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I need urgent help with this projectband I don't m...




I need urgent help with this projectband I don't mind paying for it. In the following, the introduction, the general objectives and the data collection sections of a research proposal that you are planning are described. 1. State your main specific objective (only one) and four secondary objectives based on the general objectives described. 2. Describe the statistical methods that you will use to address your objectives. Justify each of these methods. You should use methods from the material learned in this course only and each of the methods used should come from a different chapter. 3. Conduct a sample size calculation that will provide sufficient power (80% at the 95% significance level) to your main analysis (analysis of the main objective) Introduction: Chronic kidney disease progresses to end-stage renal disease (ESRD) when kidney function has irreversibly deteriorated and is no longer adequate to sustain life. Patients with ESRD require life-sustaining renal replacement therapy with dialysis or kidney transplantation if a kidney donor is available. There are two main types of dialysis, peritoneal dialysis (PD) and hemodialysis (HD). In PD, extra fluids and waste are removed from the blood inside the body, using the body's own peritoneal membrane. Dialysis fluid enters the peritoneal cavity through a flexible catheter. Extra fluid and waste travel across the membrane into the dialysis fluid, which is then drained through the catheter after a pre-determined dwell period. PD is mainly offered at home to patients who are able to perform it either independently or with the help of a trained person. In HD, blood is drawn and sent through a dialyzer (automated waste and fluid filter), before returning to the body. HD is generally performed in units situated in hospitals, satellite units (off site of hospitals but associated with an in-hospital mother unit), and sometimes at home where a dialysis machine is provided to the patient. Access-related infections are frequent in individuals receiving dialysis. In PD, access-related infections involve either the abdominal lining (peritonitis), the skin at the site of catheter placement (exit site infection), or within the tunnel of subcutaneous tissue through which the catheter passes (tunnel infection). PD peritonitis is the leading cause of PD failure. Failure of PD and transfer of patients to HD due to infection is frequent and occurs in 30-40% of PD patients. Access-related infections among HD patients are also a major concern. Access-related infection rates in HD patients vary with venous access types- Arteriovenous Fistula (AVF), Arteriovenous Graft (AVG) and Central Venous Catheter (CVC). An AVF is created by surgically joining an upper extremity artery and vein. Blood travels from the fistula through a tube to the dialyzer, crosses the dialyzer, and then returns to the fistula through a second tube. This access mode is the least likely to lead to infection, but is precluded in some patients because of obesity, small blood vessels or weakened veins and arteries. Among patients who are unable to have an AVF, an AVG is created by connecting an upper extremity vein and artery using a synthetic tube. Another alternative is placement of a CVC into a jugular, subclavian, or femoral vein, with tubing and ports outside the body for easy access. Tunnelled CVC is used permanently only for patients unable to use AVF or AVG. About 30% of HD patients use CVC. Access-related infection among HD patients may involve the skin at the catheter exit site, the tunnel in CVC, or may lead to bacteremia. Several patient factors such as age, presence of diabetes mellitus, hygiene, and nasal Staphylococcus carriers may influence access-related infection rates in both PD and HD patients. Among PD patients, access-related infection rates are higher during the first two years of catheter insertion. Among HD patients, peripheral atherosclerosis, longer periods of catheter indwelling and previous bacteremia have been associated with increased rates of infections. You wish to compare the risk of access-related infections and the risk of mortality between PD and HD patients, and among HD patients between those who received AVG, AVF or CVC. You also wish to compare the burden of access-related infections among dialysis patients by comparing the number of days spent in-hospital because of infection in the first two- years following dialysis onset between PD and HD and among HD patients between AVG, AVF and CVC. You are also interested in identifying patient characteristics associated with mortality and those associated with the risk of access-related infections and total number of in-hospital days of PD and HD patients in the two-years following dialysis onset. (Assume that patients stay on the dialysis modality and access type that they started with at dialysis onset for the time of the study) A retrospective cohort study was conducted. Study patients were all patients 18 years of age or older receiving dialysis between January 2000 and October 2006 in six dialysis centres in Quebec. Data were abstracted from dialysis unit charts. The date of cohort entry was the date of onset of dialysis. Patient characteristics assessed: Dialysis specific variables: Date of onset of dialysis, dialysis modality and type of blood access Demographics: age, sex, dry weight, socioeconomic status (Low or high), distance to dialysis centre, dialysis centre, date of death (if applicable), date and reason for ending follow-up, (kidney transplant, death, transfer to institution care, or end of the study period). Co-morbidity: hypertension, diabetes, coronary artery disease, peripheral vascular disease, seriously impaired vision, hypercholesterolemia and antibiotic resistance Medication use: ace inhibitors, lipid lowering agents, antidiabetic agents, anticoagulants, immunosuppressive agents, antidepressive agents and antibiotics .,The course chapters are: Descriptive statistics(types of data, histograms, stemplots, boxplots, means, medians, variance, relocatin/rescaling) Probabiity diagnostic tests(laws of probability, Bayes theorem, diagnostic tests And cnditional probabilities) Discrete distributions(discrete random variables, expectation and variance of discrete r.v., binomial distribution, poisson distribution) Continous distributions(continous random variables, expectation and variance of continous r.v, uniform distribution, normal distibution, area under normal curve, central limit theorem, normal approximation to the binomial) Iference for a single mean(random sampling, t distribution, hypothesis testing for means, type I and type II errors, p-values, CI for means, sample size calculation) Inference for two means (unpaired samples, paired samples, confidnece interval for differences in means, sample size calculations) Non parameteric inference(sign test, rank sum test, signed rank test, confidence interval for medians) Inference for one and two proportions(one proportion:large sample inference, exact inference, sample size calculation. Two proportions: large sample inference, sample size calculation, number needed to treat, odds ratio and relative risk, Mantel-Haenszel odds ratio) Contingency tables Correlation (one and two sample chi square test, Fisher's exact test, kappa statistics, chi square test for trend, estimation and inference for Pearson's correlatino coeeficient, spearman's rank correlation) Simple linear regression( differences between regression and correlation, Model assumptions, Least square estimates, inference, regression diagnostics, goodness of fit, transforming the outcome),I really have no clues how to do it,Could you let me know today if it is accepted or not. Thanks,I am sorry for disturbing but I would really like to know today if you accept it ot no. thanks,Is it clear now?,I have agreed to pay 60$ for all the questions.


Paper#11440 | Written in 18-Jul-2015

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