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DE LA SALLE HEALTH SCIENCES INSTITUTE COLLEGE OF MEDICINE
DEPARTMENT OF FAMILY AND COMMUNITY MEDICINE
CM2 SY 2011-2012
OUTPUT 3: RESEARCH DESIGN
I. Group 1A, Dr. Jovilia M. Abong
II. Research Question: Among students aged 13-14 with allergic rhinitis of selected schools in
Dasmarias, Cavite, will exposure to air-conditioned school rooms exacerbate their allergic rhinitis?
General Objective: To determine if the exposure to the air-conditioning system exacerbates allergic
rhinitis in high school students, aged 13-14, of selected schools in Dasmarias, Cavite.
Specific Objectives:
1. To identify the prevalence of allergic rhinitis among high school students, aged 13-14, of
selected schools in of Dasmarias, Cavite based on their exposure to air-conditioned rooms.
2. To identify the prevalence of allergic rhinitis among high school students, aged 13-14, of
selected schools in Dasmarias, Cavite based on their exposure to non-air-conditioned
classrooms.
3. To determine the severity of allergic rhinitis according to ARIA classifications.
4. To identify the risk factors of allergic rhinitis present in the classroom or school.
5. To determine the number of hours exposed to the classroom with or without air-conditioning
system.
6. Compare the severity of allergic rhinitis in students who are exposed to air-conditioned
classrooms and those who are not exposed to air-conditioned classrooms.
7. To determine which studying environment is more suitable in the prevention of allergic
rhinitis.
III. Background
a. Research Hypothesis: Exposure to air-conditioned rooms alleviates the symptoms and
occurrence of allergic rhinitis and poor ventilation leads to its exacerbation.
b. Conceptual Framework:
Exposure Variable Disease Variable
Exposure to Air-
conditioning System
Improves allergic Rhinitis
Exacerbates Allergic Rhinitis
1
+
-
Allergens/Irritants
Number of hours spent in classroom
Condition of the room
Confounders
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Animal dander is loose skin cells from animals which contain secretion from glands in
the animals skin. These skin cells float in the air where they may be breathed in by people. The
animals fur or hair per se is not an allergen, but there might be dried saliva on the hair that may
bring about the allergy. [1]
Pollens causes allergic reactions. These are tiny and come from plants (trees, grasses,
ragweed, etc.). The amount of pollen in the air plays a role in developing allergic reaction.
There is likely increased amounts of pollen in hot, dry and windy days, while a decreased
amount during cool, damp and rainy days. [5]
According to an article by deShazo and Kemp, the spores coming from molds can be a
trigger in releasing the symptoms of allergic rhinitis. Also, according to them, mold thrives in
damp environments such as air conditioning vents, water traps, refrigerator drip trays, shower
stalls, leaky sinks, and damp basements if not cleaned regularly. Under certain conditions, the
growth of these organisms can be considerable and exacerbate allergy symptoms. [6] Since
allergic rhinitis is difficult to cure, the focus is on preventing the attack of the symptoms.
Many different triggers that may cause a student to experience symptoms of asthma and
allergy are found inside a typical classroom. These triggers include the pollens from the plants
found near or inside a classroom, dust mites and mold spores. The cleanliness of the room may
also play a factor in triggering the allergic reactions. The students themselves may also carry
allergens produced by their pet cats or dogs which may cling to their clothes and trigger an
allergic reaction when the students come in contact with them. Chalk dusts are also usually the
causes of allergic reactions inside the classroom since the teachers usually use chalk for writing
on the green boards. [7]
b. Research Design
i. Type of study to be employed
The type of study that the researchers are going to be implementing is a cross-sectional research
design. The researchers deem this the most necessary research design just to see whether or not
there is a relationship between the number of hours exposed to air-conditioning systems and the
exacerbation of Allergic Rhinitis. Moreover, this research design is appropriate because the
Disease Variable of the research, which is Allergic Rhinitis, is not a rare disease (thus
eliminating the use of a case-control study). However, in doing a cross-sectional study, the
researchers must take note of and control the confounding variablesways of which will be
discussed in the latter part of the description of the research design.
ii. Definition of study groups population and sources of subjects.
The study population will be 13-14 year old children who, in the Philippine setting, are
approximately first year high school students. From this population, a sample of students who
have AR will be considered for the study. The sample populations will be gathered from select
schools in Dasmarias, Cavite, ideally one private and public school in order to acquire subjects
that have exposure to an air conditioned school environment and one that is not.
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iii. Steps to be undertaken:
These are the steps to be done in our procedure to collect data for this project:
1. Evaluate the classroom conditions of each school.
The group will visit each high school and evaluate the environmental conditions of eachclassroom that will be part of the research. A checklist will be used to document and evaluate
the conditions.
2. Screen students for allergic rhinitis.
Each student will be screened through a questionnaire, based on the ARIA questionnaire, to
eliminate those who do not have allergic rhinitis from the study group. This will help in making
the research study more specific to those who have allergic rhinitis and how the classroom
conditions can alleviate or exacerbate their symptoms.
3. Determine what conditions or things in the classroom, particularly the presence or
absence of an air-conditioning system, exacerbates or relieves each students allergic rhinitis.
A questionnaire will be given to each student who has AR in which it will ask them if their
symptoms are better or worse when they are in the classroom and what specific conditions help
or harm them.
4. Evaluate each students questionnaire.
Each students questionnaire will be evaluated to see what particular conditions exacerbate and
relieve their AR symptoms. There will also be a particular focus on whether having an air-
conditioning system present or not alleviates or worsens each students AR symptoms. [8]
iv. Schematic Diagram
Measure of Association: Prevalence Ratio
Exacerbation of
Allergic
Rhinitis
(+) (-) Total
Air-
Conditioning
(+) A B A+B
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System
(-) C D C+D
Total A+C B+D A+B+C+D
Cross-Sectional Study
Effects of exposure to air-conditioning systems
In the exacerbation of Allergic Rhinitis
Sample Population to be Tested
13-14 year-old high school students from selected
High Schools in Dasmarinas, Cavite.
Procedure
1. Evaluate classroom conditions.
2. Screen students for allergic rhinitis.
3. Determine what conditions or things in
the classroom, particularly the presence orabsence of an air-conditioning system,
exacerbates or relieves each students allergic
rhinitis.
4. Evaluate student questionnaires.
c. Biases/Limitations
i. Enumeration of all biases/limitations
The study will only focus on the role of ventilation inside the classrooms in the relief and
exacerbation of allergic rhinitis among students aged 13-14 years old studying in Dasmarias,
Cavite. It will not include other respiratory diseases and illness that may be affected by the
difference in ventilation.
The possible biases in the study are:
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Selection bias
Expectation bias
ii. Plan to minimize these biases in the study
Selection bias may happen when subjects being compared are not similar, and may result todata that is not representative of the population of interest. [9] With the use of proper screening
methods for the study population, we will select subjects that are similar in almost all aspects in
order to gather a more representative and comparable data.
Expectation bias happens when there is no masking or blinding implemented in the study
and this may influence and tarnish the data to be gathered towards the expected or desired
outcome. [9] To minimize this bias, a high level of objectivity must be maintained with each of
the members of the group of researchers in the gathering of data and its analysis.
Bibliography
[1] Healthwise Staff, Allergic Rhinitis, In: Thompson, E.G. MD, Nelson, H.S. MD, editor, Allergic
Rhinitis [cited 2011 July 31] Available from: http://www.webmd.com/allergies/tc/allergic-
rhinitis-overview
[2] Allergic rhinitis. (2010). Health encyclopedia diseases and conditions. Retrieved July 10, 2011,
from http://www.healthscout.com/ency/68/208/main.html.
[3] Retrieved on July 30, 2011 from
http://www.studenthealth.gov.hk/english/health/health_ophp/health_ophp_nos.html
[4] Air conditioner. (2009).Air conditioning and refrigeration information. Retrieved July 30, 2011, from
http://www.air-conditioning-and-refrigeration.com/air-conditioner.html.
[5] Busse, P.J. MD., (2010) Allergic Rhinitis In: Zieve, D. MD., editor., [cited 2011 July 31] Available
from: http://www.nlm.nih.gov/medlineplus/ency/article/000813.htm
[6] deShazo R., Patient Information: Trigger avoidance in allergic rhinitis. Retrieved on July 30, 2011
from http://www.uptodate.com/contents/patient-information-trigger-avoidance-in-allergic-rhinitis
[7] Health risks in the classroom: children with asthma and allergies need to take special precautions at
school. Retrieved July 30, 2011, from
http://www.kidneeds.com/diagnostic_categories/articles/classrisks01.htm.
[8] ARIA Questionnaire. Allergic Rhinitis and its Impact on Asthma [Website]. 2011 [cited 2011 July 30].
Available from http://www.whiar.org/Questionnaire.php.
[9] Hartman, J.M., Forsen, J.W., Wallace, M.S., Neely, J.G. (2002). Tutorials in clinical research: Part IV:
Recognizing and controlling bias.Laryngoscope, 112, 23-31.
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http://www.webmd.com/allergies/tc/allergic-rhinitis-overviewhttp://www.webmd.com/allergies/tc/allergic-rhinitis-overviewhttp://www.healthscout.com/ency/68/208/main.htmlhttp://www.nlm.nih.gov/medlineplus/ency/article/000813.htmhttp://www.webmd.com/allergies/tc/allergic-rhinitis-overviewhttp://www.webmd.com/allergies/tc/allergic-rhinitis-overviewhttp://www.healthscout.com/ency/68/208/main.htmlhttp://www.nlm.nih.gov/medlineplus/ency/article/000813.htm8/6/2019 Research Design 1st Submission
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