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HLSC122 Inquiry In Health Care Question: Discuss how Monty’s personal circumstances may create a barrier for the application of evidence. Discuss how closely the research aligns with the PICO question. Answer: Part A: Authorship: The two main authors of the two research articles are David Rogerson and Bianca Share. David Rogerson is a faculty of Health and well being and Sheffield Hallam University in Sheffield. His major qualification is and, Registered Nutritionist, has fellowship (FHEA) and Doctorate in professional studies. He has 6 research publications and about 458 publications read. He has 7 citations. As he is nutritionist he did justification to his research publication of weight loss as he knows the weight loss is a complex process and many factors encourages as well as discourages this process. Bianca Share is a faculty of physiology public health in Australian Catholic University. Her qualification is PhD, bachelor in exercise science (Honors). She has graduate diploma in education and graduation certificate in higher education. She has 12 research publications and 443 publications read with 18 citations. She did justification to her research publications because she is experienced in exercise science and she can manage the changes in lifestyle on participants and check for the outcome. The two researches are related to body weight and its loss but are a bit different. The research paper of author Share is based on the fact that effects of changes of lifestyle in some young women with obesity in abdomen will reduce the risk of cardio metabolic risks. This cardio metabolic risk is a state in which a possibility of occurrence of atherosclerotic cardiovascular disease and diabetes together is there because of insulin resistance and atherogenic dyslipidemia which occurs due to presence of low density lipoprotein cholesterol and high triglyceride levels. This type of condition is found in women with waist circumference above 88cm and changes in their lipid profile like cholesterol above 50mg/dl in case of females. Here a large group of females were taken into consideration for this topic. Here the population was given lifestyle changes and results were noted based on the outcomes. Results were from linear mixed model which is completely different from the other paper (Richardson-Tench et al., 2016). But the research paper of Rogerson deals with the topic of exploration of weight loss experience. Here he deals with the weight loss and its maintenance. He had a study related to factors which inhibit the weight loss and the factors which helps weight loss. His study is done using semi structured interview. Here facts were based on interview which was recorded and analysis was done of the data. At last even verification was done of the data. Research Aims: The aim of the researcher Share was to check whether there is a effect of 12 week multi disciplinary changes of lifestyle on the risk factors of cardio metabolic condition in case of young obese female women. The research was based on changes of physical activity, diet and therapy of behavior on the group set for change and leaving another group for control. The aim of researcher Rogerson was to investigate the experiences of weight loss in a group of participants using interview technique and not doing a research with clinical changes. The participants were selected who underwent the weight loss program. In case of research of Share to meet her aim she selected women of age 18-30 with obesity in abdomen and they were included in the changes program of 12 week which was done following a method and results were noted in a proper structure. All the changes were checked and results showed that the cardio metabolic risk was reduced as a change in lifestyle was implemented on the participants. This result meets the needs of her research aim. In case of Rogerson his aim was a checking of experiences of weight loss and find out the factors which discourages and encourages the weight loss. He did not use clinical interventions which are more accurate. For this he did a systematic interview of the participants without using any clinical changes and found out that factors like social and peer pressure, dichotomous thinking caused hindrance in weight loss and knowledge social support and self monitoring were factors which helped. Thus he justified his need of study (Hoffmann, Bennett & Del Mar, 2013).. Design: The final listed participants were subjected to pre changes/pre control testing and were divided into wait list group and intervention group. This wait list design was used because the researcher wanted to have a correct model which is ethical which provides all the participants with lifestyle changes. This wait list group was also more perfect then submissive control group. For each of the testing period (0,12,24) the participants were asked to visit lab in two cases, firstly the participants will come in fasting state and test will go on for 75 minutes, secondly they require to be away from coffee and alcohol before lab test. For the intervention group the tests were done at (pre) 0 week, (post)12 weeks and (sustainability phase) 24 weeks. The control group also had testing at pre and post control time period (12 weeks). All tests were done at same time and by same researcher. The testing measures were Survey data (the participants complete lifestyle data was collected), Anthropometric assessment (total body measurement was taken including BMI circumference and metabolic syndrome markers and other parameters were checked) and health evaluation (heart rate checked against the work rate). The lifestyle changes included physical activity (exercise supervised by exercise scientist), nutrition education (healthy diet habit and its maintenance was given by qualified dietician) and behavior therapy (participants were given counseling and psychosocial support provided) (Share et al., 2015). In case of research by Rogerson the methods used for exploring the experience in weight loss includes theoretical underpinning ( to get exploration of participants experience and was granted ethical by ethics committee of Sheffield Hallam University), sampling ( participant were selected based on purposive sampling and data saturation) Data collection(interview data was collected by face to face and using interview guide and were recorded in digital recording device) Data analysis( using proper framework analysis) and Verification( codes themes and theoretical framework was verified) (Rogerson, Soltani & Copeland, 2016). All the methodologies and methods used in both the research paper were required and perfect for meeting the aim of the researcher. In case of Share, she used two groups of participants and kept one as control group. The timings were fixed and conditions matched for the achieving of desired outcomes without fail. The intervention changes applied was properly managed and properly documented to check the outcome of aim. In case of Rogerson he used interview technique and recorded it as evidence and also sampling was done using purposive sampling. The data collection was done using interview guide and also verification was done to meet the required Aim (Greenhalgh et al., 2016). Almost 62 participants showed interest for research program of Author Share who were at risk of CVD. Out of these 39 finally progressed for further investigation. In case of Rogerson the participant’s number was low and only 6 were enough to get his research outcome. Findings: The results in research of Share showed that the analysis of groups gave positive outcomes. The changes in lifestyle like physical activity, nutrition education and therapy for behavior successfully reduced the risk factor of CVD after completion of research. But some positive and unexpected changes happened in control group. Thus these changes may overpower changes in intervention group. When these were considered with the difficulties in recruitment and retention like nature of control group these results provide challenge for prospective study designs with obese young women. In case of research of Rogerson he found that the weight loss is a complex experience where factors are found which inhibit and facilitate to weight loss. The sample of this research provided data saturation and the study helped in giving all information of experiences in weight loss. But the lack of diversity of sample was a problem as information related to all social and ethnic groups was not covered here. PICO question:  In female university students does healthy eating compared to exercise lead to weight loss? P (patient/population):- Female University Students I (intervention/indicator):- Healthy Eating C (control):- Exercise O (outcome):- Leading to weight loss Part B: Here according to the case scenario of Leah the PICO question was framed. Leah’s personal circumstances which create a barrier are the social or peer pressure (three international students) which made her to eat healthy foods. She started having abdominal obesity and stopped using gym which she used to do in home. She wanted to use money for partying and socializing and have alcohol and Australian take away food. She also started doing part time job so that she can carry out the Australian lifestyle. Even if she wanted to stop her friends will not leave her to do so. The research of Share follows the PICO pattern. P (participants):- 62 female students were initially selected but at last 39 were available for research to carry out. The participants were selected based on students at risk of CVD with abdominal obesity. Leah is also having abdominal obesity and can have a risk of CVD. The participants can be university students according to Pico question. I (Intervention):- This included 12 week lifestyle changes. It had three parts like physical activity, nutrition education and behavior therapy. These changes will be helpful for Leah to reduce weight and risk of CVD. C (Control):- Along with the intervention group a control group was taken to compare the research aim. O (Outcome):- The result showed that in the intervention group sufficient changes occurred in the weight due to the changes in the lifestyle. If these changes are applied to Leah then there is a possibility of her weight loss. The other research topic of Rogerson includes the weight loss experience and its maintenance. This research can be applied on Leah after the changes applied in the research of Share. In this research no clinical changes were included. People who underwent weight loss diet were selected for this research. The methods used were interview and data collection and then analysis of it and finally verification. Here the outcome is finding of factors which inhibits and facilititates the weight loss. The weight loss which is a difficult situation to achieve because of many factors and it’s hard even to maintain it. Similar to the PICO question Leah is university student who is facing problem in maintaining healthy lifestyle because she is having friends who are affecting her lifestyle. She started eating Australian take away foods and alcohol leading to obesity. She stopped going to gym because she is enjoying her life away from home and spending the money in party and socializing with others. The factors of dichotomous thinking and social and peer effect is affecting Leah in going for a weight loss mode. In this search these factors are only obtained as a result of the interview methods used on certain participants. References: Greenhalgh, T., Bidewell, J., Crisp, E., Lambros, A., & Warland, J. (2016). Understanding Research Methods for Evidence-Based Practice in Health 1e. Hoffmann, T., Bennett, S., & Del Mar, C. (2013). Evidence-based practice across the health professions. Elsevier Health Sciences. Richardson-Tench, Marilyn & Taylor, Beverley J. (Beverley Joan), 1951-, (author.) & Kermode, Stephen, (author.) & Roberts, Kathryn L. (Kathryn Louise), 1943-, (author.) (2016). Inquiry in health care (5th edition). South Melbourne, Victoria Cengage Learning Australia Rogerson, D., Soltani, H., & Copeland, R. (2016). The weight-loss experience: a qualitative exploration. BMC public health, 16(1), 371. Share, B. L., Naughton, G. A., Obert, P., Peat, J. K., Aumand, E. A., & Kemp, J. G. (2015). Effects of a Multi-Disciplinary Lifestyle Intervention on Cardiometabolic Risk Factors in Young Women with Abdominal Obesity: A Randomised Controlled Trial. PloS one, 10(6), e0130270.

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