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Letter From The Editor
With recent moves towards implementing health care reform, there are increased discussions regarding patient-centered medical homes (PCMHs) and accountable care organizations (ACOs), and how Nationwide Children’s needs to lead the way on implanting these models.

Ethical Decisions: Weight Management for the Pediatric Patient
The medical community is beginning to acknowledge obesity as a global epidemic. However, medical care is disproportionate among groups with health care access limitations. In order to accept that obesity is now a major health care issue, the medical community will require a new way of addressing pediatric health care, such as defining the roles and responsibilities of major pediatric organizations and implementing changes in pediatric medical education.

Post-Bariatric Patients: Emergency and Long-Term Care Considerations
Bariatric surgery procedures are now available to adolescents as well as adults. With this in mind, more frequently obese adolescents and their families are now seeking out these procedures as options for weight loss, to help them obtain a healthy weight and improved, long-term lifestyle.

Hidden Health Risks of the Extremely Obese Pediatric Patient
Every clinician working in critical care needs to know this: irrespective of outward appearances, obese and extremely obese children and teens are high risk patients. Even among health care professionals, bias can cloud a thorough assessment of the overweight patient.

Safe and Effective Transport of Obese Children
In the United States the percentage of overweight children is growing at an alarming rate, one in three children is overweight or obese. The Center for Disease Control and Prevention estimates among Americans age 20 to 74 years, obesity rates increased from 15 percent in 1976 to 32.9 percent in 2004.