Clinical Case Reasononing

 

Author: Sana Rehman

A concussion is the most prevalent type of mild traumatic brain injury and might cause adverse consequences (Tator, 2013). Concussion occurs frequently in all age groups, and different settings as well, but contradiction for age groups has been seen in the literature (Abrahams et al.: 2014; Marar et al., 2012). The concussion is defined as a serious pathological process, adversely impact the brain functioning due to abnormal biomechanical factors (Sharp, & Jenkins, 2015). 

The epidemiological studies have demonstrated that the prevalence rate for concussion has increased twice with recent years and the situation is growing more alarming day by day — the current clinical case reasoning following the three component of cycle considering a case of a girl. The three components of the cycle include the situation of the patients, cues & information and process or information.

Current Situation of the Patient

A 12-year-old girl named Mia Roberts, studying in grade six came in hospital emergency mainly with the complaints of headache, nausea, loss of appetite and fatigue. Her playmate also noticed that she was not eating well during that day and found to be silent during most of the day. At night, behavioural changes and fluctuations in mood have also been noticed as she was crying without any particular reason and felt confused. It was reported that Mia had a head injury in that morning during the play of the basketball tournament. During play she got stuck and headed down in the left side of her frontal bone. Her reported symptoms depicted that she might be having a concussion. Mild traumatic brain injury that dislocates the brain functions to abnormal way is termed as a concussion.

In 2015, Coronado et al., surveyed on nearly 3.42 million emergency departments for studying the sport’s concussion and reported that 70% concussion occurred during playing football, soccer, basketball and ice-hockey like games by collisions of players who were between the age of 12 to 19 years (Coronado et al., 2015). A substantial body of researchers reported a significant number of cases for developing concussion due to football, basketball and hockey (Abrahams, Fie, Patricios, Posthumus, September 2014; Marar et al., 2012). 

Concussions symptoms such as dizziness, sleeplessness, headache, behavioural and emotional changes (McCrory et al., 2017) were similar to her symptoms. Some researches resulted that the majority of athletes experienced these symptoms within days that is due to the structural anatomical changes of the brain during the injury. Mia Roberts also had an injury in the left side of the frontal lobe that’s why she is feeling symptoms like a concussion.   

Cues and Information 

Risk factors related to the occurrence of concussion were also important to be in view. Gender plays an important role in playing games, and it is one of the major risk factors in concussion. Being a female player is a potential risk factor of the concussion, which indicated that Mia Robert might have a concussion during that play (Abrahams et al.: 2014; Marar et al., 2012). Comparatively, males found to be least on the risk of developing concussion while playing games. 

The place of the injury is another risk factor of the concussion. In 2016, Caccese & Kaminski studied that aerial collision of the athletes with injury in the left side of the brain is the major risk factor of the concussion. Researches on the age limits also conclude that with the increase of age concussion’s risk factor decreases that was also assimilated with her age as she was only 12 years old that was her major risk factor of being concussion (Marar et al., 2012). Currently, from the profile of the Mia Roberts, her gender, age and place of injury, all were the major risk factors of the occurrence on concussion.  

As far as with the concern of the patient’s diagnosis, it cannot be diagnosed only on the risk factors of the problems. The patient would be medically examined properly with the interview by the doctors. Mia Roberts interviewed by the doctor, and her initial notes were taken as objective data of the patient that were as blood pressure as 105/87, temperature 36.7°C, Pulse 81, Respiratory Rate 20 and SpO2 was 98%. In a clinical interview, patient subjectively reported that she had blurred feelings, experiencing dizziness, headache and did not feel well after injury. 

The ratings of the patient on the pain scale of headache are 4 out of 10. There would be a detailed examination of the patient would be suggested that contains many domains like injury mechanism, signs and symptoms, the neurological and cognitive functioning of the patient that includes balance testing (Caccese & Kaminski, 2016).

Besides the clinical interview, neurological tests like PET scan, MMRI, functional MRI or SCAT3 would also be implemented in the assessment so that the structural changes could be seen in that tests and with better understanding diagnosis could be made (Coronado et al., 2015). The sign and symptoms of the patient clearly indicated the concussion symptoms. Studies indicated that neurochemical changes linked with the concussion problem effectively detected by the magnetic resonance spectroscopy (MRS) rather than diffusion tensor imaging and positron emission tomography (PET) scanning (Abrahams, Fie, Patricios, Posthumus, September 2014; Marar et al., 2012). Functional MRI is also effective to see the functional changes of the concussion after two months of the injury (Finch, Clapperton & McCrory, 2013).

To give the concussion diagnosis is much more difficult due to the results of the neurological tests. It is more rely on the clinical interview and the behavioural and emotional functioning that can be seen in the case of Mia Robert as she had started emotional and behavioural problems like crying without any reason that was another sign of the concussion symptoms of the patient (Marar et al., 2013).

Process and Information

In the case of Mia Robert was a 12 years old girl, which is the developing age of the brain as well. Studies described that developing brain responded differently as compared to the adult brain to any traumatic injuries and are most prone to have a concussion and highly vulnerable to the damages (Caccese & Kaminski, 2016). Same happened in the case of Mia; she got an injury in her growing age. Therefore more risk and damages have been found to be associated with her condition. It was also assessed that Mia’s injury occurred at the frontal lobe of the brain and the frontal and temporal lobes were responsible to the sensory inputs that might be affected her in long term effects of the brain (Caccese & Kaminski, 2016).

Due to the frontal lobe injury, she had the problems related to the sleeplessness, dizziness and fatigue. Brain injuries alarmingly effects the learning of the children between age five to 18. The recent studies found that children who had a concussion during play had no significant difference in the learning performances with other peer mates (Finch, Clapperton & McCrory, 2013). In contrast, Mia experienced issues in multiple areas to function well. 

Age and gender were also found to be strong determinants for developing functional, emotional, behavioural, and sensory and health issues. More assessment and management are needed in the case to achieve desirable results. From the above case clinical case reasoning, it can be hypothesized that Mia might get recover soon with the proper assessment and regular treatment plan.

 

Suicide: A Huge Mental Health Issue in Nursing Practice

 

Author: Sana Rehman

In mental health studies, suicide is a significant issue that needs to be addressed with the help of the nursing staff in clinical settings. Researchers has focused on suicidal issues and the reasons are made known to avoid the future cases of suicide. Mostly, the reasons are hard to anticipate in advance but once a patient survives, it becomes the ethical duty of the nurses to take effective care of these patients (Sheehan, et al., 2019).  Nurse teachers can teach effective strategies to their student nurses about how to implement theories in the real work settings  to save the patients who tried to commit suicide (Sun, Long, Chiang & Chou, 2019). 

“In mental health, when depression exceeds the highest levels of endurance, people tend to commit suicide and a nurse is charged with the duty to develop effective strategies which can bring back the patients towards the normal course of life."Most of the people commit suicide to get rid of psychological pain and their mental weakness offers them a solution to end up their lives because they find no charm in a life with problems. This is a serious form of self-harm and many people die during the suicide attempt. Therapies used to help out the survivors is the need of the clinical best practices and nurses have to perform their role in making the patients hopeful about life. 

The negative thoughts must be removed from the mind of the patient and effective communication along with kind words of empathy will increase the chances of the speedy recovery of suicidal patients (Rudd & Roberts, 2019). Suicide has also become 10^th biggest reason of the deaths in the USA and in the past 15 years, this rate has increased rapidly because of the mental health issues and incapability of the people to face the realities of life with courage. To prevent the precious lives of people from the attempts of suicide, national suicide preventive policies have been developed. These policies will be implemented with the help of health care providers and nurses will take care of all those who are going through severe mental issues and have tried to commit suicide once (Hogan, 2020).

In the hospitals and clinical settings, dealing with emergency cases of suicide is an important task. Healthcare providers have to take special care of these cases. The standards and recovery measures need to be implemented immediately because the number of patients with suicide risks is increasing day by day (Zhou, et. al., 2019).   Most of the people are prone to suicidal attacks because they have low self-esteem, nurses can make efforts to engage these people in positive thoughts and can increase their self-esteem. 

Nurses can also provide social support and this will remove the disappointment and despair from the lives of depressed people (Matel-Anderson, Bekhet & Garnier-Villarreal, 2019). Nurses have to fulfill another ethical guideline in which trust is developed between the patient and the nurse. This trust is maintained through open communication and respect shown towards the patient. This strategy will not only offer help to the unique cases but can also be documented for further use in psychiatric nursing practices (Vandewalle, et. al., 2019).

In Australia, NMBA (Nursing and Midwifery Board of Australia) Standards define the ethical roles of nurses and midwives. These standards guide the nurses to deal with the patients and their families in an appropriate manner. Those patients who are brought unconscious in the hospitals, they need the support of the nurses because they cannot move their bodies. So, nurses need to take care of those patients with care and affection. The families of such patients need empathy and nurses need to treat the family members of the patients with empathy. To those patients, who have tried to commit suicide, nurses must take care for the usage of those technologies which are aimed to save the lives of such patients (Aitken, Marshall & Chaboyer, 2019). 

While most of the nurses are not aware of the strategies and interventions used in clinical practices when they are dealing with a patient prone to suicide. This must be learned through a formal platform where the senior nurses can train junior nurses on the matters to handle the people at risk of suicide. This learning will be used in treating theses patients but ethical aspects to treat them will be kept at the priority (Gilje, 2018).

One ethical duty of the nurses is to get training on how to handle patients with suicide risk. If they have not leaned the practices during their education, they need to show agreeableness to go through a training program because they can save a lot of lives this way if they learn practices to deal with the suicide patients. Nurses need to be quick and efficient while handling emergencies of suicidal patients because carelessness in that critical time may take the life of the patient. On the other hand, a careful and responsible attitude of a nurse can save the life of a patient. This will be helpful in the recovery of the patient when the nurse will be able to handle the patient according to the specific needs (Siau, 2019).

 One main goal of the nursing practices in mental health is to accept the reality and to positively view suicide to move towards solution finding. Nurses are ethically bound to understand the needs of the patients and to convert their negative feelings and depression into positive and productive thoughts with the help of effective communication (Flood, 2019).

Hence, it is concluded that due to increased depression in society, the rate of suicide has gone up. Nurses have to play their major role in the treatment of suicidal patients and their mental wellbeing can be improved if the nurses take care of these patients in an ethical manner according to the NMBA standards. Moral support provided by the positive behavior and treatment of a nurse will help the patients to combat the negative thoughts and to come out of depression. This can save a lot of lives by instilling positive thoughts and showing empathetic behavior towards suicidal patients.

How to Write Critical Appraisal for Qualitative Study?

Author: Sana Rehman

This qualitative research is about the attitudes and approaches towards the vaginal atrophy when there is menopause in females and they have to face vaginal atrophy. The results were collected from the focus groups discussion of multicultural settings. These focus groups were composed of females who were experiencing vaginal atrophy after menopause and the results were collected based on personality types and the psychological factors. The study findings depicted that the responses and treatment concern for vaginal atrophy among females depends upon personality types (Utian & Maamari, 2014). The Following steps would highlight ''How to write critical appraisal for qualitative study''.

Steps of the Research Process

The purpose of the research was to collect the responses from females towards the vaginal atrophy after menopause. The focus groups discussion comprised on three-four hours and maximum 3-5 women have been a part of this focus groups. Hence, the research method for this study was the preference of focus groups to obtained the in-depth information. After FGD's, the results were presented considering the personality types of females. It was found out that those females who had individualism and stongth decision making power had taken the treatment for vaginal atrophy. In contrast those women who were submissive and had instincts of belongingness were not provided with any treatments. Their health care physicians satisfied them that vaginal atrophy is a part of aging and requires no treatment. However, it was concluded at the end of the research that the responses and approach for treatment to vaginal atrophy was based on the personality types. The findings of the study will help thefthe to understand how their personality types are interlinked with their perception towards health. 

Strengths and Weaknesses of the Qualitative Research

Congruency between the research questions and the research methodologies is the strength of good research (Lockwood, Munn & Porritt, 2015). This research has a good congruency because the research question is well explained with the help of the results collected during the focus group studies. The other strengths of this study are to make the females aware that vaginal atrophy is a medical condition and they need to take it seriously. They must see a doctor and if they are facing any severe or mild difficulty, they need to tell the doctor or their health care provider. Another strength of this research is the selection of focus groups at international level which shows that this problem prevails all around the world and females face and combat this issue according to the personality types. The research can make them stimulated to have awareness about this topic and to address this issue with the wise approach. This is so because they have all the rights to talk about their physical issues and must not hide or ignore such issues. The study is also important because all the females in the world have to pass through a phase of menopause and then they develop certain changes in their bodies and vaginal atrophy is one of them. Another positive goal of the study is the use of personality-based approaches to treat the females and to create awareness among them. This research highlights the issues and concerns about the health of females. The weakness of this research is realized when only a small fraction of respondents are included in the focus groups. Another weakness is felt that doctors or care providers have not been included in this research. So, the opinions of only females regarding the issue were recorded.

Credibility and Reliability of the Results

Good research also has unbiased goals and presentation of the results irrespective of the cultural perspectives. This shows that quality research is based on theories and facts and is not biased with the cultural backgrounds of the researcher (Lockwood, Munn & Porritt, 2015). Hence, this research is shown at an international level without considering the cultural perspectives. Only one thing was taken into account during the research and it was the medical reason of the females. The research is both credible and reliable, because it was based on a careful focus group discussion and the problems were observed and recorded all around the world that females are facing vaginal atrophy after the menopause. So, the international issue of females has come under observation and the research has put enough contribution to highlight the revolving factors. A lot of females in the world are facing this issue and there is a need to create awareness to deal with this issue and counseling of the females is needed to be done to promote awareness among them. Couselling services will help them get better health status and strenght to deal with their genuine medical issues.

Questions for Peer Follow-up

1-      The results of this research show that vaginal atrophy treatment is dependent on the personality types of the females and according to me there might be some other reasons behind this. What is your input in this regard?

2-       In the research methodology, only women were selected from four counties and the research is given the name of the international study. Is not it a partial study in which other countries needed to be added at a broad level? What is your stance on this insight?

 

 

 

 

 

 

 

 

Psychiatry of Pandemic: A Mental Health Response To Crises Management

 

Author: Sana Rehman

The book depicts the interesting but alarming picture of multiple historical infection outbreaks. It signifies how the previous infection outbreak occurred and impacted the mental, physical & psychological wellbeing of humans. Also, unlike other disaster management book, it stressed upon the formulation of mental health response to combat against unique elements of a pandemic outbreak. The has book been divided into 13 sections including, introduction, history of the pandemic, psychology of pandemic, social, public & epidemiological aspects of the pandemic, the importance of culture in managing pandemic, preparing for an outbreak, Neuropsychiatric complication of pandemic, social distancing, the mental health of isolation or quarantine, mental health care for survivors, mental health assistance to family and vaccination. 

The book is significant as it provided the historical evidenced based strategies, which would help in dealing with the contemporary COVID-19 pandemic. According to the introductory chapter, the most prevalent infection outbreaks were ZIKA Virus, MERS, SARS, HIV Pandemic, Ebola, Haemorrhage Fever, The Antoine Plague, The Justinian Plague, The Black Death, The Athenian Plague (430 B.C), SARS, Spanish Flue Pandemic (1918-1920), Swine Flue or H1N1/09 pandemic, Ebola Outbreak (2014-2016), Zika (2015-2016), and Smallpox in Yogoslavai (1972). The effects of these outbreaks developed the uneasiness & anxiety in previous centuries across the globe were described. 

According to the book, the advances in therapies, health care, technologies, and international surveillance efforts could not faint the epidemic potential of an infection outbreak. The impact of infection outbreak on socio-economic life was also observed in the form of expansion, international travel, misuse of antimicrobial agent and attitude towards immunization. Hence the international public health intends to identify the infectious disease to reduce/ overcome the public health risk.

Mental health experts devoted their contribution, but unfortunately, the psychiatric care in the infectious outbreak could not get recognition as a discipline. The subspecialty psychiatry (a) consultation-liaison psychiatry (b) and disaster psychiatry were introduced and applied to control the mental health responses of the people.

The book highlights the several pandemic responses such as time-lapse and disease modelling, mental health burden on health workers, quarantine neuropsychiatry, behavioural contagions and emotional epidemiology and the precarious status of health care facilities. The book advocates the mental health responses to these outbreaks following the insanity and plague concept. 

The book describes the number of cultural, religious and burial approaches to mitigate the devastating impact of a pandemic. Also, it, suggest that the preparation for an outbreak considering medication, psychotherapies an intervention plan helps to reduce the devastating consequences of the pandemic (Wolf, 2016).

The book acclaimed the strong relation between infection outbreak and neuropsychiatric complications. The biological and psychological impact of infection has been elaborated in the light of literature. The representation of biological anatomy due to infectious disease has been depicted very interestingly. Furthermore, it has also been elaborated that the treatment and medication of infection diseases cause neuropsychiatric complications such as delirium, dementia, schizophrenia, anxiety and depression (Munjal, 2017). The book also recommended the two effective ways to break the chain the pandemic, i.e. isolation and quarantine.

 The history and emergence of quarantine and isolation have been elaborated in details. Furthermore, it highlighted the mental health of the patients and population who are exposed to isolation and pandemic. The most commonly reported psychological issues were depression, anxiety, delirium, hopelessness, despair, psychological trauma and cognitive impairment. The mental health issues of people affected by quarantine have also been discussed. The book demonstrates the psychiatric square of surviving the pandemic its complications, and its treatment complications. In the acute phase of suffering, minor symptoms can cause psychiatric symptoms from mood changes to cognitive impairment.

The role of the health care worker in the crucial time of pandemic has been elaborated cornering their mental health. It was reported that health care workers experience psychological and emotional burnt during the isolation or quarantine. In the light of literature, multiple innervations and facilities were suggested to support them. The book provides a clear picture for providing the psychological first aid with the interventions and medications furthermore, as health care professionals provide self-less health care support.

The health care staff persistent exposure to stressful situation, increased the risk for death, separation from a loved one, traumatization and hopelessness. The findings highlight the physical, emotional, psychological and spiritual need for health care professionals such as communication, leadership, support, health assessment, prophylactic medication, relaxation, mindfulness, self-help skill workforce resilience, teamwork, self-appreciation, and psychosocial programs for families. Lastly, the employee assistance program should be introduced to access the psychiatric and pharmacological intervention, antidepressants, psychotic interventions. 

Although the provision of mental health support is hard to provide but a crucial part. The book highlight the importance and need of mental health facilities to a family member, survivors and health care staff through grief and loss counselling, medication and psychological interventions.

Finally, the role of vaccination in controlling the pandemic has been elaborated. Initially, the book illustrates the discoveries of the vaccine started from 1706s for the management of smallpox. In 1881 Loius pasture discovered the management for chicken cholera and anthrax. The twenty centuries several successful vaccinations have been introduced against Diphtheria, Mumps, Measles and Rebbula. The polio vaccine has been one of the major development for Herps, Simplex, HIV, Gonorrhoea and Malaria. Then the dependency and effectiveness of the vaccine have been elaborated. The economic changes in the development and preservation of vaccine have been elaborated.

Vaccination policy reported is being a critical element in attaining the immunity against infectious disease. Role of national authorities and agencies such as WHO, European Commission and CDC in immunization agenda has also been highlighted. Vaccination in the context of the pandemic outbreak has also been elaborated. According to the book, the vaccine was working effectively; but due to new strains, the advancement in vaccination was needed. 

The adverse effect of the vaccine on the mental health of patients has also been addressed in details. Overall, the book provided the historical background of infection diseases along with treatment modalities. The book has contemporary significance as like other historical infection diseases; the COVID-19 can also be controlled using pharmacological, psychological and vaccination (Goldberg, 2020: Li et al., 2020).

 

 

 

 

 

Childhood Obesity among Aboriginal and Torres Strait Islander children living in Rural Queensland

Author: Sana Rehman

Part A: Impact of Childhood Obesity at the Level of Individual, Community and Population 

Childhood obesity has become the most concerning issue of the current time. The action plan is needed to prevent childhood obesity in rural Queensland. For developing the action plan, the adverse impact of childhood obesity is crucial to identify. The impact of childhood obesity, key areas to make changes, and action plan are mentioned below.

 

According to the 2016 census, the ratio of Aboriginal and Torres Islander children in the rural island is 4.0% (Queensland Government Statistician’s Office, 2016). In the recent five years, the Aboriginal and Torres Strait Islander residents of Queensland rural area ratio has been increased to 19.7% (30,658) (Sherriff et al., 2019). The growing proportion of aboriginal and Torres Strait islander is adversely impacting the health conditions of the general population and the children’s as well. The ever increasing ratio is developing economic issue to meet the necessities of the population, and the most prevalent issue which has been observed is childhood obesity.

Childhood obesity is very prevalent among Aboriginal and Terror Strait Australian Children living in rural Queensland (Thurber, Dobbins, Neeman, Banwell, & Banks, 2017). In particular, the burden of disproportionate morbidity and mortality are very common among obsess children’s of rural Queen land (Phillips, Morrell, Taylor, Daniels, 2014). In 2012 to 2013 the one-third of Aboriginal and Strait Islander child (age range 12-14) estimated to be overweight (Phillips, Morrell, Taylor, & Daniels, 2014: Australian Bureau of Statistics, 2013). The impact of childhood obesity is alarming for physical, emotional, psychological and social life (Schwarzman et al., 2019). 

The physical impact of childhood obesity liked to develop type 2 diabetes. It adversely affects the life expectancy of the child for up to 27 years. Childhood obesity adversely affects the emotional well-being of the child, and they start to display inappropriate emotion in a diverse situation. The recent researches have demonstrated the positive correlation between childhood obesity and emotional problems (Phillips, Morrell, Taylor, & Daniels, 2014). 

The psychological impact of physical obesity includes low self-esteem, negative self-concept, and anxiety and body dysmorphic symptoms. The literature suggested that childhood obesity is positivity associated with the psychological disturbance, which may deteriorate the personal, social and occupational life of the children (Schwarzman et al., 2019). 

The social impact of childhood obesity adversely affect the occupational functioning of the child as further leads to isolation and leads to much antisocial behaviour (Chung et al., 2016). Therefore for the emotional, psychological, and behavioural well-being of the children, their physical fitness is crucial.

The socio-economic factors determine the prospect of any area. The lack of nutrients and medical facilities leads to poor health and low life expectancy (Sherriff et al., 2019). The environment of rural Queensland poses lack of health and nutrient facility. These deprivation are leading to childhood obesity and related issues. The Aboriginal and terror strait island child experience substantial hurdles if rural Queensland. Therefore there is dire need to devise a plan for changing the alarming current condition. 

B: Key areas where change can be made to reduce the impact of health issues

The risk factor for childhood obesity can be seen in three clusters such as biological, socio-economic and behavioural. Firstly, according to the biological perspective, obesity has some predisposed effect. According to researches, obsess parents are more at risk of having obese children’s compared to slim ones. Secondly, as mentioned earlier, Childhood obesity is interlinked with the poor socio-economic condition of children living in rural Queensland. 

The food and health care deprivation among children’s of rural areas are the primary determinants of childhood obesity. According to recent data, the proportion of childhood obesity is significantly correlated with disadvantages background (Schwarzman et al., 2019). The lack of adequate socio-economic facilities leads to childhood obesity.

 

As the rural areas posses with the least medical and nutrients facility and children with low socio-economic status bound to buy cheap and unhealthy foods (Kim et al., 2017). Furthermore, the lack of adequate medical facilities also contributes to developing health-related issues. The two main areas which have been identifying to make change are unhealthy food leads and lack of medical facilities in rural areas of Queensland. Thirdly, unhealthy behaviours are also very strong determents of childhood obesity (Australian Institute of Health and Welfare, 2018). The children often commit unhealthy behaviour due to inadequate rural environment. Therefore, the prevention of childhood obesity is essential by making changes in these areas. 

The change in reducing childhood obesity can be made by following a few steps. Initially, childhood obesity can be curbed among children of rural areas of queen land through policymaking, considering the social-economic context. The Government should take collaborative steps with the Aboriginal community for reducing nutrition deficiency and other related health issues. More actions should be taken to promote the Minjilang Health and Nutrition Project (Northern Territory; 1989-199029) in rural Queensland for the aboriginal and terror islander children (Australian Bureau of Statistics. (2016). The Government should facilitate the peoples of rural Queen land with basic health care measures.

 

There is dire need to hire more health care staff, funding aids, and workforce training in rural areas so that childhood obesity can be control. Furthermore, another is that needs attention to children behaviour. The children’s are indulged in the poor behavioural chain of food intake and routine habit. In order to break their food intake and unhealthy health habit chain, health equality policies should be promoted (Guzys, Brown, Halcomb, & Amp; Whitehead, 2017). 

The aboriginal and terror island children do not get equal, housing, medical, education and social facilities. Unequal rights lead to unhygienic or unhealthy behaviour. The implication of the Looma Healthy Lifestyle Project (Western Australia; initiated in 1993 and still ongoing) is needed for childhood obesity prevention (Schwarzman et al., 2019). The obesity itself is not that dangerous, but a risk factor for causing multiple deadly diseases. Therefore the prevention programs are essential to developing. 

C: Action plans to address the health issues

The best nursing practice is primarily associated with promoting health and fabric in the community as the current issue of childhood obesity in rural Queensland is very prevalent (Queensland Government Statistician’s Office, 2016). Here the role of a registered nurse is very crucial to develop health-related behaviour to prevalent the proportion of childhood obesity. The health promotion empowers the infected individual, family and community to develop insight by educating and developing skill to combat against disease (Edelman, Mandle, &Kudzma, 2014). 

The targeted area that needs change to overcome obesity in rural Queensland is health-related behaviour. The obsess children of rural areas found to be indulged in health risk behaviour such as cheap and malnutrient foods, improper daily routine, unhygienic habits and residential issues (Fleming & Parker, 2019). The issues should be resolve at border spectrum as Government and policymaker should invest their time and expenditures to improve the condition of the children’s. The Government and policymakers would indulge in this action plan and informed about the necessities of the medical staff, financial aid, funding and other related things. As far as the action plan for the nursing perspective is concerned, by taking multiple steps the childhood obesity can be control. 

The very first step of an action plan for the promotion of health and the prevention of childhood obesity is the regular assessment of the children. The assessment includes diet, sedentary behaviours and physical activity. The second step is the assessment of family environment such as parenting, acceptance, rejection, and quality time etc. The obtained information from this initial assessment would provide sufficient details to design an intervention plan for the children. On the basis of these assessments, it can be concluded that intervention should be universally applied or individually. 

What population should be targeted, such as children, parents, caregivers, teachers and neighbours?  

In the current issue of obesity, children will be asses on a regular basis for identifying their health habits, including nutrients, sedentary lifestyles, and physical activity. The cheap and unhealthy food and lack of physical activity will be reduced following behaviour modification technique. The children will be educated through stories, video clips and other interesting activities about how malnutirents food and lack of health activities leads to childhood obesity. The parents or caretaker of the children’s would also be psycho-educate about unhealthy health habits and would assist in developing health-related behaviour to prevent obesity among children’s. The effectivity of the action plan would be assessed through post-assessment. This action plan would help in controlling the obesity issues in rural Queensland. 

Conclusion 

The childhood obesity has arisen to an alarming extent in rural Queensland, but with appropriate aid and action plan, the issue can be controlled. Further longitudinal researchers, case studies and systematic reviews are crucial to conducting for the identification of the latest epidemiological issues so that more intervention plan can be designed.