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CAM528 Introduction To Epidemiology Assignment Sample

Task description

For this task, you are required to critique a journal article. A number of articles will be made available towards the middle of the semester. They will be chosen to reflect some of the key areas of interest that emerge from the first discussion board.

Task length

Maximum 1500 words.

Please follow CASP report as a format to write critique of journal and find the answer from the article “Early life determinants of cardiovascular health in adulthood. The Australian Aboriginal Birth Cohort study".

There are some questions on the following pages are designed to help you think about these issues systematically.

1. Did the study address a clearly focused issue?
2. Was the cohort recruited in an acceptable way?
3. Was the exposure accurately measured to minimise bias?
4. Was the outcome accurately measured to minimise bias?
5. (a) Have the authors identified all-important confounding factors

(b) Have they take account of the confounding factors in the design and/or analysis?

6 Was the follow up of subjects complete enough?

Early life determinants of cardiovascular health in adulthood. The Australian Aboriginal Birth Cohort study

1. Introduction

Life expectancy for the Indigenous population in Australia in 2010– 2012 was 10.6 years lower for males and 9.5 years lower for females when compared to the non-Indigenous population. The differences are particularly high in the Northern Territory (NT), where death rates for Indigenous Australians are 2.3 times the non-Indigenous rates.

2. Methods

. Participants

Details of the recruitment and follow-up of the ABC have been previously published in detail [15, 16]. Of all Aboriginal children born between 1987 and 1990 at the Royal Darwin Hospital, 686 of the possible 1238 were recruited into the study. There were no differences for mean birth weights or sex ratios between those recruited and those not recruited.

3. Results

The baseline characteristics of the study participants are presented in Table according to sex. Among female participants, baseline house- hold size was higher compared to males. Attrition analyses comparing baseline characteristics of follow-up study participants and non- participants were performed. Compared to non-participants, those participating in the follow-up were more often females, and they had higher IRSEO scores

CASP-Cohort-Study-Checklist_2018.pdf (196.13 KB)
Sjoholm P et al. Early life determinants of ca... (688.02



The journal critiqued for this report is "Sjoholm P et al. Early determinants of cardiovascular health in adulthood. The Australian Aboriginal Birth Cohort study. International Journal of Cardiology 269 (2018) 304-309." The CASP appraisal tool is used to correctly assess the validity of the author/s interpretation of results and conclusions. The aim of this article was to 1) illustrate the occurrence of perfect cardiovascular wellbeing metrics utilising the AHA guide and its factors and 2) to investigate the association of socioeconomic aspects and birthweight with cardiovascular wellbeing in old age in the ABC.


The study addressed a focused issue. The study had a particular population Indigenous population in Australia and studied Early life variables of Wellbeing in the middle age of this population. The study highlighted the risk factors, including tobacco smoking, inactive way of life, harmful food behaviour, psychosocial pressure, extreme body heavy, dyslipidaemia, and hypertension. The study tried to detect the harmful effects of these risk factors on the heart health of indigenous adults in Australia (Sjöholm et al., 2018). The outcomes of the study are also considered for best assignment help. The present study showed a relationship between early life forecasters associated with socioeconomic and familial rank and upcoming CV wellbeing in the indigenous populace.

The cohort was recruited acceptably. Of all indigenous kids born between 1987 and 1990 at the Royal Darwin Hospital, six hundred eighty-six of the likely twelve hundred thirty-eight were hired into the research. There were no disparities in mean birth mass or sex quotient among those hired and persons not employed. All actions adding to this research meet with the Helsinki Declaration of 1975, as amended in 2008. All contestants offered printed clued-upper mission to contribute to this research, and all actions were accepted by the Human Research Ethics Board of the Northern Territory section of Health and the Menzies School of Health Research, counting the indigenous Ethical Sub-committee which has the authority to reject (Sjöholmet al., 2018). Families in metropolitan regions were categorised as metropolitan and persons in distant sites as not cities. The similarity of the mom on the occasion of the contestant's birth was documented. Family dimension was assessed through a survey by enquiring the contestants how many individuals were sleeping in their homes the previous night.

The measurements used in the study have been validated by the Helsinki Declaration of 1975. However, there are no additional considerations visible in the study.

The outcome was accurately measured to minimise bias. A proper analysis like Attrition analysis was used to assess the outcomes. After that multivariate model attuned for age, sexual category, metropolitan/not metropolitan, and groups for birthweight, motherly BMI, IRSEO rank, family volume, and similarity were examined (Sjöholm et al., 2018).

The authors have listed important confounding factors. Relations between numerous in utero features in addition to ecological aspects in both early days and parenthood and afterwards cardiovascular wellbeing have been accepted. These aspects comprise weight at the time of birth, postnatal development outlines, motherly obesity, parental smoking, familial socioeconomic rank and neighbourhood weakness, amongst others. The authors have also listed the American Heart Association (AHA) factors (Sjöholm et al., 2018). It described a sum of seven perfect cardiovascular fitness actions or features for describing and checking cardiovascular wellbeing. These incorporated not smoking, being bodily energetic, keeping standard body mass, blood pressure, blood glucose plus cholesterol stages, and consuming a healthy food habit.

Socioeconomic factors were considered during the analysis. At delivery, birth weight was calculated and information was collected regarding the families and their livelihood circumstances. Families existing in city regions were categorised as metropolitan and individuals in secluded places as not metropolitan. Equivalence of the mother at the instance of birth of the contributor was traced. For areal drawbacks, the Indigenous Relative Socioeconomic Outcomes (IRSEO)directory was utilised. Links between socioeconomic aspects and perfect cardiovascular fitness levels were examined utilising multivariable logistic regression (Sjöholm et al., 2018). Initially, univariate analyses attuned to age and sexual category were done. After that, multivariate models accustomed for age, sexual category, urban/not metropolitan, and groups for birthweight, motherly BMI, IRSEO count, household volume, and uniformity were examined.

The final follow-up occurred in 2014–2016 and offered a follow-up pace of seventy per cent of existing contestants. The follow up might not be complete. The current follow-up inhabitants might not symbolise the creative birth group, since follow-up contributors were further frequently women and had superior IRSEO scores evaluated to non-contributors. At last, the contributors were yet young grown-upsthroughout the previous follow-up (Sjoholm et al., 2018).

The follow-ups are not long enough. It is recommended that following upcoming follow-ups, cardiovascular morbidity and clinical actions might be examined for even enhanced consideration of the scientific significance of the cardiovascular danger outlined in this group (Sjoholm et al., 2018).

The current study demonstrates that perfect cardiovascular fitness was unusual in the ABC grown-up inhabitants. The most ordinary score gathered were ultimate glucose (eighty-three per cent), cholesterol (seventy-four per cent) as well as blood pressure (seventy-three per cent) levels. The slightest ordinary metrics were linked to fitness actions: non-smoking, perfect food, as well as best stages of bodily movement were gathered by not more than half of the group. Major sex distinctions were seen in both the full score in addition to blood pressure and bodily action. Numerous early life variables were seen to separately forecast upcoming cardiovascular wellbeing (Sjöholm et al., 2018). Family dimension and motherly BMI foresee BMI in parenthood. The areal difficulty is linked with potential blood pressure and stages of bodily movement. Metropolitan livelihood surroundings were linked with non-ultimate blood pressure stages. Family volume was linked with the smoking position in middle age. Similar to the results, both family and areal socio-financial positions have been significant variables of cardio metabolic threat aspects. Regarding the scientific and community health standpoint, the current results offer significant backdrop knowledge on the premature existence determinants of cardio metabolic wellbeing in an aboriginal neighbourhood. The current research demonstrates a link between early-life forecasters correlated to socioeconomic as well as familial position and upcoming cardiovascular wellbeing in the indigenous inhabitants (Sjoholm et al., 2018). This research demonstrates that exceptional consideration requires to be placed on health actions such as smoking and dietary lifestyle and gender parity in well-being to attain these objectives.

8. The results of the study are pretty accurate as the results match with the statistics from longitudinal groups in Australia, Finland, and the USA (Sjöholmet al., 2018).

The longitudinal character and well-prearranged follow-ups with comparatively excellent maintenance rates permit us to consider the outcomes established. though, because of the alterations completed to the innovative AHA description of perfect cardiovascular fitness concerning proper food and glucose stages that were required for this research, the outcomes might not be straight equivalent to former alike resaerches (Sjoholm et al., 2018). There was no bias in selecting the participants or measuring the outcomes. The participants also went through a follow-up, which made it easier to believe the results.

The results cannot be applied to a local population. This is because the conventional variables of family earnings and learning were not accessible and might not forever be well-appropriate in distant neighbourhoods. The study populace though is comparatively small causing a few restrictions to afterwards understanding of the outcomes. consequently, it might be right to relate the outcomes to a diverse populace (Sjoholm et al., 2018).These dissimilarities might be of even well-built implication in a comparatively minute cohort. The current follow-up populace might not entirely symbolise the creative birth cohort.

The results fit other evidence. The relationship between site and cardiovascular danger outlines in indigenous Australians has been beforehand learnt in the Heart of the Heart research. It was seen that contestants from city surroundings (Alice Springs) had elevated blood pressure, superior lipid stages and inferior kidney roles than their isolated livelihood complements. Superior earnings were linked with the prominent danger of CVD in city sites but not in Alice Springs or distant neighbourhoods (Sjoholm et al., 2018). Related findings are observed in the ABC group, where city inhabitants had elevated blood pressure. Contestants from generally further privileged regions consistent with the IRSEO countpresented with superior blood pressure andinferiorstages of physical movement in this research.

Research inferences propose how the resultsmight be significant for policy, exercise, hypothesis, and following research. This research demonstrates that unique concentration requires to be placed on health actionssuch as smoking and food behaviour and sexual category equality in well-being. From the findings, policies can be put in place to help improve the CVD health of Australians. With the help of policy implementations, malnutrition can be taken into account. Cardiovascular morbidity and clinical actions might be examined in the following study for even enhanced consideration of the clinical significance of the cardiovascular danger reports in this group. The insinuations can be authenticated by study, for instance earlier research.


It can be said that the article follows all the criteria of the CASP checklist. The article has a focused issue that it discusses throughout the article. Many of the previous research also matches the article and therefore it can be said that the article is valid and genuine.


Sjoholm, P., Pahkala, K., Davison, B., Juonala, M., & Singh, G. R. (2018). Early life determinants of cardiovascular health in adulthood. The Australian Aboriginal Birth Cohort study. International Journal of Cardiology, 269, 304-309. https://ris.cdu.edu.au/ws/files/26063476/21264048.pdf

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