1.

a. The research discussed here used an observational study design. This means that instead of messing
with things or controlling factors, the researchers simply observed and recorded what naturally
happened. They didn't try to change how long people breastfed or their lifestyle choices that could
impact diabetes. They just noted down what was happening.

The study looked back in time, starting from 1976, which means they collected information after things
had already occurred. They didn't try to influence or control variables from the beginning of the study.

Basically, the researchers carefully watched how long women breastfed and if they developed diabetes
afterward, without telling them how long to breastfeed. They kept detailed records of what was already
happening, without adding any specific treatments or controls.

b. Dr. Schwartz noticed that when moms breastfeed for more than a year, the lower chance of getting
diabetes might not be just because of breastfeeding itself. It could be because these moms generally
have healthier habits. This brings up the idea of confounding factors in studies, where the observed
effect might not directly come from what's being studied (like breastfeeding) but from other behaviors
or traits of the people in the study.

In simple terms, Dr. Schwartz is saying that the positive effects linked to breastfeeding for a long time
might be because of overall healthy behaviors, not just the act of breastfeeding. This idea introduces the
concept of confounding factors in studies, where things might not be as straightforward as they seem,
and other factors could be influencing the results.

The difference between "breast-fed" and "breastfeeding itself" is about looking at the act of
breastfeeding in the context of a person's lifestyle, compared to focusing only on the direct health
benefits of the biological process. Even though breastfeeding is linked to health benefits for both mom
and baby, Dr. Schwartz is saying we need to consider the overall lifestyle and health habits of moms who
breastfeed. This emphasizes how tricky it can be to connect health outcomes to just one thing without
looking at the bigger picture of people's lives and choices. If Dr. Schwartz's idea is right, various factors
like lifestyle choices, mental well-being, biological factors, and health awareness could be playing a role
in the observed health phenomenon.

I think the study can be improved if the design is changed indefinitely for the purpose of making it more
reliable and accurate. Employing further observations using methods like Randomized Complete Block
Design (RCBD) could contribute to obtaining more reliable results regarding the relationship between
breastfeeding duration and the risk of developing diabetes.

2.

In this situation, it's better to go for an observational study. Trying to experiment by changing the type
of mass-transit vehicles (regular vs. hybrid) and checking their fuel efficiency and emissions might not be
doable or ethical.

Observational studies mean just watching and analyzing what's already happening without messing with
things. Here's how you'd set it up:

1. Clearly say what you want to find out:

This study aims to compare fuel efficiency, emissions, and user satisfaction between regular and hybrid
mass-transit vehicles. The goal is to give cities the info they need to decide if they want to switch to
hybrid technology.

2. Pick the group you're studying carefully:

The group for this study is cities thinking about changing their mass-transit vehicle tech. We'll choose
two specific cities to represent this group.

3. Design the sample selection plan: Use stratified random sampling to select mass-transit vehicles from
both cities, ensuring representation based on factors like vehicle type, route, and usage patterns. This
minimizes bias.

4. Decide on measurement methods: Choose reliable measurement instruments to collect data on fuel
economy, emissions, and user feedback to minimize bias.

5. Conduct a pretest: Test survey instruments and procedures before the main study to identify and
address any issues related to clarity, comprehension, or bias in the questions.
6. Organize data collection and management: Detail the process of data collection, specify roles and
responsibilities of data collectors, and implement effective data management strategies.

By conducting an observational study, valuable information can be provided to help cities make
informed decisions based on the real-world performance of regular and hybrid mass-transit vehicles.

Experimentation might be difficult and unethical here. Changing mass-transit vehicles in an experiment
could be costly and disrupt the current transportation system. It might not be ethical to subject one city
to potential drawbacks of traditional vehicles solely for comparison. Observational studies allow for a
more natural assessment of existing conditions without artificial changes.

Practical constraints, like the inability to control all variables in a real-world setting, make observational
studies a more realistic approach. It allows for a comprehensive understanding of the performance of
both vehicle types in the actual context of use.

In summary, executing an observational study is a more ethical and practical choice in this scenario,
providing valuable insights into the real-world performance of regular and hybrid mass-transit vehicles.

The best sampling method for this observational study would be stratified random sampling. This
involves dividing the population (mass-transit vehicles in both cities) into distinct strata based on
relevant characteristics (e.g., vehicle type, route, usage patterns) and then randomly selecting samples
from each stratum.

Stratified random sampling ensures a more accurate comparison between regular and hybrid mass-
transit vehicles by capturing variations within different subgroups. This method helps control potential
confounding variables and provides a representative sample from each city, enhancing the validity and
reliability of the study's findings.

By using stratified random sampling, biases in the study can be minimized. This approach helps prevent
overrepresentation or underrepresentation of certain subgroups in the sample, leading to more
accurate and reliable results. Additionally, by ensuring a representative sample from each city, stratified
random sampling helps to avoid biases associated with specific geographic areas or demographic factors
that may influence the study's outcomes.
By following these key elements, the study will offer reliable and relevant information to guide the city
in deciding whether to adopt hybrid mass-transit vehicles.

3.

a. In this scenario, where a pediatric surgeon is interested in testing the theory that playing video games
can reduce children's pre-operative anxiety as measured by the Yale Pre-operative Anxiety Scale, a
suitable research design could be use:

1. Stating the Objectives clearly:

- To assess whether playing with Game Boys before surgery can lower pre-operative anxiety in children
and understand how this effect interacts with other factors like age, gender, and severity of planned
surgery.

2. Defining the target population:

- Children scheduled for planned surgeries, randomly selected with consideration for potential
blocking factors.

3. Using Randomized Block Design (RBD) as the sampling method:

- Participants are grouped into blocks based on potential influencing factors (age, gender, severity of
planned surgery).

- Within each block, participants are randomly assigned to two groups:

a. Intervention Group (Game Boy):

- Children are allowed to play with Game Boys before their surgery.

b. Control Group (Standard Care):

- Children receive the standard pre-operative care without access to Game Boys.
4. Method of Measurement of Anxiety:

- Utilize the Yale Pre-operative Anxiety Scale to measure anxiety levels in children before and after the
intervention/control treatments across all blocks.

5. Implementation:

- Standardize conditions across all blocks, including the surgical environment, healthcare team, and
pre-operative procedures.

- Ensure equal playing time with Game Boys for children in the intervention groups across different
blocks.

6. Data collection and data management:

- Collect data on pre- and post-intervention anxiety levels, noting specific block characteristics.

- Record observations or comments from healthcare providers and participants regarding the
intervention.

7. Use an appropriate data analysis method:

- Analyze the data to compare pre-operative anxiety levels between intervention and control groups
within each block.

- Perform interaction analysis to examine how the effect of the Game Boy intervention varies across
different blocks defined by age, gender, and surgery severity.

8. Interaction Effect implementation:

- Specifically, analyze for interaction effects to understand how the impact of the Game Boy
intervention on anxiety levels might change based on the child's age, gender, or the severity of the
surgery.

9. Replication for added reliability of the results:

- Consider possibilities for replicating the study in various settings or with different participant
demographics to ensure findings are generalizable.

10. Ethical Considerations:

- Secure informed consent from parents or guardians.

 - Prioritize the comfort and safety of participating children.

11. Report conclusions in light of the original Objectives:

- Thoroughly report on the methodology, including the use of RBD and interaction effect analysis, as
well as the findings, limitations, and recommendations for future research.

This experimental design aims to provide a more detailed understanding of how pre-operative use of
Game Boys affects anxiety in children and how this effect might vary among different subgroups,
improving the specificity and applicability of the results.

b. In this situation, an experiment to compare the effects of using anti-anxiety drugs and allowing use of
Game Boy on anxiety level before surgery. The following design could be use:

1. Stating the Objectives clearly:

- To compare the effectiveness of anti-anxiety drugs and Game Boy use in reducing pre-operative
anxiety in children scheduled for surgery.

2. Defining the target population:

- Randomly selected children scheduled for planned surgeries, ensuring diversity in age, gender, and
severity of planned surgery.

3. Using Completely Randomized Block Design (CRBD) as the sampling method:

- Group participants into blocks based on potential influencing factors such as age, gender, and
severity of planned surgery.

- Randomly assign participants within each block to three groups:

- Anti-Anxiety Drug Group:

- Children receive a standard dose of an anti-anxiety drug before surgery.

- Game Boy Group:

 - Children are allowed to play with Game Boys before surgery.

- Control Group (Standard Care):

- Children receive the standard pre-operative care without any specific intervention.

4. Method of Measurement of Anxiety:

- Utilize the Yale Pre-operative Anxiety Scale to measure anxiety levels in children before and after the
intervention/control treatments.

5. Implementation:

- Standardize conditions across all groups, including the surgical environment, healthcare team, and
pre-operative procedures.

- Ensure consistency in the administration of anti-anxiety drugs and the time allotted for Game Boy
play.

6. Data Collection and data management:

- Collect data on pre- and post-intervention anxiety levels for each group within each block.

- Record any observed side effects or adverse reactions related to the use of anti-anxiety drugs.

7. Use of data analysis method:

- Conduct statistical analyses to compare anxiety levels between the anti-anxiety drug group, Game
Boy group, and control group within each block.

- Explore potential variations based on participant characteristics and block factors.

8. Ethical Considerations:

- Obtain informed consent from parents or legal guardians.

- Monitor for any adverse effects or discomfort in participants, especially in the anti-anxiety drug
group.

9. Reporting conclusions in light of the original objectives:

- Provide clear and concise reporting of methods, results, and conclusions.

 - Include information on the comparative effectiveness of anti-anxiety drugs and Game Boy use,
considering potential variations based on participant characteristics and block factors.

10. Replication on different settings:

- Consider possibilities for replicating the study in different healthcare settings or with diverse
participant demographics to enhance the generalizability of findings.

Using CRBD allows for better control of known influencing factors by grouping participants into blocks
before randomization, thus enhancing the validity and reliability of the study.

However, several potential confounding variables may arise in the experiment, impacting the
interpretation of results. It's vital to identify and control for these variables to ensure the internal
validity of the study. It could pose on the two experiments including of that in the first design (a).
Possible confounding variables in this experiment may include:

1. Individual Differences:

- Variation in baseline anxiety levels among participants may influence the outcomes. It's essential to
measure and control for individual differences in anxiety predisposition.

2. Previous Experience with Surgery:

- Participants with prior surgical experiences may exhibit different anxiety levels. Consider assessing
and controlling for participants' previous surgical encounters.

3. Familiarity with Game Boy:

- Children's familiarity with playing Game Boy could influence anxiety levels. Those unfamiliar may find
it more distracting, while frequent users may not experience the same effect.

4. Parental Involvement:

- The level of parental involvement or support may impact a child's anxiety. Consider assessing and
controlling for the parents' presence and engagement during the pre-operative period.

5. Surgical Procedure Severity:

 - The severity of the planned surgical procedure may influence anxiety levels independently of the
interventions. Stratify or control for this variable during the randomization process.

6. Health Status:

- Participants' overall health status and any pre-existing medical conditions may impact anxiety levels.
Ensure a thorough health assessment and consider controlling for health-related variables.

7. Time of Surgery:

- The time of day when surgeries are scheduled may impact anxiety levels. Ensure that surgeries are
distributed evenly across different times, or control for the time variable in the analysis.

Careful consideration of these potential confounding variables during the design, implementation, and
analysis stages of the experiment will enhance the validity and reliability of the study's findings. Such
design would be credible if these variables are taken into account.

c.

To differentiate the two experiments, the following hypothesis are assumed:

a. Experiment to test the surgeon's theory with Gameboy:

Expected Conclusion:

- If the results indicate a statistically significant reduction in anxiety levels among children who played
with Game Boys compared to a control group, the conclusion would support the surgeon's theory. The
finding would suggest that Game Boy use is a viable and potentially beneficial strategy for managing pre-
operative anxiety in children.

b. Experiment comparing anti-anxiety drugs and Game Boy use:

Expected Conclusion:

- The conclusion from this experiment will provide insights into the relative effectiveness of anti-
anxiety drugs and Game Boy use. If one intervention is found to be significantly more effective than the
other in reducing anxiety levels, the conclusion would recommend the adoption of the more effective
intervention for pre-operative anxiety management in children.

Key Differences in Conclusions:

1. Scope of Intervention:

- Experiment (a) focuses solely on the effectiveness of Game Boy use, while experiment (b) compares
two interventions: anti-anxiety drugs and Game Boy use.

2. Specificity of Recommendations:

- Experiment (a) will specifically recommend or refute the use of Game Boys as a pre-operative anxiety
management strategy. In contrast, experiment (b) will provide a comparative assessment,
recommending which of the two interventions (anti-anxiety drugs or Game Boy use) is more effective.

3. Applicability of Findings:

- The conclusions from experiment (a) are directly applicable to the use of Game Boys, while the
conclusions from experiment (b) have broader implications for choosing between anti-anxiety drugs and
Game Boy use as pre-operative interventions.

4. Clinical Decision-Making:

- Experiment (b) is more relevant for clinical decision-making, as it directly compares two different
interventions that clinicians may choose between. Experiment (a) is more specific to the use of Game
Boys and may not inform choices between different interventions.

In the essence, while both experiments contribute valuable information on pre-operative anxiety
management, the conclusions differ in scope, specificity, and applicability. Experiment (b) provides more
comprehensive guidance for clinicians by directly comparing two interventions, whereas experiment (a)
specifically addresses the theory of efficacy of Game Boy use.