PICOT Question

In United States of America (USA), the prevalence of obesity was 10% among children 2 to 5 years of age and 15% among adolescents. When children at risk for obesity (overweight) were included, the values increased to 20% and 30%, respectively. Therefore, > 1 of every 4 patients examined by pediatricians either is obese or is considered to be at high risk for developing this challenging health problem (Ogden et al.,

The PICOT question: Population of patients, patient’s family in the Emergency Department (P), Workplace violence prevention program to reduce the rate of physical and non-physical violence to hospital staff (I), Patient or workmate, with a violence prevention program compared to violence prevention program (C), Reduction in physical and non-physical abuse to hospital staff (O), Within a period of 60 day trial (T)?

In America childhood obesity statistics show that almost 60 percent of children are obese. This statistic continues to grow at an alarming rate. 70 percent of obese adolescence become obese adults. This means when these children grow into adults they will have more health problems than they already do and their quality of life will decrease. The amount of children who are obese between ages 6-11 years old has risen from 6.5 percent in 1980 to 19.6 percent, in 2008. In adolescents ages 12-19 years old the obesity rates risen from 5.0 percent in 1960 to 18.1 percent in 2008. Last year the United States government stated that obesity and type 2 diabetes have become a national epidemic.

Childhood onset overweight and obesity and its’ associated health consequences are quickly becoming major significant public health issues facing America today. Centers for Disease Control and Prevention (CDC) define overweight as a body mass index (BMI) between the 85th and 95th percentile while obese is defined as BMI above the 95th percentile for children of the same age and sex . The prevalence of overweight children, defined based on 2009 CDC’s National Center for Health Statistics data, has more than tripled in the past 30 years. Between 1980 and 2006, the incidence of overweight among children aged 6 to 11 years increased from 6.5% to 17.0% while overweight levels for adolescents aged 12 to 19 years increased from 5.0% to 17.6% .

“I think I may go out on the town today and see what kind of fun things I can do.” Mommy look at that fat girl, fat people shouldn’t be allowed out, quack quack waddle fat girl, hey shamu go back to the water. These are some of the things that I have endured and heard on a day-to-day when going out in public as an obese individual. Like myself, a lot of other obese individuals have embarked on many failed weight loss attempts only to gain instead of lose weight. Bariatric Surgery is a great lifelong tool to help aid in weight loss and manage the success;, however, many individuals shy away from the surgery because many health professionals only state the risks over the benefits. Bariatric surgery has become very popular in the United States, but there are many factors to consider such as the risks and benefits, success rates, and procedure options offered. Bariatric surgery has afforded many obese individuals a new lease on life. Medical doctors and insurance companies seem to be down playing the benefits as a way to keep patients with many obesity related ailments to keep them in business. The benefits that bariatric surgery has greatly outweigh the risks and allows for new beginnings.

When it comes to surgery, there is an intensive pre-operative and post-operative procedure to ensure that the patient is well-prepared and healing mentally and physically, respectively. Now depending on the type of surgery performed, there are a specific set of health risks. Two types of weight loss surgery are currently being utilized, Roux-en-Y gastric bypass, a form of stomach stapling to curb food intake, and adjustable gastric banding, a placing of an adjustable band around the stomach to restrict food intake. With Roux-en Y Gastric Bypass, the health risks include Infection at incision points, narrowed links between the stomach and the intestines, loosened staples, vomiting, diarrhea, and hernia. Gastric Banding has health risks, including bleeding, infection, erosion of the band into the inside of the stomach, blockage of the stoma, and band slippage, occurring when moderate food intake does not take place, thus inducing vomiting. Other concerns for both these types of surgery is the after effect and the true effectiveness of the procedure, and the careful and strict adherence to diet, exercise, mental support groups, body contouring, etc. A 2006 group of obese teens who have undergone surgery will be interviewed again in 2011 to determine the actual effectiveness of their

Obesity has reached epidemic proportions in the United States and other developed economies. Over the past 30 years, the prevalence of obesity among children and adolescents in the U.S. has increased at an alarming rate, from 5-7% to 18-20% by 2008 (CDC, 2012). In addition, a full one third of all children in the U.S. are now overweight.

Weight loss surgery, also known as bariatric surgery is recommended by many physicians to people who are unable to benefit from traditional weight loss methods. However, choosing to undergo weight loss surgery isn’t an easy decision. It is an important decision that will drastically and permanently impact a person’s life. Therefore, before making such a significant decision, an individual should be aware of both the risks and benefits associated with weight loss surgery (McGowan & Chopra ix).

The obesity rate in America has become a major national health issue over the last several decades. Increasingly alarming statistics have garnered national headlines. Current statistics place 68.5% of the U.S. population in classifications ranging from "overweight" to "super obese." Approximately 35% of all U.S. adults currently fall under the label of "obese".(Ogden, et al., 2014) Potentially more alarming is the prevalence of obesity in adolescents. U.S. youth are becoming obese at earlier and earlier ages. One out of six children ages 2-19 are now obese and fully one-third of adolescents are overweight or obese. (Ogden, Carroll, Curtin, Lamb, & Flegal, 2010) Between 1980 and 2000, obesity rates among adults doubled and tripled among adolescents. (CDC.gov)

Surgeons’ have an easy approach to doing the surgery. They have more of the right tools to do the procedure with. It results in the surgery being done correctly. Those who have gastric bypass know it is not an easy ticket out. This surgery is to help reduce and keep weight off; those that experienced it have to manage their diet, physical activity and psychological change. There required to think positive about their weight loss approach. Although, many insurers cover this surgery (“Is”). Most people who qualify are afraid to get the procedures, but bariatric surgery has been proven to be effective” Is gastric surgery the solution to America’s Obesity problem? Well for most of it yes, according to research more people are starting to get gastric surgery than a little bit. There are more people who have decided to get this procedure done. However, obesity may explain why weight loss interventions accumulate financial and social support in the past may prove to be the ultimate expansion of gastric surgery

In a research article by Gee, Chin, Ackerson, Woo & Howell, (2013) from the years of 1970 to 2000 the pediatric population in the U.S. tripled in obesity rates, interestingly from the year 2000 – 2010 BMI’s have held steady yet a staggering 30.4% of this population were either overweight or labeled obese. Kaiser Permanente Northern California (KPNC) performed a research study in 2001, which had three goals related to the study

As defined by the World Health Organization, obesity is “an abnormal or excessive fat accumulation that may impair health. a BMI greater than or equal to 25 is overweight and a BMI greater than or equal to 30 is obesity”. Being obese or overweight is especially common in the US and is increasing nationally and globally. As per The Online Journal of Issues in Nursing (OJIN), recent studies show over 67% with BMI greater than 25 and Americans between the ages 26 - 75 are 10% to 40% morbidly obese with BMI greater than 30. Excess weight greater than the ideal body weight is a danger to one’s health. Obesity is one of the major risk factors for many diseases such as, Metabolic syndrome, osteoarthritis, cardiovascular diseases, respiratory compromise, intra-abdominal pressures, skin conditions and mental illness and last but not least, some cancers. As a nurse, anticipating obesity-related issues will only increase and nursing care plans will have to adjust as this epidemic continues. This epidemic can and will affect the goal of Interdisciplinary Team Health Care members in providing Holistic Care in an individual who is obese.

“Bariatrics is the branch of medicine that focuses on the causes, prevention, and treatment of obesity” (“Medical Dictionary,” 2015). Bariatric surgery is a specific discourse community connecting individuals through mutual interests, shared knowledge, and expertise of treating obese populations. The field of bariatric surgery is a discourse community with several purposes. It encourages innovative surgical and nonsurgical solutions in obesity care. It formulates hypotheses and develops and conducts experimental designs to test the hypotheses’ reliability and validity. Furthermore, it aims to stimulate discussion about its findings.

In Bijal P. Trivedi’s report “The Bypass Cure,” she details the history of gastric bypass surgery, its effect on type two diabetes, and the how one doctor is using his understanding of modern gastric bypass applications to save the lives of his patients. Diabetes is a serious disease that affects over 25 million people in America, and 439 million people worldwide. Over 200,000 gastric bypasses are performed in America each year. Due to the cost many patients are unable to receive the life changing procedure. One of the patients who will be receiving this procedure is Nancy Rubio who was nearly twice the normal weight of a person her height. Her weight had slowly increased throughout her life, due to her unhealthy diet and having two children. She eventually developed type two diabetes which then led to arthritic knee pain, high blood pressure, increased cholesterol and elevated blood sugar. Fearing for her life, Rubio opted to receive a modern version of the Roux-en-Y. The Roux-en-Y involves surgically decreasing the lining of the stomach to a small pouch, which reduces the patient’s appetite and eating. The pouch is then connected to the lower section of the intestine. Due to the nature of the surgery Rubio will lose weight very fast, but also miraculously have her type two diabetes go into remission or possibly eliminated.

A rising health epidemic that America is currently facing today is obesity. This is becoming very wide spread among all races and class levels due in part to the abundance of inexpensive food available, most notably, fast food restraints . There are literally thousands of diet books available but due to the extreme will power many of these programs demand, more and more people are turning to weight loss surgery as a final solution. The most popular procedures being Gastric Bypass, and Lap Band surgery. Although these are now fairly common procedures with a high rate of success there are also many differences that one should consider when choosing which would be a better fit for themselves . Three of the biggest differences would be