Clinical Research - Identify A Clinical Problem - Assessment Answer

Clinical Research Assignment

Assignment Task

Identify a clinical problem and develop a research question;

Search and retrieve 4 relevant primary research articles with results to answer your research question;

Critique your 4 primary research articles.

Introduction

Obesity as epidemic is a global concern, with the problem being foreseen as increasing with time. However, there is a knowledge gap on the effects of the increase in weight on the functioning of the respiratory system. It is imperative to note that obesity plays an important role in obesity hypoventilation syndrome and obstructive sleep apnoea. It is also worth to note that asthma is very common and usually very hard to treat in most of the obese population. As stated above, there is little information that is available on the general effects of increase in weight on respiratory mechanics and airway inflammation. Therefore, this research seeks to bridge the knowledge gap stated. Moreover, the study seeks to establish the interaction between COPD (chronic obstructive pulmonary disease) as well as the body mass index. The challenges and problems associated with taking care of obese people is fundamentally enormous. Therefore, the outcomes of this research will highlight some of the complications experienced by obese patients undergoing surgical procedures. This aspect is pronounced with the current increase in the utilization of Bariatric surgery. Eventually, the knowledge on the relationship between obesity and respiratory conditions will be essential in providing adequate healthcare service for the increasingly obese patient population.

Clinical problem

In this contemporary world, obesity has been established as a significant risk factor for many respiratory infections. In many cases, loss of weight has been linked with significant symptomatic improvement. Furthermore, obesity has been shown to influence the development as well as the manifestations of respiratory diseases. This paper seeks to review four articles on the current status of the understanding of the impact of increased weight on respiratory diseases as well as clinical management of the disease associated with COPD, asthma, obesity hypoventilation syndrome or obstructive sleep pane.

Research question

Does obesity have any effect on the respiratory system of human being?

Littleton, S.W., 2012. Impact of obesity on respiratory function.Respirology,17(1), pp.43-49.

The argument in this paper is that obesity is a condition that has been for a long time established to have a crucial effect on the functioning of the respiratory system (Littleton 2012, p. 47). This is undoubtedly true. However, there are other health conditions that have serious implication and the respiratory systems. This may include malignant or cancerous growth on the walls of the respiratory system. The author needed to point out such information so that the audience or the reader of this article should not develop the sole belief that obesity in the only trigger of respiratory conditions (Yu et al 2011, p. 930). It is worth to note that my research has pointed out that patients with obesity tend to develop higher respiratory rates, but lower tidal volumes as have been explained by this author. In terms of how this research plan would be implemented, the mean respiratory rate of people who are obese would be observed at a rate ranging from 15 to 21 breaths per every minute. The research plan would be implemented for about two weeks with data being collected on an hourly basis. The target people being obese people. These obese people will be made to reduce weight and the effect of lost weight on respiratory condition observed. Based on a research study conducted by Littleton (2012, p. 47), the result of the implementation of the project showed that fat distribution on either the upper or lower body part is an important factor in influencing respiratory conditions rather than the general body mass index.

Robinson D, P, 2014. Obesity and its impact on the respiratory system. Paediatric Respiratory Reviews, Volume 15, p. 219–226.

In this article, the author seeks to unveil the complex relationship between obesity and respiratory conditions among children (Robinson 2014, p. 221). The topic sounds good and realistic since children are so susceptible to obesity. However, the insinuation that obesity in children differs significantly from those in adults may be far from the truth. This is because the risk factors of obesity conditions are similar in both adults and children. On the other hand, the suggestion that there are evidences that excess adipose tissues may have adverse effects upon dynamic and static respiratory function based on the measurements of lung volumes, airway functions, lung compartment mechanics and exercise potential of different degrees (Ora et al 2011, p. 12). This is very true for most research postulate the same argument as the author of this article. However, there is limited literature to support the understanding of the effect of obesity in young children. The author concurs with many other researchers that there is limited information on the significance of the duration and onset of obesity on subsequent respiratory response. The research plan for this study will be implemented by measuring lung volumes of 30 patients as well as the subsequent weight loss during the experiment. The research plan would be implemented for about two months with data being collected on an hourly basis. The target people being obese people. The data collected from this study will be analysed by comparing the respiratory imaging trends during the period of study to check for any change in breathing.

Zammit, C., Liddicoat, H., Moonsie, I. and Makker, H., 2010. Obesity and respiratory diseases.Int J Gen Med,3(3), pp.335-343.

According to some studies (Zammit et al 2010, p. 340), obesity is a global epidemic that is likely to increase with time. This argument is likely to be true since most studies have shown that obesity exists both in the tropics and in the temperate worlds in all continents. The authors of this article emphasizes on the mechanical impacts of obesity, especially on the physiology of the lung as well as on the adipose tissue functioning. This objective is too wide, especially when linked with the endocrine organ that produces systemic inflammation that affect the central respiratory control. The study would have been precisely achievable if the main objective was narrowed so as to have utmost three specific objectives unlike in the current scenario. However, the author of this paper is in agreement with many documented literature that says that greater understanding of impacts of obesity on respiratory conditions. Moreover, adequate healthcare provision is essential for many obese patients (Salihoglu et al 2013, p. 380). The research plan for this study will be implemented by monitoring and measuring the BMI of selected patients as well as the subsequent weight loss during the experiment. The experimental unit will be the obese patients. The research plan would be implemented for approximately four months with data being collected on an hourly basis. The target people being obese people. The data collected from this study will be analysed by comparing the BMI of the patient during the period of study to check for any change in body activity.

Brazzale, D.J., Pretto, J.J. and Schachter, L.M., 2015. Optimizing respiratory function assessments to elucidate the impact of obesity on respiratory health.Respirology,20(5), pp.715-721.

In this article, the author's argument is that the prevalence of obesity is increasing globally and it has significant impact on the respiratory system. This is realistic since several obesity mechanics affect the respiratory system (Brazzale et al 2015, p. 720). Such obesity mechanics may include deposition of fat in an individual’s systemic inflammation, abdomen, chest wall and upper airway. Moreover, this study is in agreement with several other studies which have documented that in obese individuals, increased mechanical load have led to the decreased chest wall and increased breathing activity as well as lung compliance. In addition, there is increased little effect of obesity on spirometric values, the volume of expiratory reserve, the increase in body mass index and consequently the functional residual capacity. The research plan for this study will be implemented by conducting lung function tests of selected patients as well as the subsequent weight loss during the experiment. It is important to note that a significant consideration is the documented information that outline that respiratory physiology impacts of obesity may be reversible by loss of weight. The experimental unit will still remain as the obese patients. The research plan would be implemented for approximately four months with data being collected on an hourly basis. The target people being obese people. The data collected from this study will be analysed by comparing the residual lung capacity of the patient during the period of study to check for any change in body activity. This will be done for a period of one month and data collected on a daily basis.

Discussion

According to Littleton (2012), this topic on the effect of obesity on the functioning of the respiratory system has been studied for almost a century now, with clear patterns on the trend being established (Littleton 2012, p. 47). This could be true. However, the trend on how obesity affects different races world-wide is still amorphous. On the other hand, Robinson (2014, p. 221) argues in his article that there is no clear consensus on how adiposity can be expressed as well as the distribution of fat as part of studying the effect of obesity on respiratory ailments. The argument of the author is that there are many challenges in identifying a deconditioned obese child based on the clinical perception of a non-atopic asthma child. This is attributed to the fact that the symptoms for both conditions overlap. In addition, there is a challenge in testing the lung function through responses observed during airway constriction and relaxation challenges (Dong et al 2013, p. 89). This argument of the author seems to hold water since numerous evidences purport that there are challenges when weight loss is used to try and achieve normal lung functioning in obese conditions. Moreover, according to Brazzale et al (2015, p. 720), studying asthma in relation to obesity without looking at the compounding effects such as respiratory mechanics and airway inflammation would have been sufficient for the specific objectives (Piper 2013, p. 4). For example, much research has noted the challenging aspects of studying the interactions between the body mass index and COPD (chronic obstructive pulmonary disease) severity as a consequence of obesity. During such studies there are numerous practical challenges in handling the obese patients. The studies are even more compounded when considering obese patients having undergone surgical procedures like Bariatric surgery. Notably, Brazzale et al (2015, p. 720), argues that the functional residual capacity may reduce when residual volume is approached in severe obese conditions. However, this argument is disputed by other scientific evidences that suggests that individuals who are obese can also be free from a lung ailment and may have relatively normal respiratory gas exchange. To some authors, there is a loose connection between obesity and asthma (Lin & Lin 2012, p. 407). This is yet to be proven scientifically, but today some studies will agree that with an asthma phenotype has the likelihood of being obese. A recent research established that there is no link between airway hyper-responsiveness and obesity even though obesity is a crucial risk factor in the development of asthma in many populations. Therefore, accurate assessment of respiratory functions should be done before associating dispense found in symptomatic obese patients with obesity. Additionally, it is realistic to argue that the prevalence of obesity is increasing globally and it has significant impact on the respiratory system. This is realistic since several obesity mechanics affect the respiratory system. Such obesity mechanics may include deposition of fat in an individual’s systemic inflammation, abdomen, chest wall and upper airway. Moreover, this study is in agreement with several other studies which have documented that in obese individuals, increased mechanical load have led to the reduced chest wall and increased breathing activity as well as lung compliance. The research plan and implementation of each study will vary as outline above in individual articles. The plans are similar with slight moderations on experimental unit.

According to Littleton (2012 p. 47) obesity is a condition that has been for a long time established to have a crucial effect on the functioning of the respiratory system. This is undoubtedly true. However, there are other health conditions that have serious implication and the respiratory systems. This may include malignant or cancerous growth on the walls of the respiratory system. On the other hand, Robinson (2014, p. 221)seeks to unveil the complex relationship between obesity and respiratory conditions among children. Moreover, according to Zammit et al (2010, p. 340), obesity is a global epidemic that is likely to increase with time. The authors of this article emphasizes on the mechanical impacts of obesity, especially on the physiology of the lung as well as on the adipose tissue functioning. Finally,Brazzale J., et al., (2015, p. 720), argues thatis that the prevalence of obesity is increasing globally and it has significant impact on the respiratory system. The future direction is to conduct more research among all age bracket to check the prevalence of obesity among all age groups.