Research Proposal

Senior Project Proposal

Lior Attias

 November 19, 2012

 

 

   I.            Title of Project:

            What’s the Skinny?

             A Hepatology and Psychology research initiative

 

 II.            Statement of Purpose:

In Arizona, it is estimated that 20% of children aged 2 to 19 years suffer from obesity. Obesity has serious and lasting health effects. Through this project, I will examine the factors influencing obesity, as well as the factors influencing a society’s success at reducing the childhood obesity rate. Working closely with Dr. Tamir Milo at the Phoenix Children’s Hospital, I will develop a plan for families and schools to counter childhood obesity.

III.            Background:

Hepatology is a subset of medicine. It studies the digestive system, specifically the liver, pancreases, and gallbladder, and the disorders associated with these organs. Personally, I believe the science of Hepatology and the work of Dr. Milo, the doctor I will be working with closely, is important and relevant in today’s America. Obesity in children is an increasingly alarming problem, and the more research that is done on this topic, the better future doctors will be able to treat and prevent the problems that come from obesity.

I first became interested in this field after speaking with Dr. Tamir Milo about his work in Hepatology and seeing how passionate he was about his research. He truly believes his work can make a difference. We will  be working closely with patients and will be able to see direct results and gain immediate feedback, making the findings of the research project relevant to the people we hope to help with it.

Through my internship with Dr. Milo, I will also be exposed to the psychological effects of obesity. As we interview adolescents, we will study how society’s perception of obesity affects their psychological states. The results will allow Dr. Milo to incorporate the psychology of his patients into his research, and will allow me to increase my understanding of psychology, a field I am greatly interested in and intend to pursue in higher studies. Additionally, working in the lab will show me what medical research is, how it is done, and if I personally am a good fit for a career in medicine.

IV.            Prior Research:

The science of Hepatology is well developed. Already, we know of many liver, gallbladder, and pancreas disorders, and have developed many preventive measures, such as colonoscopies, and cures, such as chemotherapy for liver cancers. (Johns Hopkins).  Obesity is marked by a Body Mass Index, an indicator of fatty tissues. For each age and height, there are different Body Mass Indexes accordingly (Basics).

Currently, obesity is the “number two cause of preventable death in the United States,” according to the Get America Fit Foundation. Additionally, diseases that were once restricted to adults—diabetes, liver problems, and hypertension—have now become prevalent in children that are obese. Children who are suffering from obesity are at risk to develop serious health problems later on in life.  In the past twenty-five years, the “prevalence of obesity [has] quadrupled” among children.

The extreme overweightness of the United States has lead to alarming increases in life-threatening diseases. According to the Get America Fit Foundation, 8 out of 10 over twenty-five year olds are overweight, while 78% of adults do not get the recommended 150 hours of physical aerobic and anaerobic activity a week (How Much). In addition, 25% are completely sedentary, meaning they do no physical activity at all. In a case study conducted by the organization, it was found that “1 [in] 7 low-income, preschool-aged children is obese. in 2008, 14.6% of preschool –aged children were found to be obese.

According to the CDC Behavioral Risk Factor Surveillance System, in 2000 the “fattest” part of America is the East South Central Region, consisting of Alabama, Mississippi, and Tennessee. These four states had a 23.05% population that was obese. In 1991, this same region had only a 13.1% population that was obese.

With these daunting statistics, it may seem that obesity is an epidemic that cannot be controlled. However, efforts to reduce the obesity rate have been working.  New York and Philadelphia, both of which were reported to have a 20-24% obesity rate in 2003 by the Get America Fit Foundation, have experienced bout a 5% decline in obesity rate among school children (Rettner). Though this is only a small decrease, it shows that the fight against obesity can yield fruitful results. In fact, New York has already created and implemented a plan to overcome obesity in the state (Strategic).

According to the National Council on Strength and Fitness, Arizona has an obesity rate of 25.4%. Mississippi, the most obese state in the US, has a 34.4% obesity rate. Colorado, the least obese state in America, has an obesity rate of 19.8%. I ask, what is Colorado doing right, what is Mississippi doing wrong, and what can Arizona do better? Additionally, it is interesting to note that Utah, only a short drive away from central Arizona, has an obesity rate of only 23.4%. Obesity is known to exhibit similar trends within cultural groups, and thus it is noteworthy that Utah, with such similar population demographics to Arizona, has a lower rate.

I plan to explore what factors are causing some states to have a lower obesity level than others, specifically focusing on the extremes, Mississippi and Colorado, and comparing them to Arizona. Additionally, I will be exploring why states similar in demographics, such as Arizona and Utah, differ in childhood obesity rates.

V.            Significance:

 As obesity rates in the United States skyrocket, the field of Hepatology has become more and more developed; however, there is still much research to be done in this emerging field. The research I will be doing will focus not only on understanding the field of Hepatology, but also augmenting it. I will not only be studying the many diseases of the digestive system and their cures (or lack thereof). I will be working closely with Dr. Tamir Milo, who has a PhD in Hepatology studies to develop a practical and efficient plan for schools and families to implement. We will be working closely with an elementary school on a reservation to find the best way to get children to create healthy eating habits.

Additionally, I will be considering the psychological effects of childhood obesity. I will be working with the Phoenix Children’s Hospital to evaluate children suffering from obesity to see firsthand the psychological effects of obesity in children. Hopefully, this aspect of my research project will directly change the lives of these children, as through the evaluative process.  I will also be educating them on healthy eating habits.
 

This research, concerning the most effective method of reducing childhood obesity, will provide an effective starting point for children to solve their obesity problems. The work I do with Dr. Milo will be published and will allow future doctors to better treat, understand, and prevent obesity in children. This research will directly affect the children I will work with, the schools I will help inform, the families I reach out to, and the greater medical community. 

VI.            Description:
 

My research will consist of interviews, lab work, observations, internet research, and personal reading on the topics. I will be doing a variety of projects in my internship with Dr, Milo. The end goal of the project is to find the most efficient and most effective way of controlling and containing childhood obesity. Utilizing research and data analysis, I will be creating a healthy living campaign that will include the most effective ways (meal plans, parent involvement, children’s autonomy, choice, instruction, etc.)  for schools and for families to limit children’s obesity .

VII.            Methodology:

Beginning in February, I will start working in Dr. Milo’s Lab in the Phoenix Children’s Hospital. I have already registered and sent in the due paperwork to begin working at the Hospital as soon as I am able to.

Dr. Milo is currently conducting Hepatology research. I will assist him in the lab, working and evaluating children, helping to create individualized meal plans, and forming an efficient way to educate students about healthy eating habits.

Then, researching the topic myself and interviewing doctors including Dr. Milo, I will compare the methods of obesity control of Colorado, which has the lowest obesity rate in the United States, and Mississippi, which has the highest, to Arizona’s current methods of childhood obesity control. I will also consider the nuances in control methods of states that have similar demographics, such as Arizona and Utah, to gain a greater understanding of the actions that societies can take to prevent obesity. Once I have gathered sufficient data, I will present a report on the differences between these states in terms of childhood obesity control and create an effective, efficient  healthy living and awareness  campaign for children in Arizona.

A main part of Dr. Milo’s research concerns the psychological effects of obesity of children. Using a set guideline, I will be speaking to children and report the results of the interviews to Dr. Milo. We will then consider issues such as self esteem, self worth, and self perception as they affect the children.

Once sufficient data has been accrued, I will travel to a nearby school on the Pima reservation and explain our meal plan to the school. The school will return feedback and back in the lab we will continue to work on developing more efficient methods of education.

The work I do in the Hepatology lab in the Phoenix Children’s’ Hospital will, if ready in time, be published under Dr. Milo’s work. The work I do in the lab will also directly affect the reservation schools I work with. Analyzing the research and knowledge I have gained in the lab along with my own personal research, I will present a health plan that schools may implement to produce healthier students that are more aware of they way they treat their bodies.

VIII.            Problems:

I may encounter various problems in my research, the most obvious one being the issue of time. If my work in the lab is not ready to be published after three months, then my work will not be published. However, my time and effort will not have gone to waste because Dr. Milo may still use the research I gained for him when he is ready to publish. Additionally, I will still be able to incorporate my research experience into my final presentation.

 

IX.            Bibliography:

“2011 Updated Obesity Statistics.” National Council on Strength and Fitness. 1           August 2011. Web. 13 December 2012. <www.ncsf.orf/NewsArticles/0-         155/2011UpdatedObesityStatistics.aspx> 

“Basics About Childhood Obesity.” Centers for Disease Control and Prevention—      CDC 24/7: Saving Lives, Protecting People. 27 April 2007. Web. 12 December      2012. <www.cdc.gov/obesity/childhood/basics/html.>

“Child Obesity in Arizona, 2010.” Arizona Department of Health Services. Web. 13     December 2012. <www.azdhs/phs.owch/pdf/issues/ChildObesityAZ2010.pdf

“How Much Physical Activity do Adults Need?” Centers for Disease Control and       Prevention. 1 December 2011. Web. 13 November 2012.       <www.cdc.gov/physicalactivity/everyone/guidelines/adults.html> 

“Obesity Related Statistics in America.” Get America Fit Foundation—Making            America Stronger. Web. 13 December 2012. <www.getamericafit.org/statistics-     obesity-in-america.html>

2009. Strategic Plan for Overweight and Obesity Prevention. New York State   Department of Health. <www.health.ny.gov.prevention/obesity/strategic_
plan/>

2011. Clinical Gastroenterology and Hepatology. American Gastroenterological          Association. < http://www.cghjournal.org/>

2012. Journal of Gastroenterology and Hepatology Research. 1 (10). <       http://www.ghrnet.org/index.php/joghr/index>

2012. Journal of Hepatology. Official Journal for the European Association of the        Study   of Liver. 57 (6). < http://www.jhep-elsevier.com/>

Johns Hopkins Gastroenterology and Hepatology. Johns Hopkins Medicine. <       http://www.hopkins-gi.org/JHH_Home.aspx

Journal of Pediatric Psychology: Oxford Journals.                http://jpepsy.oxfordjournals.org/content/current

Kalil, Robert. Psychological Science. American Association for Psychological   Sciences.          < http://www.psychologicalscience.org/index.php/publications>

Kaneko, Shuichi. 2011. Hepatology Research. Wiley Online Library. 42 (10). <       http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1872-034X>

Nathanson, Micheal. Hepatology. American Association for the Study of Liver Diseases. < http://www.aasld.org/journals/hepatology/Pages/default.aspx>

Rettner, Rachel. “Childhood Obesity Rate Drops in Some US Areas, Report Finds.”   The Huffington Post. 11 December 2012. Web. 12 December 2012.       <www.huffingtonpost.com/2012.12.11.childhood-obesity-rate-       drops_n_2277390.html> 

Rimola, Antoni, Diagnosis, treatment and prophylaxis of spontaneous bacterial            peritonitis: a consensus document. Journal of Hepatology - January 2000  32 (1),      142-     153. < http://www.journal-of-hepatology.eu/article/S0168-    8278(00)80201-9/abstract>

What is Hepatology? News Medical. May 2004. Web. November 2012. <         http://www.news-medical.net/health/What-is-Hepatology.aspx>