Annotated Bibliography 

•Length: 5 citations and annotations  

Research Paper

•Length: 2-3 pages

Research Infographic Assignment

•Length: One poster page 

Annotated Bibliography Practice Sheet

APA Bibliographic Citation (Be sure to include the hanging indent)
	Example of a Parenthetical In-text Citation for this Source	Type of Source (ex. journal article, book, website)
	Summarize this source in one to two sentences
	Explain why this is an authoritative source in one to two sentences
	Explain how this source will likely feature in your paper in one to two sentences

Use this table as a format for your annotated bibliography.

SAMPLE:

Example of a Parenthetical In-text Citation for this Source

Summarize this source in one to two sentences

Explain why this is an authoritative source in one to two sentences

Explain how this source will likely feature in your paper in one to two sentences

APA Bibliographic Entry
Schmidt, L., Jacobs, L., and Spetz, P. (2016) Young people’s more permissive views about marijuana: Local impact of state laws or national trend?. American Journal of Public Health 106.8 : 1498-1503. Retrieved from https://libsecure.camosun.bc.ca:2443/login?url=http://search.ebscohost.com/ login.aspx?direct=true&db=c8h&AN=116795701&site=eds-live>
Type of Source (ex. journal article, book, website, etc.)
(Schmidt, Jacobs, and Spetz, 2016, 1498)	Academic journal article
In their article “Young People’s More Permissive Views About Marijuana: Local Impact of State Laws or National Trend?” Laurie Schmidt, Laurie Jacobs, and Joanne Spetz (2016) analyze data over a span of 10 years from the US National Survey on Drug Use and Health (2004-2013) to determine if relaxed medical marijuana laws within states encourage young people to adopt a more positive stance towards marijuana. The authors assert that, according to their analysis, while relaxed marijuana laws within a state didn’t appear to directly result in youth within that particular state acquiring more permissive attitudes towards the drug, the authors did detect, over the time of the study, a national trend of youth adopting a more positive attitude towards the drug as some states relaxed their marijuana laws.
This article was published in a peer-reviewed academic journal. Moreover, having been published just three years ago, it provides current information on the topic.
This article provides recent evidence, in an American context, that as states relax their marijuana laws, at the national level, youth appear to be adopting a more positive stance towards marijuana. This article provides support for my contention that as Canada legalizes marijuana, Canadian youth may increasingly view the drug as less harmful.

Research Paper topic confirmation

Class Number English 151 – _____

Student Name_____________________________________

This is the problem I have identified.

_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

This is the technology/idea/concept I would like to propose to solve or address this.

_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

I plan to address my paper to this person or group of people

_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

StudentName

Class name

Date

Burdened No Longer: How Continuous Glucose Monitoring is Revolutionary in Diabetes Care

and Why British Columbia Should Fund It

Abstract

This paper discusses what Continuous Glucose Monitoring (CGM) technology is, and

draws on recent scientific research to explain why it is more effective for managing blood

glucose levels and preventing adverse health outcomes in patients with type 1 diabetes than other

methods. It further examines how, despite the health benefits associated with CGM use, the

technology has not yet seen widespread use in Canada due to the high out-of-pocket costs for

patients. Thus, this paper asserts that the British Columbia Ministry of Health should begin

providing public funding for CGM devices to ensure that all type 1 diabetics are able to access

this revolutionary technology and manage their health more effectively.

Figure 1 (left): ​Woman wearing a CGM sensor (Juvenile Diabetes Research Foundation, 2019)
Figure 2 (right): ​CGM sensor, insulin pump and smartphone with glucose data (Diabetes Canada, 2018)

Context

Type 1 diabetes is a chronic, autoimmune condition characterized by the body’s inability

to produce insulin. Without insulin, a person’s cells cannot perform the metabolic processes

necessary for life, and so people living with diabetes follow intensive treatment regimens of

injecting insulin and monitoring blood glucose in order to maintain their health. Though the

management of this condition places a significant burden on the patient, recent developments in

technology have begun to provide more effective and less laborious methods of regulating blood

glucose. One of these technologies, Continuous Glucose Monitoring (CGM) has demonstrated

promising benefits for alleviating the medical burdens of type 1 diabetes by reducing the

incidence of extreme hyperglycemia and hypoglycemia (Diabetes Canada, 2018). CGM involves

the insertion of a disposable electrochemical sensor into the skin, which continuously measures

the glucose levels in subcutaneous tissue, and then wirelessly transmits this data to the user’s

insulin pump or smartphone (Vettoretti & Facchinetti, 2019). However, for many people living

with type 1 diabetes in Canada, CGM is a potentially life-saving technology that remains out of

reach due to high costs (Juvenile Diabetes Research Foundation, 2019).

The inaccessibility of CGM technology represents a significant problem, since studies

show that regulation of blood glucose levels using the conventional method of self-monitoring

blood glucose (SMBG), which requires collecting small blood samples from the fingers six to

eight times daily, is demonstrably less effective (Diabetes Canada, 2018). Indeed, as shown in

figure 3, CGM use is associated with lower hemoglobin A1c (HbA1c) levels, which is the

standard metric used to assess a patient’s blood glucose regulation over a three month period

(Senn, Fischli, Slahor, Schelbert, & Henzen, 2019). This is due in part to the fact that the blood

glucose data attained through SMBG only offers information from individual points in time,

whereas CGM allows the patient to make more effective treatment decisions based on 24-hour

data on their blood glucose and its trends. Considering how long-term elevated HbA1c levels can

lead to diabetes-related complications such as kidney failure, neuropathy and amputation, the

importance of utilizing technologies such as CGM to avoid such outcomes becomes evident.

Figure 3​: The impact of CGM use on blood glucose control through trends in HbA1c during a
6-month study (Giani, Snelgrove, Volkening, & Laffel, 2016).

Furthermore, CGM plays a crucial role in the safety of people with type 1 diabetes, as it

provides alerts when blood glucose is too high or too low. This technology can prevent

life-threatening emergencies due to high or low blood glucose by informing the user when there

is a problem and giving them the opportunity to act before serious health problems, such as

seizures, diabetic coma, or ketoacidosis, arise. According to Diabetes Canada, CGM use is

especially effective for type 1 diabetics who experience frequent episodes of hypoglycemia, and

is associated with a decrease in hospitalizations for those who use it (2018).

Finally, a 2019 study seeking to understand the benefits and limitations of CGM use

found that while CGM is generally seen as favourable by type 1 diabetics, one of the primary

reasons for discontinuing the treatment method was the high associated cost (Sørgård, Iversen, &

Mårtensson, 2019). As there is no national funding for CGM in Canada (Graham, 2017), type 1

diabetics without specific private health insurance must pay out-of-pocket for the cost of the

sensors, which ranges from $3000 to $6000 annually (Diabetes Canada, 2018). However, the

study by Sørgård, Iversen, and Mårtensson ascertained through interviews that many of the

diabetics who discontinued their use of CGM would resume using the technology if the cost

barrier were to be eliminated (2019). Thus, it can be concluded that the key to implementing

more widespread use of CGM among type 1 diabetics, and reaping the health benefits it

provides, could be achieved by removing the barrier of cost.

Recommendation

In light of the evidence for how CGM use improves health outcomes, and in accordance

with the recommendations of Diabetes Canada (2018), it is imperative that the British Columbia

Ministry of Health begins providing public funding for the use of CGM by people with type 1

diabetes. All costs associated with CGM should be covered under the province’s health insurance

in order to ensure that every type 1 diabetic in British Columbia can access this potentially

life-saving technology.

Though some may argue that providing this coverage would constitute an increase in

healthcare spending that the province cannot afford, there is evidence to indicate that this policy

would instead be cost-effective. One study tracking the public costs of pregnancy and delivery

for 1441 diabetic women found that the overall costs for the women regulating their glucose

using CGM was lower than for those using SMBG ​(Murphy, Feig, Sanchez, de Portu, & Sale,

2019). As illustrated in Figure 4, although the immediate costs of CGM are higher than SMBG,

this cost is offset by the reduction in length and frequency of neonatal intensive care unit

admissions. Though this data pertains specifically to pregnant women using CGM, the same

principle may be extrapolated to infer that the cost of providing public funding for CGM would

be offset by the consequently reduced medical complications associated with poor blood glucose

regulation.

Figure 4​: Healthcare costs of pregnant women with type 1 diabetes when using CGM compared
to SMBG (Murphy, Feig, Sanchez, de Portu, & Sale, 2019).

Another benefit of instituting public funding of CGM would be the opportunity to use it

in conjunction with an insulin pump. CGM sensors now have the ability to communicate with

some insulin pumps in such a way that allows the pump to increase or decrease insulin dosage

based on blood glucose readings (Graham, 2017). While these so-called “closed-loop systems”

or “artificial pancreases” are still an emerging technology, many experts expect them to quickly

become the new standard of care as they are demonstrating even more positive effects on blood

glucose regulation than CGM or insulin pumps alone (Graham, 2017). Thus, if British Columbia

Ministry of Health was to provide CGM funding, it would simultaneously be paving the way for

even more advanced and effective diabetes management technology.

In conclusion, in order to improve care for type 1 diabetics across the province and

reduce healthcare costs associated with poor blood glucose regulation, the British Columbia

Ministry of Health must make CGM accessible through the provision of public funding.

According to an article in the BC Medical Journal, diabetes places a significant burden on the

province’s healthcare system, accounting for over 70% of non-traumatic limb amputations, and

prevalence of both type 1 and type 2 diabetes is expected to continue increasing (Ur, 2018). In

order to ensure that taxpayer money is being spent effectively and that our limited healthcare

resources are not being wasted on preventable hospitalization, it is essential that the province

ensures all diabetics can access the care they need – not just those wealthy enough to afford it.

As long as there remains no cure for type 1 diabetes, those living with the condition rely on the

regulation of blood glucose for their health and survival, and the investment in technologies like

CGM are what allow diabetics to live long, fulfilling lives.

List of Works Cited

Diabetes Canada. (2018). Continuous glucose monitoring [PDF file]. Retrieved from

https://www.diabetes.ca/DiabetesCanadaWebsite/media/Managing-My-Diabetes/Tools

and Resources/Continuous_Glucose_Monitoring_Advocacy_Pkg_4 ?ext= .

Giani, E., Snelgrove, R., Volkening, L. K., & Laffel, L. M. (2016). Continuous glucose

monitoring (CGM) adherence in youth with type 1 diabetes: Associations with

biomedical and psychosocial variables. Journal of Diabetes Science and Technology,

11(3), 476–483. doi: 10.1177/1932296816676280

Graham, C. (2017). Continuous glucose monitoring and global reimbursement: An update.

Diabetes Technology & Therapeutics​, ​19​(S3). doi: 10.1089/dia.2017.0096

Juvenile Diabetes Research Foundation. (2019). Making continuous glucose monitoring

accessible to all. Retrieved from

https://www.jdrf.ca/blog/making-continuous-glucose-monitoring-accessible-to-all/.

Murphy, H. R., Feig, D. S., Sanchez, J. J., de Portu, S., & Sale, A. (2019). Modelling potential

cost savings from use of real-time continuous glucose monitoring in pregnant women

with Type 1 diabetes. ​Diabetic Medicine​, ​36​(12), 1652–1658. Retrieved from

https://www.ncbi.nlm.nih.gov/pubmed/31162713

Nicolucci, A., Rossi, M., Dostilio, D., Delbaere, A., Portu, S. D., & Roze, S. (2018).

Cost-effectiveness of sensor-augmented pump therapy in two different patient

populations with type 1 diabetes in Italy. ​Nutrition, Metabolism and Cardiovascular

Diseases​, ​28​(7), 707–715. doi: 10.1016/j.numecd.2018.03.011

Senn, J.-D., Fischli, S., Slahor, L., Schelbert, S., & Henzen, C. (2019). Long-term effects of

initiating continuous subcutaneous insulin infusion (CSII) and continuous glucose

monitoring (CGM) in people with type 1 diabetes and unsatisfactory diabetes control.

Journal of Clinical Medicine​, ​8​(3), 394. doi: 10.3390/jcm8030394

Sørgård, B., Iversen, M., & Mårtensson, J. (2019). Continuous glucose monitoring in adults with

type 1 diabetes: A balance between benefits and barriers: A critical incident study.

Journal of Clinical Nursing​. Retrieved from

https://onlinelibrary.wiley.com/doi/epdf/10.1111/jocn.14911?referrer_access_token=q1k

_7aXykr48U6_XxdyywYta6bR2k8jH0KrdpFOxC66IhzyHis-koEHmqbXOOW96jaGP0a

MwdHAAReGIq07PWYoRJc0FjDXoxMYZNuRXa60lBkU3HQlin4bBuaLXW2uSAdp

QKDpjlQLYlFvJBf5OBw%3D%3D

Ur, E. (2018). Diabetes in British Columbia: Starvation in the midst of plenty. ​BC Medical

Journal​, ​60​(9), 436–438. Retrieved from

https://www.bcmj.org/editorials/guest-editorial-diabetes-british-columbia-starvation-mids

t-plenty

Vettoretti, M., & Facchinetti, A. (2019). Combining continuous glucose monitoring and insulin

pumps to automatically tune the basal insulin infusion in diabetes therapy: a review.

BioMedical Engineering OnLine​, ​18​(1). doi: 10.1186/s12938-019-0658-x

https://www.bcmj.org/editorials/guest-editorial-diabetes-british-columbia-starvation-midst-plenty

https://www.bcmj.org/editorials/guest-editorial-diabetes-british-columbia-starvation-midst-plenty

Research!

Linked Assignments
Annotated Bibliography
Length: 5 citations and annotations
Value: 15%
Research Paper
Length: 2-3 pages
Value: 20%
Research Infographic Assignment
Length: One poster page
Value 10%
 

Annotated Bibliography
Provide a working bibliography of FIVE (5) sources, with annotations indicating why you believe the work you have chosen is a suitable one for your research paper. Use the criteria from the course notes to prove that your source is appropriate.
Each entry should include:
1. Full bibliographical information: author, title, publisher, date, internet address (URL) or library database. For this class we will be using APA format.
2. Two to four sentences that summarize what the article/book/video (or other item) is about. Two to four sentences that discuss the usefulness of this article to your paper. One or two sentences identifying why you determined whether this was an appropriate source.
Each of the annotations should be about a paragraph, no more than half a page. You will be judged on accuracy, quality of research and critical ability. Note that all five works are expected to be judged suitable.

Sample
See handout

Research Paper
Using the Powerpoint presentation for inspiration, research a technology, idea or concept that you would like to see implemented in the field of public health, food security, public art, or climate change adaptation to address an issue or problem you have identified. Your goal is to write a short paper in which you try to convince your audience to adopt this new technology, concept or idea. This paper is based on the concept of a policy briefing, though we will be adapting the format to suit our needs.
Audience: your audience should be a person or group of people who have the capacity to implement the technology, idea or concept you are proposing. For example, if you think that a great climate change adaptation idea is to build porous sidewalks and alleys as they have in Chicago and other cities, then you would address your paper to city council. If you think that Camosun College should have more public art, then you would address your paper to Camosun College Administration. So do a bit of research and discover whom to address your paper to.
Tone and Terminology: Make sure that the tone you use in your writing is appropriate. In most cases, your tone should be professional and concise. Avoid jargon that your audience would not know. (And please remember that I need to understand what you are writing). Your goal is to communicate, not to confuse.
Purpose: Your purpose is to persuade your reader to adopt the technology, idea or concept that you are presenting. Make sure to inform your reader what the current issue or problem is, as well as how it will be addressed by adopting the technology, idea or concept you propose. To do this, you will have to research what the current dialogue or conversation on the topic is. A strong persuasive paper will include well used evidence of both the issues at hand and the efficacy of your solution.

Format:
Title: use the title to quickly communicate the contents of the paper memorably
Abstract (or Executive Summary): in 3-4 sentences, summarize the key points of your paper. This should include an overview of the problem and the proposed solution in the form of the technology, idea or concept you are writing about.
Context: Provide the reader with some context for why the new technology is needed. Identify and briefly discuss the problem or issue. Use examples to illustrate your point. This is the “They Say” portion of your paper where you can point out problems or issues others have identified. You can use graphs, charts or images to make it easier for your reader to follow your information.
Recommendation: In this section, outline what you are proposing and why it is a good choice. How will it help to solve the problem or issue you are discussing? Are there any possible challenges with this choice? How can you overcome these challenges? Has the technology, idea or concept been adopted elsewhere? How is it being used there? How effective is it in that context? Why will it be effective in the context you propose?

Marking Criteria:
Content:
Clearly indicates what the problem is that the new technology or idea will solve or address. In other words, the paper provides context.
Provides a detailed overview of the technology or idea that is being presented.
Indicates how that technology or idea will solve or address the problem presented.
Indicates why the technology or idea presented is a good choice.
Technique:
Uses persuasive language without being overbearing.
Uses other tools of persuasion such as rhetorical appeals and organization appropriately.
Shows an understanding of the audience’s needs (word choice, depth of explanation, etc.).
Expression:
Uses clear, well constructed sentences.
Uses words appropriately to create the desired tone.
Uses language appropriate to the audience (keeping in mind that I also have to understand).
Mechanics:
Uses grammar, punctuation and spelling correctly.
Is properly formatted according to given instructions.

Research Infographic Assignment
Purpose/ Audience: Your audience is the general public. Your purpose is to provide an overview of the research (from your Research Essay) in an easily understandable format. You will present this infographic to the class to share your research findings.

Task:
Create an engaging infographic based on your research paper findings. This infographic should present complex information in an easily accessible format.
Use concise language, careful formatting, and appropriate images to communicate your complex research information in a simplistic and easy to understand format.
The most important element of this assignment is that your information is accurate, concise, and easy to follow. The graphic design of your infographic is secondary but still very important (after all, you have already received a mark for your research papers and your infographic is meant to translate that research into a more engaging and accessible format).
I will provide a few infographic examples for you to follow.

Samples

Samples

Topics for research

Food Security
Lisa Dyson A forgotten Space Age technology could change how we grow food:https
://www.ted.com/talks/lisa_dyson_a_forgotten_space_age_technology_could_change_how_we_grow_food

The Urban Aboriginal Community Kitchen Garden Project http://www.vidinfo.org/video/28040115/the-urban-aboriginal-community-kitchen-garden

Devita Davison: How urban agriculture is transforming Detroit: https://www.youtube.com/watch?v=G88JZ1DIdg8

Public Art
Cody Graham and Carey Newman, Witness Blanket: https://m1films.ca/portfolio_page/witness-blanket/
Helen Marriage, Public art that turns cities into playgrounds of the imagination:https
://www.ted.com/talks/helen_marriage_public_art_that_turns_cities_into_playgrounds_of_the_imagination#t-17864
Jody Broomfield, Chrystal Sparrow, Jordan Gallie, City of Vancouver, First Nations Art Instilations: https://www.youtube.com/watch?v=T9EV6ygpthc
Americans For the Arts: Https://www.americansforthearts.org/by-topic/public-art/why-murals

Climate change
CBC Spark: A 200-Year-Old Bicycle Design for Climate Change: https://www.cbc.ca/radio/spark/a-200-year-old-bicycle-inspires-design-for-climate-change-1.5141222
ITC solutions narrated by Jeffrey Sachs: https://unfccc.int/climate-action/momentum-for-change/information-and-communications-technology-solutions
Preventing Flooding in Belford – a new approach: https://www.youtube.com/watch?v=JFShVPlS-QQ
Ranchers Combat Overgrazing to Flight Climate Change: https://youtu.be/ct7iQxs7RMQ 

Public health

https://radiopublic.com/99pi/ep/s1!68812
Max Little, A Test For Parkinson’s With A Cell Phone: https://www.ted.com/talks/max_little_a_test_for_parkinson_s_with_a_phone_call?referrer=playlist-the_future_of_medicine

Mark Kendall A needle-free vaccine patch that’s safer and way cheaper: https://www.ted.com/talks/mark_kendall_demo_a_needle_free_vaccine_patch_that_s_safer_and_way_cheaper?referrer=playlist-the_future_of_medicine

99% Invisible: Sound and Health: Hospitals:https://radiopublic.com/99pi/ep/s1!68812