Article One

Purpose of the Study

The authors identify and state the purpose of the study, which is twofold: to approximate sex-specific vulnerabilities of an exhaustive range of somatic conditions in alcohol-dependent (AD) persons versus a control group and, within the same cohort, to approximate sex-specific vulnerabilities to mortality from the studies somatic conditions (Becker, Holst, Sørensen, &Tolstrup, 2017).

Methodology

The researchers preferred a register-oriented matched cohort design to conduct the inquiry and structure their approach.

Participant Information and Data Collection

In conformity with the principles of a cohort study, the authors relied on the Copenhagen Alcohol Cohort, the Danish Civil Registration System, the Cause of Death Registry, and the Danish National Patient Registry to identify AD persons and select the control population (Becker et al., 2017). Specifically, the Danish Civil Registration System was the source of the control group while the Danish National Patient Registry and Cause of Death Registry provided data about somatic diseases and causes of mortality, respectively (Becker et al., 2017). Using participants’ identification numbers (PINs) and the Cox proportional hazards framework, the researchers linked all the registries mentioned above and measured hazard ratios (HRs). AD participants were selected from the Copenhagen Alcohol Cohort and dovetailed with the Danish Civil Registration System, thus facilitating the constitution of a control group from the wider Danish populace (Becker et al., 2017). Finally, data on causes of death, somatic conditions, and vital status was derived.

The number of AD participants was 19,002(14 091 male and 4911 female) while that of the control group was 186,767 (Becker et al., 2017). There was no room for selection bias as the researchers employed some filters to arrive at the final number of respondents automatically. Some of these included: only the initial registration for people with several records, people diagnosed with alcohol dependence based on revisions 8 or 10 of ICD,and exclusion of people whose dates of birth and death were earlier than 1 January 1927 and 1 January 1977 respectively, thereby ensuring respondents were not more than 50 years-old when data on somatic conditions was first documented (Becker et al., 2017). In trying to obtain the control group population, the researchers first linked each AD person with ten persons who were randomly chosen from the greater Danish population according to sex, birth date, and municipality when alcohol treatment was first administered (Becker et al., 2017). Next, people who were born before 1 January 1927or whose date of death was earlier than 1 January 1977 were excluded.

Variables

According to Becker et al. (2017), the variables are 11 disease families and 29 subfamilies, classified based on the International Classification of Diseases (ICD). Diagnosis of alcohol dependence concerning ICD was the key predictor variable.

Data Analysis

The researchers relied on a number of statistical tools and methods: Stata version 14.0, Cox proportional hazards (to approximate HRs), 95% confidence intervals (CIs), interaction terms, the Charlson Comorbidity Score (CCS), a two-dimensional p-value of 0.05, and SAS Software Enterprise Guide version 5.1 (Becker et al., 2017).

Weaknesses of the Study

According to Becker et al. (2017), the research is vulnerable to residual confounding since it did not include data on socio-economy. The study design impeded access to smoking information, thus hindering the investigation ofhow smoking potentially affects mortality and morbidity.Lastly, the study only observed somatic illnesses needing hospital admission, leading to the incorrect non-differential categorization of the findings as well as a decline in the impacts of estimates (Becker et al., 2017).

Outcomes and Implications for Implementation

The researchers concluded that alcohol dependence is linked to an increased predisposition to a wide variety of somatic illnesses and a high death rate from most of the conditions (Becker et al., 2017). As such, alcohol dependence is a risk element for somatic conditions and could be more harmful in a larger gamut of somatic illnesses than previously imagined.

Article Two

Purpose of the Study

The researchers explain that the objective of the research is to examine the correlation between pediatric leukemia and breastfeeding in the People’s Republicof China (Dong, Gao, Liu, Qin, & Wang, 2018).

Methodology

Using a case-control study design, the authorsinvestigated between March 2008 and April 2017, focusing on the Children’s Hospital of Zhejiang University in Zhejiang province of the People’s Republic of China (Dong et al., 2018).

Participant Information and Data Collection

The children in the case population numbered 958 (378 female and 580 male), all of whom had been diagnosed with pediatric leukemia (Dong et al., 2018). On the flip side, the control population comprised 785 children (336 female and 449 male) in good healththroughout the research. The study collected the followingdemographic and clinical data from participants’ health records and parents. The family background vis-à-vis neoplasm of the lymphatic/hematopoietic systems and malignant tumors, family address, age of the child, birth weight,mode of delivery, mother’s age, education, abortion history and dates, Down’s syndrome history, marital status, smoking background, birth control pill usage beforepregnancy, breastfeeding trend and duration (Dong et al., 2018). Other types of data encompassed hair dye use among parents and background of residential decoration. There is no recruitment bias.

To be included, members of the case group had to meet the following requirements: aged between 0 and 14 years old; had been diagnosed with pediatric leukemia; resided in Zhejiang province of the People’s Republic of China; and the mother recalled the precise breastfeeding time (Dong et al., 2018). The same criteria were applied for members of the healthy cohort, with the addition of two more: the children’s parents agreed to participate in the research, and the children had not been diagnosed with cancer before.To be excluded, members of the case group had to satisfy the following conditions: a subsequent primary tumor; no response or no relation; death prior to the interview date; inability to interview biological mother, including absence due to adoption or death; and refusal to participate in the research (Dong et al., 2018). Similar criteria were used in the healthy group, except the first – subsequent primary tumor.

Variables

The clinical and demographic data collected also constituted the variables that were analyzed during the study and used to compare the two groups (Dong et al., 2018).

Data Analysis

The researchers employed SPSS version 17.0 to express dataeither as mean and standard deviation (SD) or percentage and frequency (Dong et al., 2018). The disparities between the two different groups were contrasted by way of Student’s t-test for continuous variables. Using chi-square (χ 2)test and multivariable logistic regression analysis, the authors compared categorical variables and assessed risk factors for pediatric leukemia (Dong et al., 2018). The authors also captured odds ratios (ORs) as well as 95% confidence intervals (CIs). The statistical significance of all analyses was pegged on a binary p-value of <0.05.

Weaknesses of the Study

According to Dong et al. (2018), the research focuses on just one institution, thus limiting its scope; also, it does not account for the existence and influence of confounding factors.

Outcomes and Implications for Implementation

The authors inferred that breastfeeding has considerably positive effects regarding averting childhood leukemia; breastfeeding for between 7 and 9 months is particularly beneficial(Dong et al., 2018). There is an urgent need to concentrate on a breastfeeding technique that minimizes childhood leukemia and strongly supports the conclusion.

References

Becker, U., Holst, C., Sørensen, H.J., & Tolstrup, J.S. (2017). Alcohol dependence and risk of

somatic diseases and mortality: a cohort study in 19002 men and women attending alcohol treatment. Addiction, 112, 1358–1366.

Dong, A., Gao, Z., Liu, C.B., Qin, Z.X., & Wang, R. (2018). Protective effect of breastfeeding

against childhood leukemia in Zhejiang Province, P. R. China: a retrospective case-control study. Libyan Journal of Medicine, 13(1), 1508273.

 
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