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Assignment Questions

Diabetes 2 Mellitus

Critical review of evidence for association between Type 2 Diabetes
Mellitus and intake of fruit and vegetables.

Provide a written report (2000 words) summarising and appraising the evidence from
eight * studies that helps answer the following research question. What is the
association between Type 2 Diabetes Mellitus (T2DM) and fruit and vegetable intake?
These studies may relate to the role of fruit and vegetables in either the prevention or
the management of T2DM. Write a 500 word conclusion from this evidence including a
brief discussion of the quality (strengths and weaknesses) of the epidemiological
evidence that you have presented.
2 relevant studies will be reviewed in class tutorials in weeks 11 and 12 and can count
as 2 of the 8 studies that you summarise. In addition to the written summary you must
summarise each study using an evidence table which provides details of the sample,
exposure and outcome measures and key findings. Tables should be single spaced
Maximum length is 2000 words for the study summary plus 500 words for an overall
conclusion. The content of the table will not contribute to the total word count but you
must use the table effectively to complement your text.
You must also hand in a photocopy of the abstract of each of the papers you choose to
review, with full reference for the paper.
Guidelines for Assessment Task:
This task requires you to provide a list of primary papers (not review articles or text
book chapters) including full bibliographic details, a short summary of the content and
critique/appraisal of each of the papers. This requires you to summarise the content of
the paper in condensed form and provide some interpretation and evaluation of the
evidence provided in the paper. You need to decide what are the key points/findings of
the paper in the context of the assessment task and present these main ideas, in your
own words. It is important to be as concise as possible, to provide the essential details
in as few words as possible.
Where available you should use at least two examples from each of the major
categories of epidemiological study designs, that is cross-sectional, case-control,
longitudinal cohort and randomised control trial. If a category of design is not available
you should substitute additional studies from another design category. In addition you
should provide a statement giving reasons why the missing study design has not been
used in this context

You need to
Provide full bibliographical details of each study in Harvard format
Describe the content, the main aim of the study, the central hypothesis, the
subjects/population and methods used (including study design) and the
relevant exposures and outcomes and conclusions.
o It is important to give size and direction of effect and measures of
statistical significance. For example do not just say the intervention
group had a higher incidence of an outcome, say how much higher and
provide details of the level of confidence around this estimate or the p
value. Provide odds ratios (OR) or relative risk ratios (RR) and the 95%
confidence intervals. Imagine that the assessor has not read the text and
in many cases they will not have done so
Analyse the strengths and limitations of the evidence. Consideration of study
design/type, assessment of exposures and outcomes, and potential for bias and
confounding will be an important component of analysis
Evaluate the overall quality of the evidence and the conclusion drawn by the
authors. If a paper reports different results or conclusions to other studies that
you have reviewed try to identify some factors that may explain the different
results.
Ensure you focus on the particular research question identified in the
assessment task.
In your conclusion consider the overall strength and consistency of the evidence
across the different study types. What recommendations would you make on the
basis of the evidence that you have reviewed?
Managing your time
This is a large assignment task and you do not want to leave it until the end of
semester before you start working on this task.
Week 4 By the end of this week you should have sufficient understanding of the
research question, the terms exposure and outcome and the study
design types to be able to start your literature search to identify suitable
studies which address the research question
Week 7 By the end of this week you should have a sufficient understanding of
disease frequency and effect size, and errors, confounding and bias
to be able to start your written summary of the individual studies
Week 10 By the end of this week you will have had some practice in summarising a
study in an evidence table

Useful references:
Greenhalgh, P. How to read a paper: Getting your bearings (deciding what the paper is
about). http://bmj.bmjjournals.com/cgi/content/full/315/7102/243
Langseth L. Nutritional epidemiology: Possibilities and limitations. ILSI Europe 1996
Margetts, M and Nelson, M. Design Concepts in Nutritional Epidemiology, 2nd Ed.
Oxford Medical Publications, 1997.
Beaglehole, R and Bonita R. Kjellstrom. Basic Epidemiology. WHO, 2000, Geneva.
Sempos et al Am J Clin Nutr 1999; 69 (suppl): 1330S-8S
(Whole supplement is devoted to nutritional epidemiology)

Assessment Criteria
1. Summary of evidence (30 marks)
Synthesises and integrates evidence, does more than describe studies
Relevant focus on and accurate presentation of the measures of dietary
exposure and outcomes
Sufficient study details, size and direction of effect
Good understanding of diet-disease link
Evidence of wide reading
2. Critical approach to individual studies (20 marks)
Considers strength and weaknesses of study design
Considers hierarchy of evidence
Considers overall quality of evidence
Justifies absence of study design if necessary
3. Overall conclusion & critical approach (10 marks)
Acknowledges controversy and limitations to overall quality of evidence
Clear conclusions, consistent with evidence presented
Considers broader nutrition implications
4. Evidence tables (5 marks)
Table structure well organised, logical, flows well, easy to follow
Tables stand alone
Provides sufficient detail of sample
Adequately defines exposure measure or intervention
Adequately defines outcome measure(s)
Provides sufficient detail of effect size and statistical significance
Provides additional comments, where appropriate
5. Presentation and Referencing (5 marks)
Adequate number and range of study designs
Study details and results referenced in the text
Adequate in-text citation
References cited in bibliography according to Harvard format
Well written according to normal academic standards

When you write this task : this my teacher’s notes.

– introduction

– summary study and description every study and you must write 200-250 words every study ( 8 studies) / so 8 studies paragraphs.

– conclusion ( summary all studies 500 words)

– One table for all 8 studies
– you reasearch 6 studies and add 2 studies . 2 studies and tables in my resources

There are main points: this my teacher’s notes

Assignment cor criteria

8 relevant primary studies

# Exposure:

– How measured?

-How quantified?

– How were comparion group categorised?

# Outcome:

– What?

– How measured?

# Effect size:

-Odds ratios

– Relative risk

-95% confidence intervals

I will add resources for lectures and articls and you can research like two sutdies in my resources . 2 studies as model when you reaserch you find the articles the first paper and find main point like this :

Objective: The consumption of different foods was studied for their ability to predict type II diabetes mellitus.
Design: The study design was a cohort study, based on the Finnish Mobile Clinic Health Examination Survey.
Setting: A total of 30 communities from different parts of Finland.
Subjects: A total of 4304 men and women, 40??”69 y of age and free of diabetes at baseline in 1967??”1972 and followed up for
incidence of diabetes medication during 23 y (383 incident cases).
Results: Higher intakes of green vegetables, fruit and berries, oil and margarine, and poultry were found to predict a reduced
risk of type II diabetes. The relative risks of developing type II diabetes between the extreme quartiles of the intakes were 0.69
(95% confidence interval (CI)¼0.50??”0.93; P for trend (P)¼0.02) for green vegetables, 0.69 (CI¼0.51??”0.92; P¼0.03) for fruit
and berries, 0.71 (CI¼0.52??”0.98; P¼0.01) for margarine and oil, and 0.71 (CI¼0.54??”0.94; P¼0.01) for poultry.
Conclusion: The results suggest that prevention of type II diabetes might be aided by consumption of certain foods that are rich
in nutrients with hypothesized health benefits.
European Journal of Clinical Nutrition (2005) 59, 441??”448. doi:10.1038/sj.ejcn.1602094
Published online 12 January 2005…. etc . >>>>>> you must see 2 studies in my resucese what I meaning

And you reaserch 6 studies and you summary every study 200 words for every study for 8 studies.
I will put my friend’s answer but my friend’s answer not comeplet you can just see it. I will give you Web.

I don’t know this report or essay, but I put my teacher’s notes.

when you write refrences for example:

In tex refrences
(Kelehare & MacDougall 2009, pp.3-16)

In the list refrences

Keleher, H & MacDougall, C 2009, ‘Understanding health’, in H Keleher & C MacDougall (eds) , Understanding health a determinants approach, 2nd edn, Oxford University Press, Melbourne, pp.3-16.

Also ,
In tex refrence

(WHO 2010)

In the list
World Health Organisation 2010, Social determinants of health, n.d., viewed 18 April 2010,< http://www.who.int/social_determinants/en/>.

I have resources ( lectures) and I have an example from my friend’s answer that help you. you can ues it and make paraphrase
There are faxes for this order.

There are faxes for this order.

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