discussion 6 div

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Hyde Pfiefer, a retired 70-year-old German American, has lived in the United States for the last 50 years. A widower of 5 years, Mr. Pfiefer prepares his own meals following his wife’s recipes from the old country. Nine months ago, Mr. Pfiefer was told that his cholesterol is elevated, and he was instructed about a low-fat diet. His most recent test results show his values to be unchanged.

  1. Discuss the meaning of food in the German culture.
  2. Using the predominant health beliefs of people of German ancestry, how might you help Mr. Pfiefer reduce his cholesterol level?

Submission Instructions:

  • Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources.  Your initial post is worth 8 points.
  • You should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts. Your reply posts are worth 2 points (1 point per response.) 
  • All replies must be constructive and use literature where possible.
  • Please post your initial response by 11:59 PM ET Thursday, and comment on the posts of two classmates by 11:59 PM ET Sunday.
  • You can expect feedback from the instructor within 48 to 72 hours from the Sunday due date. 

FEEDBACK

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PLEASE FOLLOW ALL DIRECTIONS 

NEED help

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Based on course readings, resources, and discussions, create your own theory based on your specific practice area. For example, Liken’s Theory of Nurse/Patient Connectedness for Individuals with a Diagnosis of Depression. 

Be sure to include definitions and descriptions of at least two key concepts that make up your theory. Describe the relationships between these concepts. For example “connectedness” and “depression.” 

What role does research play in the development and use of your theory in practice? 

Give a case example of how your concepts and theories would be used in a specific client situation in practice. What are the barriers to using your theory in practice? 

Nursing assignment

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To Prepare:

· Review the Resources on healthcare policy and regulatory/legislative topics related to health and nursing informatics.

· Consider the role of the nurse informaticist in relation to a healthcare organization’s compliance with various policies and regulations, such as the Medicare Access and CHIP Reauthorization Act (MACRA).

· Research and select one health or nursing informatics policy (within the past 5 years) or regulation for further study.

The Assignment: (1 page not including the title and reference page)

Create a 1-page fact sheet that your healthcare organization could hypothetically use to explain the health or nursing informatics policy/regulation you selected. Your fact sheet should address the following:

· Briefly and generally explain the policy or regulation you selected.

· Address the impact of the policy or regulation you selected on system implementation.

· Address the impact of the policy or regulation you selected on clinical care, patient/provider interactions, and workflow.

· Highlight organizational policies and procedures that are/will be in place at your healthcare organization to address the policy or regulation you selected. Be specific.

· Use APA format and include a title page, in-text citations, and reference page.

· Use the Safe Assign Drafts to check your match percentage before submitting your work.

FPA legislation

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What are the advantages and disadvantages of collaborating with physician organizations when pursuing FPA legislation?

Case study

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 CASE STUDY: An Older Immigrant Couple: Mr. and Mrs. Arahan Mr. and Mrs. Arahan, an older couple in their seventies, have been living with their oldest daughter, her husband of 15 years, and their two children, ages 12 and 14. They all live in a middle-income neighborhood in a suburb of a metropolitan city. Mr. and Mrs. Arahan are both college educated and worked full-time while they were in their native country. In addition, Mr. Arahan, the only offspring of wealthy parents, inherited a substantial amount of money and real estate. Their daughter came to the United States as a registered nurse and met her husband, a drug company representative. The older couple moved to the United States when their daughter became a U.S. citizen and petitioned them as immigrants. Since the couple was facing retirement, they welcomed the opportunity to come to the United States.

 The Arahans found life in the United States different from that in their home country, but their adjustment was not as difficult because both were healthy and spoke English fluently. Most of their time was spent taking care of their two grandchildren and the house. As the grandchildren grew older, the older couple found that they had more spare time. The daughter and her husband advanced in their careers and spent a great deal more time at their jobs. There were few family dinners during the week. On weekends, the daughter, her husband, and their children socialized with their own friends. The couple began to feel isolated and longed for a more active life. 

Mr. and Mrs. Arahan began to think that perhaps they should return to the home country, where they still had relatives and friends. However, political and economic issues would have made it difficult for them to live there. Besides, they had become accustomed to the way of life in the United States with all the modern conveniences and abundance of goods that were difficult to obtain in their country. However, they also became concerned that they might not be able to tolerate the winter months and that minor health problems might worsen as they aged. They wondered who would take care of them if they became very frail and where they would live, knowing that their daughter had only saved money for their grandchildren’s college education. They expressed their sentiments to their daughter, who became very concerned about how her parents were feeling. 

This older couple had been attending church on a regular basis, but had never been active in other church-related activities. The church bulletin announced the establishment of parish nursing with two retired registered nurses as volunteers. The couple attended the first opening of the parish clinic. Here, they met one of the registered nurses, who had a short discussion with them about the services offered. The registered nurse had spent a great deal of her working years as a community health nurse. She informed Mr. and Mrs. Arahan of her availability to help them resolve any health-related issues. 

Reflective Questions 

1.What strategies could be suggested for this older adult couple to enhance their quality of life? 2.What community resources can they utilize? 3.What can the daughter and her family do to address the feelings of isolation of the older couple? 4.What health promotion activities can ensure a healthy lifestyle for them? 

DB

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  Due 09/13/23

Respond using APA and include at least 3 scholarly references.

· Review the national healthcare issue/stressor and review the analysis of the healthcare issue/stressor you selected.

**National healthcare issue is Mental health and substance abuse **

· Identify and review two evidence-based scholarly resources that focus on proposed policies/practices to apply to your selected healthcare issue/stressor.

Add a section to the topic you previously submitted. The new section should address the following in 1-2 pages:

· Identify and describe at least two competing needs impacting your selected healthcare issue/stressor.

· Describe a relevant policy or practice in your organization that may influence your selected healthcare issue/stressor.

· Critique the policy for ethical considerations and explain the policy’s strengths and challenges in promoting ethics.

· Recommend one or more policy or practice changes designed to balance the competing needs of resources, workers, and patients, while addressing any ethical shortcomings of the existing policies. Be specific and provide examples.

· Cite evidence that informs the healthcare issue/stressor and/or the policies and provide three scholarly resources in support of your policy or practice recommendations.

· 

Video Discussion Wk 4

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·Given her medical history, what other psychotropic medications would you recommend for the client? Answer This Question Only

Provide a response to 1 of the 3 discussions prompts that your colleagues provided in their video presentations. You may also provide additional information, alternative points of view, research to support treatment, or patient education strategies you might use with the relevant patient.

Responses exhibit synthesis, critical thinking, and application to practice settings…. Responses provide clear, concise opinions and ideas that are supported by at least two scholarly sources…. Responses demonstrate synthesis and understanding of Learning Objectives…. Communication is professional and respectful to colleagues…. Presenters’ prompts/questions posed in the case presentations are thoroughly addressed…. Responses are effectively written in standard, edited English.

Assigment .Apa seven . All instructions attached.

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2

PICOT Question for Preventing Childhood Obesity

Tahimi Salfran Mesa

Florida National University

Professor: Yesenia Osle

September 15, 2023

PICOT Question for Preventing Childhood Obesity

Obesity is a pressing public health issue with serious long-term consequences. Obesity is a chronic medical condition characterized by excessive body fat. A body mass index (BMI) of 25 or above is considered overweight, and a BMI of 30 or higher is considered obese (WHO, 2021). Obesity has witnessed a global upswing, with a particularly alarming impact on children, sparking significant public health apprehension. Childhood obesity has become a pressing global concern, transcending the confines of adulthood. The alarming trend exposes children to immediate obesity-related health risks and casts a shadow over their future. Children are categorized as overweight or obese based on their BMI exceeding age and gender-specific thresholds. Precise height and weight assessments form a crucial aspect of routine physical examinations. Childhood obesity sets the stage for a lifelong battle, predisposing youngsters to adult obesity and a spectrum of non-communicable diseases like diabetes mellitus, hypertension, and osteoarthritis in adulthood.

Childhood obesity is driven by complex interplay of genetic, environmental, and behavioral factors. Genetic predisposition increases child's susceptibility to obesity. Environmental factors entail easy access to high-calorie, low-nutrient foods, and sedentary lifestyles influenced by modern technology and urbanization (Lister et al., 2023). Lower-income families may have limited access to fresh, nutritious foods and safe places for physical activity. Advertising of unhealthy foods and beverages targeted at children further exacerbates the problem. Behavioral factors are the psychological factors driving stress and emotional eating that hinder healthy habits. Addressing this burgeoning crisis demands urgent, comprehensive action to safeguard the well-being of our youngest generation and mitigate the far-reaching health consequences they face in adulthood. This paper explores the problem of obesity and identifies effective prevention strategies are essential to mitigate the growing concern using the PICOT framework.

Problem Statement

Childhood obesity rates have been steadily increasing worldwide. The global prevalence of overweight and obese children has risen dramatically in recent years. The World Health Organization (2021) reports that in 2020, 39 million children under five were overweight or obese. Over the past four decades, the global count of school-age children and adolescents grappling with obesity has skyrocketed by over tenfold, surging from 11 million to a staggering 124 million by 2016. Additional 216 million fell into the category of being overweight but not yet classified as obese in 2016. The numbers are projected to substantially increase by 2030.

The primary driver of obesity and overweight issues worldwide stems from a crucial energy imbalance: consuming calories exceeding those expended. The global challenge is exacerbated by an alarming surge in the consumption of energy-dense foods rich in fats and sugars and rise in physical inactivity (Fox et al., 2019). The latter can be attributed to the increasingly sedentary nature of many job roles, shifts in transportation methods, and the expanding urban landscape. These dietary habits and activity levels shifts often result from broader environmental and societal changes linked to development.

Childhood obesity elevates the risk of numerous health issues, encompassing asthma, sleep apnea, bone and joint problems, type 2 diabetes, and precursors to heart disease like high blood pressure. It also exerts substantial impact on healthcare costs. In adulthood, individuals grappling with obesity face increased susceptibility to stroke, various cancers, heart disease, type 2 diabetes, premature mortality, and mental health conditions such as clinical depression and anxiety. Therefore, childhood obesity carried over to adulthood will expose them to these problems. The problem affects both developed and developing nations. However, gender disparities are relatively minimal. Addressing the escalating obesity epidemic necessitates a comprehensive approach considering genetic predispositions and environments that encourage unhealthy behaviors. However, identifying the most effective strategies and interventions for specific populations is crucial.

PICOT Question

In school-aged children (P), does a comprehensive school-based nutrition and physical activity program (I) compared pharmacological interventions (C) reduce prevalence of obesity over 12-month period?

Explanation of PICOT Components

Population of Interest (P)

The population of interest for this PICOT question is school-aged children, typically ranging from 5 to 18 years old. The age group is particularly susceptible to obesity due to dietary habits, physical activity levels, and environmental influences. Childhood often emerges as a pivotal phase in development. It is increasingly acknowledged as a critical period influencing an individual's susceptibility to obesity in later life (Smith et al., 2020). During this window, taste preferences, dietary patterns, and lifestyle behaviors take shape and have a lasting impact. Interventions implemented during these early years possess the potential to redirect this trajectory, reshaping a child's preferences and habits before they solidify, offering a vital opportunity to mitigate the risk of obesity in the future.

Intervention of Interest (I)

The intervention of interest is a comprehensive school-based nutrition, behavioral therapy, and physical activity program. School-based nutrition interventions are strategies enacted within school environments to cultivate positive nutritional attitudes, knowledge, and behaviors in school-aged children and adolescents (O’Brien et al., 2021). These initiatives encompass various facets, including food policies, environmental enhancements, and nutrition education. Their recipients may range from school administrators, food service personnel, and teachers to parents and students. Conventional classroom educators or specialized program instructors can carry out implementation.

Physical activities are bodily engagements that require energy expenditure. They encompass exercises, sports, recreational pursuits, and daily tasks like walking or climbing stairs. Encouraging regular exercise helps children achieve and maintain a healthy weight while promoting overall well-being. Activities should be age-appropriate, enjoyable, and integrated into daily life. School-aged children and adolescents should engage in minimum of 60 minutes of daily physical activity, with at least 30 minutes devoted to structured activities like sports and supervised exercises, aligning with recommendations by the American Academy of Pediatrics (van Sluijs et al., 2021). Behavioral therapy focuses on modifying unhealthy behaviors and promoting positive lifestyle changes. It encourages self-monitoring, where children track their eating habits, physical activity, and food-related emotions. Second, the education encourages setting specific, achievable goals for healthier eating and increased physical activity tailored to their age and abilities.

Comparison of Interest (C)

The comparison of interest in this PICOT question is pharmacological intervention. Pharmacological intervention encompasses using pharmaceutical agents or drugs to manage obesity in children. These interventions include prescription medications like orlistat for reducing fat absorption in the digestive tract or metformin to regulate blood sugar levels and treat obesity-related insulin resistance (Florencia et al., 2022). Other weight management medications may also be considered, although their use in pediatric populations is generally more limited and carefully monitored due to potential side effects. Comparing the effectiveness of these pharmacological interventions with comprehensive school-based nutrition and physical activity programs is essential to determine the most appropriate and beneficial approach to address childhood obesity.

Outcome of Interest (O)

The primary outcome of interest is the body mass index (BMI) percentile reduction. BMI percentile is a commonly used metric to assess and monitor children's weight status. Decrease in BMI percentile indicates positive change in weight status and reflect progress in preventing childhood obesity.

Timeframe (T)

The proposed timeframe for implementing and evaluating the comprehensive school-based program's impact on BMI percentile is 12 months. The duration ensures comprehensive assessment of intervention's effectiveness over reasonable period.

Conclusion

Childhood obesity is a growing public health concern with far-reaching consequences. It stems from energy imbalance and has intensified due to increased consumption of energy-dense foods and reduced physical activity, driven by societal changes. Childhood obesity exposes children to immediate health risks and sets foundation fo lifelong battle with obesity-related diseases in adulthood. Interventions for combating childhood obesity should consider the complex interplay of genetic, environmental, and behavioral factors. Addressing childhood obesity requires comprehensive strategies illustrated through the PICOT framework. The outlined PICOT question focuses on school-aged children and impact of comprehensive school-based nutrition and physical activity program on BMI percentile reduction over 12 months. The question is designed to guide research and evaluation efforts in determining effectiveness of such interventions in preventing childhood obesity. Comparing the approach with pharmacological interventions is critical in determining appropriate effective path forward.

References

CDC. (2022, August 29).
Preventing Childhood Obesity: 4 Things Families Can Do. Centers for Disease Control and Prevention. https://www.cdc.gov/nccdphp/dnpao/features/childhood-obesity/index.html

Florencia, M., Gonzalez, C., Hirschler, V., & Guillermo Di Girolamo. (2022). Pharmacotherapeutic options in pediatric obesity: an urgent call for further research.
Expert Opinion on Pharmacotherapy,
23(8), 869–872. https://doi.org/10.1080/14656566.2022.2050212

Fox, A., Feng, W., & Asal, V. (2019). What is driving global obesity trends? Globalization or “modernization”?
Globalization and Health,
15(1). https://doi.org/10.1186/s12992-019-0457-y

Lister, N. B., Baur, L. A., Felix, J. F., Hill, A. J., Marcus, C., Reinehr, T., Summerbell, C., & Wabitsch, M. (2023). Child and adolescent obesity.
Nature Reviews Disease Primers,
9(1), 1–19. https://doi.org/10.1038/s41572-023-00435-4

O’Brien, K. M., Barnes, C., Yoong, S., Campbell, E., Wyse, R., Delaney, T., Brown, A., Stacey, F., Davies, L., Lorien, S., & Hodder, R. K. (2021). School-Based Nutrition Interventions in Children Aged 6 to 18 Years: An Umbrella Review of Systematic Reviews.
Nutrients,
13(11), 4113. https://doi.org/10.3390/nu13114113

Smith, J. D., Fu, E., & Kobayashi, M. A. (2020). Prevention and Management of Childhood Obesity and Its Psychological and Health Comorbidities.
Annual Review of Clinical Psychology,
16(1), 351–378. https://doi.org/10.1146/annurev-clinpsy-100219-060201

van Sluijs, E. M. F., Ekelund, U., Crochemore-Silva, I., Guthold, R., Ha, A., Lubans, D., Oyeyemi, A. L., Ding, D., & Katzmarzyk, P. T. (2021). Physical activity behaviours in adolescence: current evidence and opportunities for intervention.
The Lancet,
398(10298). https://doi.org/10.1016/s0140-6736(21)01259-9

World Health Organization. (2021, June 9).
Obesity and Overweight. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight