List of Resources and Methodology of Literature Review: A Holistic Health Approach - Research Proposal Example

List of Resources and Methodology of Literature Review Introduction A holistic health approach may be very suitable to target pediatric population in order to modify these lifestyle behaviors very effectively. This is specifically important since the acquired diseases are preventable, and prevention has been demonstrated to be possible through sustained actions directed at families and individuals, where the target areas are not biomedical rather holistic in the sense of broader social, cultural, and economic determinants of life per se. Holistic approach of health promotion for behavior modification through broad health education and a life course approach for promotion of healthy behavior may be the solution of many such problems, of these are attempted early in life. Thus a holistic intervention in childhood may indeed bring about the desired individual behavioral changes, which may be imbibed and continued into the adulthood leading to control of the adult burden of disease. Background Throughout the world, the incidence and prevalence of childhood obesity is increasing. The phenomenon to childhood overweight and obesity is a growingly serious public health concern, and despite advancement in knowledge about these conditions, definite biomedical interventions have failed to achieve any success in controlling these potentially morbid conditions which have proven serious health consequences in the adult health profiles. This has been reflected in trebling of the prevalence of these conditions in the last 20 years, and many children are affected with the negative health consequences of obesity. The prevention of childhood obesity is an active research area. It is now clear that management and prevention of childhood obesity is a problem that would need a strategic focus. Intervention through community programs have been suggested as important means. The childhood obesity research summit indicates the need to investigate the ways obesity intersects with the health care system. It has also been suggested that there is a need for focus on ongoing research and public health policy initiatives. The intervention at the family life course approach is an option; however, the exact interventions are not known, since the theoretical backgrounds of the etiology of childhood obesity are not distinctly and specifically known. Research investigating the pathophysiological parameters may serve as information to design interventions. They indicate that there may be three perspectives, the epidemiological, pathological, or homeostatic or energy balance perspectives. All interventions thus should be directed to control these factors. Control of current overweight in children at a behavioral level and sustained behavioral changes and their promotions would lead to reduction of excess fat and would thus reduce the risks of future disease. Need to Pursue the Research The most successful approaches to weight management in childhood have been indicated to be comprehensive interventions involving behavior management in relation to diet and physical activity, which have implications in long-term weight control and overall health status. The clinical trials that have investigated these approaches and interventions are limited in their abilities to determine the relative efficacies of individual strategies. The basic fact is that there exists an imbalance between intake of energy and expenditure. For example dietary pattern, addiction to television, tendency to have sedentary lifestyles, and an overall paucity of physical activities play key roles in creating these imbalances and thus represent an opportunity for intervention in a holistic fashion. If such interventions are applicable in the home environment, it would be most ideal. Therefore, a research is indicated and due which is being proposed here which would investigate the role of holistic family-oriented treatment in reducing pediatric obesity. The Research Question What is the role of holistic family-oriented treatment in reducing pediatric obesity Methodology of Literature Review Methodology is important to fill in the intellectual vacuum that may be associated with a research question, and therefore, there is a need to pinpoint the context of a research within the existing knowledge base. Since there is a considerable body of existing literature depicting the studies in several areas of science and practice, while performing a literature review, it is pertinent and important to perform the review in a systematic and logical manner. A mapping and precise documentation of the systematic process ensure and indicate that the researcher had employed a comprehensive and systematic plan to undertake the review. This would also ensure reproducibility of the review, if some reader desires to perform it. A literature review that is approached systematically is very different from one that is approached in a haphazard manner. A thorough and comprehensive search strategy will help to ensure that key literature and texts on the focus topic are identified. Without a thorough search strategy, searching will be random and disorganized, and the reader of the review will not be confident that all the relevant research papers relating to the topic have been identified. A strong methodological rigor ensures repeatability of the system of retrieval of information, and thus, an audit trail is necessarily important in systemic review of literature. The focus question must be followed closely throughout the review and obtain only that information which is relevant to the research question in the search for literature. All literature must address the focus question of the review. Thus a strategy needs to be developed for managing the literature so it can be identified quickly which literature is directly related to the question. This would need development of exclusion and inclusion criteria for the review. This literature review bases on the research question about the role of holistic family-oriented treatment in reducing pediatric obesity. This is really a search about the possible rationale and reason for interventions where the families are enabled to modify their lifestyle associated risk factors before or after having obesity in the children. Ideally, this should be guided by evidence from the existing research, whereas in reality, lifestyle practices are governed by personal beliefs of the patients, and if not guided by evidence from literature, there is also a fair chance that these will fail. On the contrary, if well informed by research information, the holistic practitioners may influence the individuals within a family. Inclusion and Exclusion Criteria Studies on ideal preventive measures against childhood obesity had been done by mostly randomized controlled trials. However, since the objective of the study is to investigate the efficacy of holistic family centric interventions through behavioral modification and environmental changes along the theoretical framework of a life course approach within the families, randomized controlled trials may not be that suitable. Although randomized controlled trials provide the least biased estimate of the effect size of any particular intervention, a specifically designed trial would be necessary that have implemented lifestyle measures in a holistic fashion in the families that had solely treated families with childhood obesity. Moreover, a long-term trial period would be essential, since other studies have demonstrated that most interventions in the short run are effective, while they prove to be futile in the long run. Thus a study period of at least 6 months to one year would be ideally suitable. Over that, the long term effects of a behavioral intervention are actually in the sustenance of the behavior and its effects. Thus it would be ideal to include a 2 year followup investigation across outcome measures would be warranted in order to see the effects on the hypothetical intervention in realizing the primary outcome, reduction in the prevalence of childhood obesity or overweight in the trial children. Given the chronic nature of obesity, the longer term effects need to be evaluated, since these would provide more valuable indication of effectiveness. Thus the timeframe would include the time allotted for intervention and a combination with it to the followup phase. A study of data of the last 30 years indicates the incidence has tripled in the age group of 2 to 5 years and in the age group of 12 to 19 years. The incidence of obesity has quadrupled in children and adolescents of 6 to 11 years of age. This indicates the sample population for this study would include families where children of all age groups belong, and the age cut off point should be 18 years of age. The mean age of the study population with a mean age of 18 years at the commencement of intervention would be a prudent inclusion criterion. However, since this study is designed to investigate the role of holistic family interventions, the target families would really be the samples. These families would comprise of a mix of all children of different age groups. Since this study attempts to investigate the factors and their influences relevant to childhood obesity and its modification through family interventions, the appropriate behavioral model would be that which would be influenced by family and its inherent environments. Thus the age of 18 years seems to be appropriate. Moreover, the secondary causes of obesity should be excluded from the study population due to the fact that the obesity due to these reasons would be hardly affected by interventions in the life course interventions and behavioral and lifestyle modifications would be ineffective in these cases. Criteria Description Client group Families with children aged up to 18 years with history of or predisposition to obesity with no restriction on race or gender Date Restriction Most updated information from original research articles published in English Language in the time frame of last 10 years with preference to most recent studies between 2001-2010, preferably focusing on United States Geographical Restriction Childhood obesity is a worldwide problem, and lifestyle associated risk factors are known to influence incidence or outcome of this problem, and if feasible holistic intervention is necessary everywhere around the globe, this study will accept any article published from anywhere in the world in the English language. However, given the country of origin of this researcher, studies involving families and children and adolescents in United States would be given preference. Holistic Health Studies dealing with holistic health intervention or biomedical health interventions in the form of health promotion health education, behavioral modification, dietary behavior, physical exercise, and social support, cognitive behavioral interventions, family interventions in relation to pediatric obesity Beliefs Studies dealing with family beliefs regarding the role of lifestyle related risk factors in causation of obesity and evidence that modification of these can alter the course or outcome of future or established disease respectively. Strategy for Literature Review Inclusion and exclusion criteria enable the literature reviewer to identify the literature that addresses the research question and that which does not. The developed criteria would be guided by the wording of the focus question. It was decided that primary research on the topic would be looked for, since primary research provides research findings from a study and is reported first hand. Primary research is most often published in journals and the most up-to-date resources are available in journal articles rather than in textbooks. Findings If the following criteria had been fulfilled, then a range of databases were searched based on key words derived from the above concepts. Based on these criteria, out of about 257 initial articles, only 21 main latest research articles that fit the criteria described above were selected to be critically reviewed to synthesize evidence relevant to the focus question. Those which were review, conversation, editorial, poster presentation, or letters to the editor were excluded. To further narrow the search, a combination of search words were used so specific areas of holistic and biomedical models of obesity prevention in childhood is reflected in the research. Other Concepts that are Included in Keyword-based Search Theoretical Framework The prevention of childhood obesity is an active research area. It is now clear that management and prevention of childhood obesity is a problem that would need a strategic focus. Intervention through community programs have been suggested as important means through ongoing research and public health policy initiatives based on evidence from research. The intervention at the family life course approach has been indicated to be an option despite knowledge gaps about the exact interventions, mainly due to the ignorance about the theoretical backgrounds of the etiology of childhood obesity, distinctly and specifically. Thus it has been suggested that research investigating the pathophysiological parameters of childhood obesity may be instrumental in designing interventions, which revealed that there may be three perspectives, as has already been cited earlier, the epidemiological, pathological, or homeostatic or energy balance perspectives. An ideal intervention would control these factors as completely as possible mainly at behavioral levels and promotion of sustained behavioral changes in order to reduce excess fat, which could reduce the risks of future disease. Interventions A review of literature indicated different options in the area of lifestyle modifications. The prominent lifestyle interventions indicated dietary, physical activity and behavioral therapy interventions. Alternative therapies were not indicated in the reviews. Thus there is a potential for research in behavioral lifestyle interventions in the family settings. It remains to be explored what could be the possible interventions in a family-centric approach toward behavioral modification through a life course approach. This objective may be served through this dissertation through an appropriate design that can validate and establish the reliability of such interventions. The possible topics would include diet and nutrition, exercise and physical activity, lifestyle and social support that would involve the children of the above age groups with and without associated family members. The interventions would be family based. The delivery of the interventions would be through the researchers. Health promotion agencies may be included as delivery agents; however, they would need training in holistic medicine. Outcome Measures Self reported measurements of height and weight should be excluded from the measures of outcome. The primary outcomes would be measured at baseline, at post-intervention period, and at followup at 1 year. Height and weight will be measured by the researcher, since these measures measured in this manner have been reported to be reliable. The sex and age related changes in these parameters over time the body mass index standard deviation score has been reported to be reliable. For comparison of overweight status, the percentage overweight has been a reliable indicator. Bioelectrical impedance analysis or dual energy x-ray absorptimetry can measure body fatness accurately. Some secondary outcomes have also been indicated in studies. These are measurement of body fat distribution by visceral fat estimation, measurement of subcutaneous adiposity, waist and hip circumference either by anthropometric measurements or by instrumental measurements such as absorptimetry. Other important category of metabolic measurements would include lipid profile, markers of glucose and insulin metabolism, leptins, adipocytokines, or other obesity markers. Markers of change in behavior weekly energy intake through dietary recall and changes in weekly activity levels through self report. The participants' view of intervention, measures of self esteem, health status, well being, and quality of life comprise important parameters of secondary outcome measurement. There can be questions regarding harm associated with the interventions, since this is new and unconventional intervention, and thus the design must prove this intervention to be harmless. The cost-effectiveness of the intervention should also be measured secondarily. Resources The library would expectedly be an important source of information. However our college do not have a library. Thus I decided to look for literatures in the internet, where Google scholar and Highwire Press proved to be important sources. Since beliefs are important factors in determining whether any educative and promotional interventions would be culturally compatible for a population at risk, and gray literature such as lay web publications and quality newspaper articles were kept outside the search, since it was decided that only academic articles will be included in the review. It was also decided that apart from academic journal articles, the ready sources of reference books from the Google Books will be utilised. Through catalogue and hand search, factual biological information regarding childhood obesity and roles of different lifestyle associated factors were located, and these constituted peripheral matters for reading. The databases had extensive full-text medical and nursing journals, which can serve as references. I had access to databases, which revealed numerous studies on this specified area of practice. To build a scientific basis of evidence, a comprehensive literature search was undertaken and then evaluated critically. For the purpose of the review of literature, to support the rationale, need, and continuation of the project, this author conducted a literature search across databases. Those accessed for information included: CINHAL, Medline and Pubmed along with the Google Scholar internet search engine. Moreover MEDLINE, EMBASE, and CINAHL and Cochrane databases were searched to identify relevant literature on prevention of childhood obesity through lifestyle risk factor modification. HighWire Press was also searched. These sites were accessed through online registration in the respective websites. Apart from these, printed journal articles from American Journal of Epidemiology, European Journal of Public Health, Archives of Internal Medicine, European Heart Journal, Circulation, Age and Ageing, British Medical Journal, Journal of Cardiovascular Nursing, and Journal of Royal Society for the Promotion of Health were surfed through the index, and all probable articles were located. Nursing Standards and Nursing Times also served as a source for some articles. Strategy The search for relevant literature began with identification of the key words. These words were coined from the rationale and the focus question of this particular research. Then through application of Boolean logic, some combinations of key words were decided to be searched. The initial search was conducted on the abstracts of the prospective articles, and if an article could be narrowed down with presence of the combination key word terminology, a detailed search was undertaken on that article. The articles that appeared in the reference of these articles were also located and searched to see whether they match the inclusion criteria mentioned above. All of these resulted in access to about 252 articles, and for a more focused search was conducted through combination of key words with use of Boolean adjuncts "and", "or", or "not." The literature search included opinion papers, systemic reviews and meta-analysis, original research articles including randomized clinical trials, qualitative and quantitative data reports, which kept the rationale and the focus question at the centre. Once the studies and papers were defined in this manner, the most appropriate ones were selected based on the aim of this review which was to elicit the best available current evidence to enable best evidence-based practice of the holistic and/or biomedical practitioners in relation to health promotion, health education, behavioral interventions, family interventions, dietary modification, physical exercises of the children and families with obesity or at risk of obesity. This could also serve as the evidence to develop guidelines for evidence-based holistic practice and policies that need to be implemented to improve care of the children at risk of obesity, where a decision for lifestyle modification needs to be implemented by the families. Key Words The key words included childhood obesity, family, risks, overweight, effects, interventions, causes, pathophysiology, markers, social support, cognitive behavioral changes, leisure practices, physical activities, resources, health promotion, health education, awareness, holistic health, risks of interventions, primary and secondary outcomes, perceptions, practices, beliefs, community, peer pressure, energy intake, energy consumption and other words. Validity Validity in research terminology refers to the accuracy of the data and the findings. It is also important to validate the concepts that are being evaluated in any particular study. Reliability is related to the proof of consistency and dependability of the data. This would also indicate generalizability of the findings irrespective of the time, place, and subject of the research. This researcher used the following programme to assess the quality of the studies. The articles reviewed would fit the quality and credibility of the study. The status of peer review and standards of the authors and their qualification and experience also adds. Peer review is one of the methods of sympathetic critical review by colleagues, where the pros and cons of a research article is analyzed in order to better the quality of the study. The accuracy and coherence of the content with the existing knowledge on the subject would also grade the study. In the appendix, the summary of the all the reviewed literature are placed in the evaluation grid, however it must be stated that this author's lack of knowledge on assessment of quantitative data had exerted some limitations on the appropriate assessment of the reviewed literature. Literature on Holistic Medicine Bloomfield HH, Kory RB, (1978). The Holistic Way to Health and Happiness. New York, Simon & Schuster Inc Publishers, 1978, pp 45-57, 233-239. Frank J., (1975). Holistic approaches in ancient and contemporary medicine, in Proceedings of the Conference on Future Directions in Health Care: The Dimensions of Medicine. Dec 10-11, 1975. New York, Rockefeller Foundation, 1975, pp 62-67 Obel D., (1976). Ways of Health: Holistic Approaches in Ancient and Contemporary Medicine. New York, Grossman/Viking, 1976, pp 92-108. Ventegodt, S., Morad, M., and Merrick, J., (2004). Clinical holistic medicine: developing from asthma, allergy, and eczema. ScientificWorldJournal; 4: 936-42. Ventegodt, S., Morad, M., Hyam, E., and Merrick, J., (2004). Clinical holistic medicine: when biomedicine is inadequate. ScientificWorldJournal; 4: 333-46. Ventegodt, S., Morad, MM., Kandel, I., and Merrick, J., (2004). Clinical holistic medicine: treatment of physical health problems without a known cause, exemplified by hypertension and tinnitus. ScientificWorldJournal; 4: 716-24. Ventegodt, S. and Merrick, J., (2005a). Clinical holistic medicine: chronic pain in internal organs. ScientificWorldJournal, Mar 2005; 5: 205-10. Ventegodt, S. and Merrick, J., (2005b). Clinical holistic medicine: chronic infections and autoimmune diseases. ScientificWorld Journal; 5: 155-64. Ventegodt, S., Flensborg-Madsen, T., Andersen, NJ., and Merrick, J., (2005c). The life mission theory VII. Theory of existential (Antonovsky) coherence: a theory of quality of life, health, and ability for use in holistic medicine. ScientificWorldJournal; 5: 377-89. Ventegodt, S., Clausen, B., Nielsen, ML., and Merrick, J., (2006). Clinical holistic health: advanced tools for holistic medicine. ScientificWorldJournal; 6: 2048-65. Ventegodt, S., Kandel, I., and Merrick, J., (2007). Clinical holistic medicine: factors influencing the therapeutic decision-making. From academic knowledge to emotional intelligence and spiritual "crazy" wisdom. ScientificWorldJournal; 7: 1932-49. What's The Harm (2010). Holistic Medicine from http://whatstheharm.net/holisticmedicine.html available on April 6, 2010. Yahn, G., (1978). The Impact of Holistic Medicine, Medical Groups, and Health Concepts. JAMA; 242: 2202 - 2205. Childhood Obesity Related Literature Braet, C, Tanghe, A, Decaluw, V, Moens, E, and Rosseel, Y, (2004). Inpatient Treatment for Children With Obesity: Weight Loss, Psychological Well-being, and Eating Behavior. Journal of Pediatric Psychology 29(7) 519-529 Cummins S, MacIntyre S. (2006). Food environments and obesity: neighbourhood or nation Int J Epidemiol;35:100e4. Daniels, DY., (2008). Examining Attendance, Academic Performance, and Behavior in Obese Adolescents. The Journal of School Nursing; 24: 379 - 387. Daniels, SR, Jacobson, MS, Brian W. McCrindle, Robert H. Eckel and Sanner, BM (2009). American Heart Association Childhood Obesity Research Summit Report. Circulation; 119;e489-e517; Edwards, KL., Clarke, GP., Ransley, JK., and Cade, J (2010). The neighbourhood matters: studying exposures relevant to childhood obesity and the policy implications in Leeds, UK. J Epidemiol Community Health; 64: 194 - 201 Ford, AL, Bergh, C, Sdersten, P, Sabin, MA, Hollinghurst, S, Hunt, LP, and Shield, JPH (2009). Treatment of childhood obesity by retraining eating behaviour: randomised controlled trial. BMJ; 340: b5388. Johnson, D., (2006). New board member Dr. Hassink takes holistic approach to pediatrics. AAP News; 27: 20. Lee, A., (2009). Health-promoting schools: evidence for a holistic approach to promoting health and improving health literacy. Appl Health Econ Health Policy; 7(1): 11-7 Lee, A., Wong, MCS., Keung, VMW., Yuen, HSK, Cheng, F. and Mok, JSY (2008). Can the concept of Health Promoting Schools help to improve students' health knowledge and practices to combat the challenge of communicable diseases: Case study in Hong Kong BMC Public Health, 8:42 Luttikhuis OH, Baur L, Jansen H, Shrewsbury VA, O'Malley C, Stolk RP, et al. (2009) Interventions for treating obesity in children. Cochrane Database Syst Rev 2009;(1):CD001872. Mantzouranis, N., Pilianidis, T., Douda, H., and Tokmakidis, S., (2008). Comparison Of International Obesity Taskforce Cutoffs, Centers For Disease Control And Prevention Growth Charts, And Body Mass Index Z-Score Values In The Prevalence Of Childhood Obesity: The Greek Obesity And Lifestyle Study. Pediatrics; 121: S149. Nowicka, P and Flodmark, C (2008). Family in pediatric obesity management: A literature review. International Journal of Pediatric Obesity, Vol. 3, No. s1 , Pages 44-50 Ochoa, MC, Moreno-Aliaga, MJ, Martinez-Gonzalez, MA, Martinez, JA, Marti, A, GENOI Members, (2007). Predictor factors for childhood obesity in a Spanish case-control study. Nutrition; 23(5): 379-84. Poskitt, EM (2005). Tackling childhood obesity: diet, physical activity or lifestyle change Acta Paediatr; 94(4): 396-8 Reynolds, KD and Spruijt-Metz, D (2006) Translational Research in Childhood Obesity Prevention. Eval Health Prof; 29: 219 - 245. Serra-Majem L, Aranceta Bartrina J, Perez-Rodrigo C, Ribas-Barba L, Delgado-Rubio A., (2006). Prevalence and determinants of obesity in Spanish children and young people. British Journal of Nutrition; 96(suppl 1):S67-72. Slawta, J., Bentley, J., Smith, J., Kelly, J., and Syman-Degler, L., (2008). Promoting Healthy Lifestyles in Children: A Pilot Program of Be a Fit Kid. Health Promot Pract; 9: 305 - 312. Spear, BA, Barlow, SE., Ervin, C., Ludwig, DS., Saelens, BE., Schetzina, KE., and Taveras, EM., (2007). Recommendations for Treatment of Child and Adolescent Overweight and Obesity. Pediatrics; 120: S254 - S288. Stephenson J and Imrie J. (1998) Why do we need randomised controlled trials to assess behavioural interventions. BMJ ;316:611-3. St Leger L. and Nutbeam, D., (2000). A model for mapping linkages between health and education agencies to improve school health. Journ al of School Health 2000, 70:45-50. Ventegodt, S., Merrick, J., and Andersen, N.J. (2003) Quality of life as medicine: a pilot study of patients with chronic illness and pain. The Scientific World JOURNAL 3, 520-532. Vignolo, M, Rossi, F, Bardazza, G, Pistorio, A, Parodi, A, Spigno, S, Torrisi, C, Gremmo, M, Veneselli, E, and Aicardi, G (2008). Five-year follow-up of a cognitive-behavioural lifestyle multidisciplinary programme for childhood obesity outpatient treatment. Eur J Clin Nutr; 62(9): 1047-57 Weker H (2006). Simple obesity in children. A study on the role of nutritional factors. Med Wieku Rozwoj; 10(1):3-191. Wing, RR, Goldstein, MG, Acton, KJ, Birch, LL, Jakicic, JM, Sallis, Jr., JF, Smith-West, D, Jeffery, RW, Surwit, RS (2001). Behavioral Science Research in Diabetes: Lifestyle changes related to obesity, eating behavior, and physical activity. Diabetes Care; 24: 117 - 123. Answers to questions on Assignment #4, order # 459745 On this order # 459745 what I need is some clarity relative to pages 5, 6, and 7. Inclusion and Exclusion Criteria- I am a bit confused. Was this a study or are you proposing it Can you explain the point of it and what is the chart I am not clear as to what you are saying/doing. Thank you. When we do a lit review, based on our focus questions we find out literatures published. The focus of the literatures varies. Now the question is selection of the study literatures, which one to take. Keeping the research questions in focus we decide beforehand which are the studies that are most relevant These are inclusion and exclusion criteria, meaning based on my research question, I decide which studies I will take (Inclusion) and which I will not consider (exclusion) for review. Lastly on this order # 459745 can you please go to page 13 under subheading Validity. In the first paragraph- sentence five: "This researcher used the following program to access the quality of the studies." 1) Who is the researcher (Are you referring to me Do I need to change the wording) In the last three sentences: "In the appendix, the summary of all the reviewed literature are placed in the evaluation grid, however it must be stated that this author's lack of knowledge on assessment of quantitative data had exerted some limitations on the appropriate assessment of the reviewed literature." 1) Which author are you talking about (Are you referring to me - Do I need to change the wording) Yes by the phrase researcher I am referring to you. When I say I or researcher it always means you, I am just your ghost writer. Please note that on page 2 under subtitle "Background" and on page 8 under "Theoretical Framework" the context noted below is identical for both areas. The childhood obesity research summit indicates the need to investigate the ways obesity intersects with the health care system. It has also been suggested that there is a need for focus on ongoing research and public health policy initiatives. The intervention at the family life-course approach is an option; however, the exact interventions are not known, since the theoretical backgrounds of the etiology of childhood obesity are not distinctly and specifically known. Research investigating the pathophysiological parameters may serve as information to design interventions. They indicate that there may be three perspectives, the epidemiological, pathological, or homeostatic or energy balance perspectives. All interventions thus should be directed to control these factors. Control of current overweight in children at a behavioral level and sustained behavioral changes and their promotions would lead to reduction of excess fat and would thus reduce the risks of future disease. Also on page 8 "Other Concepts that are Included in Keyword-based Search" kind of just stands alone. Is there suppose to be context under the sub-title or should I just delete it Please advise..... sorry to be a pain but I am handing this document (assignment#4) in with the power point presentation, the summarized four questions, the research process, journal 1 & 2 and if completed the first three chapters.... along with the new outline (assignment #6 to be completed). I am sorry for this confusion. To avoid confusion I am changing the text. However, Other Concepts that are Included in Keyword-based Search is the section to indicate how you have developed the key words. Key words for literature search are important for electronic literature search from databases. Apart from research question other concepts such as background, theoretical framework, interventions, outcomes all are used to develop key words focusing mainly on the research questions. Thus this is an important context under which subsections such as "theoretical framework, interventions, outcomes" come. Read More