. Management of obesity: improvement of health-care training and systems for prevention and care. The Lancet. 2015 Jun 20; 385(9986):2521-33.
  5. Naimi TS, Stockwell T, Zhao J, Xuan Z, Dangardt F, Saitz R, Liang W, Chikritzhs T. Selection biases in observational studies affect associations between ‘moderate’ alcohol consumption and mortality. Addiction. 2017 Feb; 112(2):207-14.

Comments received from reviewer: –

I think this is a very reasonable project. This sort of thing has been done before though (John Ioannidis had a paper in JAMA a few years ago comparing trials vs observational studies – I recommend the student look at that)

http://www.ncbi.nlm.nih.gov/pubmed/11497536

My main criticism is that the method for selection of the trials and observational studies is too vague. Why 5 trials? That is completely arbitrary. It would be better to select a defined (sub)area of the subject and then select all observational and all trials in that area.

Then the most logical thing to do is to determine how the outcomes (trials vs Obs) compared as per the Ioannidis paper using methods like meta-analysis.

Analyse and reflect on observations of fieldwork placement/s in relation to the allocation of clients, case work and group work Submission.

a) Illustrate the value and purpose of professional supervision within the placement context.
c) Demonstrate ability to work collaboratively in the field and to use judgement and initiative.
d) Evaluate learning experiences within the placement.
e) Analyse and reflect on observations of fieldwork placement/s in relation to the allocation of clients, case work and group work Submission.

Context:
As students progress through their placement experience, they will develop their counselling skills as well as their understanding of professional practice in the counselling environment. Work placement is both a new and very different experience within the course framework. It can be exciting, challenging and confronting when students experience fieldwork, workplace expectations, fitting in to a new group and extending their professional capabilities.
Students are required to keep a ‘reflective journal’ that describes and mirrors their placement experience.
Instructions:
Students are to complete a journal throughout their placement that considers their experiences and documents their learning, especially in relation to any applicable Learning Goals that were identified in the Learning Contract (Assessment 1).
Entries are to be both academic and personal and will include references/citations. There are three elements of placement that need specific focus:
1) Skills development;
2) Supervision; and
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3) The workplace/organisation and the student’s place in it
Students are to identify counselling skills used, define the skills according to the literature, and pair these with brief examples from the student’s fieldwork.
You are also expected to discuss the supervision process and speak about what was learnt and how you were able to use this to develop as a practitioner. Provide a brief description of supervision, including the number and duration of meetings. Highlight issues that emerged and improvements made. Discuss the supervisor-student relationship and comment on the impact this had on your development and how you were able to use supervision effectively to enhance your skills.
Students should also provide a brief description of the work environment and your place in it.
Describe your use of assertive communication skills and capacity to deal skilfully with workplace interactions and client encounters. Include specific examples of how you have engaged collaboratively with colleagues and what positive contributions you have made in the workplace. Reflect on what you learnt about yourself in these situations and on your emerging professional identity.
The journal should provide personal reflections of your experience. Recognising that all learning involves ups and downs, you should include times where your own effort or experience has not resulted in desired outcomes as well as when there was a positive outcome. The journal will be assessed not on the difficulties or successes themselves but rather the student’s ability to reflect on and evaluate the personal experiences in counselling work.
In summary, the Reflective Journal must include the following:
 Appropriate reflection and commentary on any applicable ‘Learning Goals’ identified in Assessment 1 to whatever extent fulfils the validation requirement
 Reflection on counselling skills used throughout the fieldwork, defining the skills according to the literature, and pairing them with brief examples from the student’s fieldwork. Include information on what changes you noticed in your skills. This can include personal responses to the experience of improving your technique.
 A brief description of supervision, including the number and duration of meetings. Highlight issues that emerged and improvements made. Discuss the supervisor-student relationship and comment on the impact this had on your development and how you were able to use supervision effectively to enhance your skills.
 A description of the work environment and your place in it, including examples of how your contribution positively impacted the workplace. Reflect on what you learnt about yourself in that situation.
 Describe the use of assertive communication skills in the workplace, the capacity to deal skilfully with workplace interactions and client encounters, and on operating in a professional manner.
 Reflection on any difficulties that may have arisen and conceptualise how these may be addressed
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IMPORTANT: Students must ensure that any references to clients are de-identified. Clients should only be mentioned to the degree that their issue or presentation in session is related to the learning being described.
Referencing:
In-text citations as well as your reference list should follow the latest APA referencing style. The APA referencing guide can be located in the Academic Writing Guide at http://library.think.edu.au/ld.php?content_id=1882254. Direct quotes and references do not contribute to the word count.
Submission Instructions:
 Prior to submission, the journal can take any form (ie handwritten notes, typed notes, voice recordings, etc). However, the final submission must be a single word processed document that contains edited and collated information from the entries that meets the length requirement and addresses the points above.
 Submit your reflective journal on Blackboard via the ‘Assessment’ link in the main navigation menu in PFP107: Professional Practice.
The Learning Facilitator will provide feedback via the Grade Centre in the LMS portal. Feedback can be viewed in My Grades
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Learning Rubric: Assessment 2
Assessment Attributes Fail (Unacceptable) 0-49% Pass (Functional) 50-64% Credit (Proficient) 65-74% Distinction (Advanced) 75 -84% High Distinction (Exceptional) 85-100% Grade Description (Grading Scheme) Fail grade will be awarded if a student is unable to demonstrate satisfactory academic performance in the subject or has failed to complete required assessment points in accordance with the subject’s required assessment points. Pass is awarded for work showing a satisfactory achievement of all learning outcomes and an adequate understanding of theory and application of skills. A consistent academic referencing system is used and sources are appropriately acknowledged. Credit is awarded for work showing a more than satisfactory achievement of all learning outcomes and a more than adequate understanding of theory and application of skills. A consistent academic referencing system is used and sources are appropriately acknowledged. Distinction is awarded for work of superior quality in achieving all learning outcomes and a superior integration and understanding of theory and application of skills. Evidence of in-depth research, reading, analysis and evaluation is demonstrated. A consistent academic referencing system is used and sources are appropriately acknowledged. High Distinction is awarded for work of outstanding quality in achieving all learning outcomes together with outstanding integration and understanding of theory and application of skills. Evidence of in‐depth research, reading, analysis, original and creative thought is demonstrated. A consistent academic referencing system is used and sources are appropriately acknowledged.
Maps to SLO d) & e)
Reflecting on professional working experience to enhance and develop clinical practices and professional identity
Does not reflect / or complete the journal throughout their placement.
Limited identification of how experience has enhanced their practice and minimal or absent reflection on professional Reflects on experiences and documents their learning, especially in relation to any applicable Learning Goals Uses adequate reflection for own learning. Able to nominate specific areas of growth and deepened understanding of Reflects on experiences clearly using both academic and personal commentary. Refers to applicable Learning Goals Considers burgeoning professional identity and Reflects on experiences clearly using both academic and personal commentary. Refers to applicable Learning Goals Uses the journaling process effectively to document and Critically reflects and analyses own professional development in relation to organisation influences and ethos. Considers how this impacts on professional practice and professional responsibility with a
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50% for this criterion
identity. Provides little or no rationale about what did or did not work.
Is unreliable and/or untimely in carrying out reflective tasks.
Blames others for inefficiencies and inaction.
theory based on practical exposure. Takes responsibility for own actions and completes reflective tasks independently on time.
ways to enhance it. Able to reflect on overall experience and what has been gained in terms of understanding the field, developing therapeutic capacity and the student’s own future direction. Work is backed up by definitions, concepts and appropriate referencing.
expand their understanding of the experience. Able to connect the experiences to theory and practice. Reflects on challenges and success and relates this to theory. Demonstrates behavioural changes incorporating the learning Able to comment on client presentations and conceptualise these according to theory, demonstrating clinical learning. Shows thoughtful consideration of professional identity with suggested areas of development. Work is backed up by a number of definitions, concepts and appropriate referencing
willingness to adapt and grow. Reflects on challenges and success and relates this to theory. Demonstrates behavioural changes incorporating the learning. Applies critical reflective practice for own learning. Takes responsibility for own actions and completes reflective tasks such as posting reflective journal entries independently on time.
Demonstrates effective resilience strategies by balancing competing priorities, managing time effectively and overcoming obstacles.
Sensitive to diverse and complex contexts.
Work is backed up by a number of relevant definitions, concepts and extensive referencing
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Maps to SLO a),
Identification of the purpose of supervision in counselling, and application of supervision in placement
20% for this criterion
Limited understanding of supervision concepts and rationale
Does not demonstrate an ability to apply supervision to the placement context
Key components of the assignment are not addressed.
Able to show a knowledge of supervision concepts
Is able to show the impact of supervision within the placement context
Often confuses assertion of personal opinion with information substantiated by evidence from the research/course materials.
Clearly shows a thorough understanding of the supervision process
Makes clear connections with supervision processes and concepts and counselling work
Supports personal opinion and information substantiated by evidence from the research/course materials.
Demonstrates a capacity to explain and apply relevant supervision concepts within the counselling setting.
Highly developed understanding of supervision theory and its application.
Makes strong connections between the supervision process and the student’s own skill development
Discriminates between assertion of personal opinion and information substantiated by robust evidence from the research/course materials and extended reading.
Well demonstrated capacity to explain and apply relevant concepts to supervision.
A sophisticated understanding and application of supervision theory and practise.
Able to make succinct and pertinent connections between supervision process and their own development and conceptualisation of client issues.
Systematically and critically discriminates between assertion of personal opinion and information substantiated by robust evidence from the research/course materials and extended reading.
Mastery of supervision concepts and application to new situations/further
learning.
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Maps to SLO c)
Provides examples of collaboration and positive contributions to the workplace
20% for this criterion
Reflection suggests inadequate collaborative practices and limited contribution to workplace processes
Reflection demonstrates some collaborative practices with colleagues, supervisors and clients Provides basic examples of positive contributions to workplace processes or tasks.
Reflection demonstrates effective collaborative practices with colleagues, supervisors and clients Provides relevant examples of positive contributions to workplace process or tasks that incorporate feedback from the supervisor or colleagues
Reflection demonstrates skillful interactions utilising assertive collaborative practices with colleagues, supervisors and clients Provides varied and regular positive contributions that address problems in workplace processes or tasks Reflection demonstrates skilful interactions at a professional level, utilising assertive collaborative practices with colleagues, supervisors and clients
Consistently provides insightful contributions that resolve problems in workplace processes or tasks
Correct citation of key resources and evidence
10% for this criterion
Demonstrates inconsistent use of good quality, credible and relevant resources to support and develop ideas.
Demonstrates use of credible and relevant resources to support and develop ideas, but these are not always explicit or well developed.
Demonstrates use of high quality, credible and relevant resources to support and develop ideas.
Demonstrates use of good quality, credible and relevant resources to support and develop arguments and statements. Shows evidence of wide scope within the organisation for sourcing evidence
Demonstrates use of high-quality, credible and relevant resources to support and develop arguments and position statements. Shows evidence of wide scope within and without the organisation for sourcing evidence