Exercise Capacity and Mortality in Black and White, Article Critique Example

The reference style of the article was not up to APA standards because there were no indentations for each new paragraph, no publishers’ locations, and the title of the respective article was not italicized.  The research staff was consisted of individuals with PhD and M.D. backgrounds; therefore, the team was well qualified to conduct the research in question, using the variables, methodology, and target population identified.  In terms of the abstract, the researchers provided all the components that they were going to be using, and in a format that could be easily understood.  They wanted to measure the capacity and mortality in both blacks and whites at different MET levels, and with and without Cardiovascular Disease.

Based on the fact that all the participating patients were veterans and had equal access to the medical benefits of the hospital, and were in a similar socio-economic class, the problem statement was quite researchable.  This problem statement was also important to the Nursing profession, in terms of future health and physical activity recommendations that they will be able to make to patients they will see.  Patients could be told of the need to place greater emphasis on participating regularly in physical activities in order to reduce their mortality levels.

The researchers’ purpose was to provide evidence to support the long-term and widely cited epidemiological studies that the fitness of an individual is inversely and strongly related to cardiovascular and overall mortality in apparently healthy individuals (Kokkinos et al., 2008).  Long-term analysis of vitality records and the social security death records were used to suggest a correlation between overall exercise and fitness health having a positive or negative impact on overall cardiovascular health or vitality.  Research was conducted on 15,660 white and black males ranging between 58-60 years old that were examined for fitness and exercise tests on a routine basis from 1983 to 2006.  Through testing at different MET levels the researchers were guaranteed answers to their problem statement at the conclusion of the exercise.

Nine studies were quoted by the research team in utilized previous research as warranted basis for the current study.  This research was explained in detail in order to derive the conclusion that the exclusion of the lower socio-economic strata, the association between the exercise capacity and mortality for blacks, and the potential racial differences regarding the association are all lacking base on the literature review presented.  At the outset of the study the theoretical concept was established that an inverse relationship exists between the exercise capacity and mortality in healthy and CVD black and white men.  These research questions were very much consistent with the purpose and frame work of the study, because once pursued they were used to provide the answers necessary to arrive at the appropriate conclusions.

The researchers identified the major variables, namely the peak exercise capacity for each group at different MET increments, race, age BMI, CV risk factors, and CV medications could be measured at different hazard levels, confidence levels and probabilities.  These variables were designed so that they measure the MET at four different levels and then have them recorded. The peak exercise capacity at each MET increment, CV, factors, and CV medications are the independent variables for the research, while age, race and BMI falls into the dependent class.  However potential or extraneous variables in the research could be found in the application of the Bruce and ramp protocol.  It is assumed that they have no effect on the research without any verifications being made.

Furthermore, the researchers employed a stratified purposeful sampling method.  This method according to Creswell (1998) is one which illustrates sub-groups and facilitates comparisons.  In the research literature, there are no references to participants that dropped out, or chose not to participate in the exercise, but veterans who had pace makers, or had developed bundle-branch block, or were unstable during the tests were excluded.  These non-participants had no effect on the overall sample size or results because they did not meet the pre-established requirements, and the research findings could be applied in generalities towards blacks and whites without reservations.

During the early aspects of the research, future ethical questions and problems were addressed, when the participants were asked for their written consents, and the Review Board sent its approval for the study to be conducted.  The Social Security Death Index, the Veterans Affairs Beneficiary Locator System, the Bruce Protocol, the individualized ramp protocol, and indirect sphygmomanometry were all utilized to collect relevant and appropriate data on vitality and health records.

Standard Deviations were used to express the continuous variables, while absolute and relative frequencies defined the categorical aspects, and its association was measured by the Pearson’s chi test. The researchers also used a one way ANOVA to determine age and BMI differences between races, the Bonferri rule to correct inflations in type 1 errors, and the ANCOVA to assess whether the exercise variables were race associated.

Individuals with an exercise capacity of <5 MET were classified as low-fit, and used as the reference group, while the Kaplan Meir was used to perform Survival Analyses, and the Cox proportional hazard model was used to determine variables that were independently and significantly associated with mortality. These and all other unnamed variables including the logistic regression were performed using the SPSS software, which is universally recognized.

The findings of the study reinforce the concept that the fitness of an individual is inversely and strongly related to mortality, with or without cardiovascular disease, and regardless of the socio-economic strata.  This can be used throughout the entire nursing profession as a tool to enhance the health and well being of all present and prospective patients who will come under the care of any medical institution.  However, the research was weak in terms of the greater involvement of other members of the population, including women, and lack details on the physical history of black participants.  The study also did not take into consideration the cause of deaths as individuals may perish due to an unusual car accident as opposed to a health causal factor.  Nevertheless, the research was very strong in the multitude and quality of variables and tools used to generate the data.

In the final analyses, and with all things considered, the paper was an excellent use of research and quality conclusions that enabled a benefit for all areas of the medical community.  The problem questions were adequately answered, and the support needed to establish past works that were cited were affirmed.

References

Creswell, J.W. (1998) Quantitative Inquiry and Research Design, Data Collection, Sage Publications, Thousand Oaks, CA, p.118, print.

Kokkinos, P., Myers, J., Kokkinos, J.P., Pittaras, A., & Narayan, P. (2008). Exercise capacity and mortality in black and white men. Journal of the American Heart Association, 117(5), 614-622.