Journal Entry

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Steve is now of the age in which he can be considered as an adult. Due to ASD, he has had very few friends in his life, and even though he wants to have some, this has proved to be very difficult for him. Steve has a speech problem, and he cannot communicate properly. When he tries to communicate to the best of his ability, Steve can only use simple words such as yes, no, and okay (Autism Society, 2018). These words are mostly passive, and thus Steve cannot start a conversation or express feelings to other people. Inability to start a conversation around the issues he feels like talking with other people makes him feel frustrated and useless while he is with other people (Diehl et al., 2016). As a result, he admitted to his therapist that he enjoys the company of himself with his phone as they understand each other well. 

Due to his communication defects, Steve finds his community a struggle to live in. as a child, some people used to call him stupid.  People have always looked at him negatively and do not expect much from him. This has made him feel like someone less when compared to other people of his age. Even in drawing, where he has shown great skills, the community does not offer him the opportunity to show his skills (Autism Society, 2018). His lack of emotional control has become trouble for everyone around him, especially those who do not understand him. His temperament, for example, made parents tell their children not to play with him. This left him with no option but to stay alone. Before the diagnosis of his condition, teachers used to send him out of the class whenever he would make some unusual noises in class, and other children would laugh at him (Diehl et al., 2016). This made him feel like he did not belong to a school. Even when he worked at the local stall, his lack of emotional control made him lose his job after he walked out without permission. 

With all these experiences, Steve feels as if it’s his problem that makes it hard to connect well with his people. His anger, complications in speech, making scaring noises as he sees it makes friends and the community fear him. However, it important that the community and friends are made aware that Steve has a condition that makes him the person he is. Therefore, other people need to understand. On the other hand, Steve needs to have some essential social skills that will help him connect well with others in society and maintain the relationship for a long time. 

 

References

Autism Society. (2018, July 18). Social/Relationships. https://www.autism-society.org/living-with-autism/autism-through-the-lifespan/adulthood/socialrelationships/

Diehl, S., Wegner, J., & Rubin, E. (2016). Children with autism spectrum disorders: Three case studies. The ASHA Leader, 15(1), 14-17. https://doi.org/10.1044/leader.ftr2.15012010.14

 

Katrina hits New Orleans

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Hurricane Katrina hit the city of New Orleans and the neighboring environs in August 2005 and was recorded as the fourth most intense to make fall in the United States. The category five Atlantic hurricane caused over one thousand eight hundred deaths and approximately one hundred and twenty-five billion dollars in the total property value that was damaged. Notably, most of the lives lost during the pandemic resulted from flooding caused by engineering flaws in the levees around New Orleans (Sandro, R Chris, Gruber, & T Jones, 2007). The flooding consequently destroyed communication and transportation networks in the city, leaving thousands of people stranded with little access to necessities such as food and shelter.  

In the aftermath of Hurricane Katrina, New Orleans got characterized by extensive reports of rape, looting, shooting against rescuers, and violence. While some of these crimes did happen, like Walmart’s total emptying, there were levels of exaggeration or only fabrication of these reports. The false statements included but were not limited to snipers taking potshots at rescuers on helicopters.  Reports indicated that gangs were roving New Orleans shooting at survivors and police officers. Notably, in the real sense, only one police officer got shot in the wake of Katrina, and the authorities did not induct the supposed gangs.  The looting cases happened as the many stranded survivors not evacuated in time scavenged for necessary supplies such as shelter, clothing, food, and water (Sean P, Schafer, Cancino, Decker, & Greene, 2010). The New Orleans sex crime unit investigations on rape found two verifiable cases of sexual assault. Additionally, there were rumors of significant chaos in the Superdome, which got dismissed later on as efforts to frustrate rescue missions worsening the survivors’ living conditions. Stories about many deaths in the Superdome got majorly exaggerated, and government officials expected many deaths. Only six people died: one suicide, one drug overdose, and four natural deaths. 

 

References

Galea, S., Brewin, C. R., Gruber, M., Jones, R. T., King, D. W., King, L. A., … & Kessler, R. C. (2007). Exposure to hurricane-related stressors and mental illness after Hurricane Katrina. Archives of general psychiatry, 64(12), 1427-1434.

Varano, S. P., Schafer, J. A., Cancino, J. M., Decker, S. H., & Greene, J. R. (2010). A tale of three cities: Crime and displacement after Hurricane Katrina. Journal of Criminal Justice, 38(1), 42-50.

Cardio exam questions

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Answer each question with 2-4 sentences. Be sure to give a brief answer without typing too much unnecessary information. Get straight to the point for each question. The document that I upload has to be answered as well. Cardiovascular system exam questions. How does blood pressure in the arteries compare to blood pressure in the veins? Briefly explain why very small organisms can survive without a circulatory system? Briefly explain the mechanism by which positive inotropic agents change cardiac output. Be sure to include how the relevant measures change( ESV or EDV, SV etc). Where are red blood cells formed in an adult? Where are they broken down? Imagine blood pressure were too high in the arterioles leading to a capillary bed. Briefly explain how the too high blood pressure would affect capillary exchange. Imagine the delay between the P wave and QRS complex increases. What could this indicate about the electrical system of the heart? A man has type AB blood and is Rh-positive. What blood types could he recieve? What blood types could he donate to ? How do the skeletal muscle pump help with the flow of blood and lymph? Describe the position ( open or closed) of all four heart valves just before the end of ventricular systole. Similarly describe the position of the valves just before end of ventricular diastole. Briefly describe the mechanism by which the baroreceptors reflex prevents orthostatic hypotension when you go from lying down to standing up. Describe the role of prothrombinase in the coagulation phase of hemostasis. How does lymphatic capillary differ from a continuous capillary? How does blood flow velocity in large artery compare with that in a large vein? Briefly describe what happens to the iron in hemoglobin when a red blood cells is broken down. Why is the SA node the pacemaker of the heart? Why not a location within the ventricles? Cardiac tamponade occurs when fluid and pressure builds up in the pericardial cavity. Briefly explain how cardiac tamponade would affect end diastolic volume. Briefly describe the structure of red blood cell. How does this structure help the red blood cell with its function? Briefly compare and contrast the properties of monocytes and neutrophils. Briefly describe the mechanism of platelet plug formation. Briefly explain why the heart can’t normally undergo a tetanic contraction, while skeletal muscle can. Briefly explain why vessel diameter is a better mechanism for controlling blood pressure than vessel length. How is the structure and function of the spleen similar to that of a lymph node? Briefly describe the flow of lymph through a lymph node.

Answer

 

Cardio Exam Questions

 

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Date 

 

Cardio Exam Questions

  1. How does blood pressure in the arteries compare to blood pressure in the veins? 

Blood pressure in the arteries has high pressure as it is carried away from the heart, while in the veins, it is low since the blood is taken to heart from the rest of the body. Therefore, arteries have thick walls, while veins have thin walls. 

  1. Briefly explain why very small organisms can survive without a circulatory system? 

Small organisms do not require an elaborate circulatory system as oxygen and carbon dioxide exchange occur directly between the environment and the body tissues. They possess an open circulatory system that contains a hemocoel cavity. 

  1. Briefly explain the mechanism by which positive inotropic agents change cardiac output. Be sure to include how the relevant measures change (ESV or EDV, SV, etc.). 

An increase in the concentration of intracellular calcium or sensitivity of receptor proteins to calcium results in positive inotropic agents is increasing myocardial contractility. Cardiac output as a result of positive inotrope can be calculated by multiplying the stroke volume SV, with the heart rate HR, i.e., CO = HR × SV. SV is measured by recording EDV and ESV and subtracting the two, i.e., SV = EDV – ESV

  1. Where are red blood cells formed in an adult? 

Red blood cells are formed in the red bone marrow of the bones of adults. Hemoblasts or stem cells in the red bone marrow provide all components of blood. 

  1. Where are they broken down?

They are broken down in the red bone marrow, where hemoblasts form proerythroblastt cells that develop into red blood cells.

  1. Imagine blood pressure was too high in the arterioles leading to a capillary bed. Briefly explain how the too high blood pressure would affect capillary exchange. 

When there is too much pressure in the capillaries, the capillary exchange would be disrupted, leading to the interference of the movement of substances in and out of the blood vessels. This would lead to the bursting of the capillaries as they are unable to handle the pressure due to the thin walls they have. 

  1. Imagine the delay between the P wave and QRS complex increases. What could this indicate about the electrical system of the heart? 

The deflection of the P wave is an indication of right and left atrial depolarization. QRS complex causes depolarization of the right and left ventricular. 

  1. A man has type AB blood and is Rh-positive. What blood types could he receive? 

The man can only receive blood from all positive blood types, which include A+, B+, AB+, and O+. The donors must be Rh-positive for their blood to be compatible with that of the man. 

  1. What blood types could he donate to? 

He can donate blood to people with only blood group AB+. He is a universal receiver but not a universal donor. 

  1. How does the skeletal muscle pump help with the flow of blood and lymph? 

Skeletal muscles contract and relax and thus aid in the flow of blood in the venous. Their rhythmic movements are increased by a person engaging in an exercise. 

  1. Describe the position (open or closed) of all four heart valves just before the end of ventricular systole. 

During ventricular systole, the aortic and pulmonic valves are open to allow blood to flow into the aorta and the pulmonary artery. The atrioventricular valves are closed so that blood does not flow back into the ventricles.

  1. Similarly, describe the position of the valves just before the end of the ventricular diastole. 

The aortic and pulmonary valves are closed in the ventricular diastole. The atrioventricular valves are opened for blood to be pumped into the ventricles. 

  1. Briefly describe the mechanism by which the baroreceptors reflex prevents orthostatic hypotension when you go from lying down to standing up.

When you stand up, the baroreceptor reflexes are quickly activated to bring back the arterial pressure. When standing, the arterial pressure is maintained by increasing the systemic vascular resistance and heart rate while decreasing stroke volume and venous compliance. This helps to prevent orthostatic hypotension. 

  1. Describe the role of prothrombinase in the coagulation phase of hemostasis.

Prothrombin is a Vitamin-K dependent coagulating element that is activated proteolytically to release thrombin. Thrombin acts as a serine protease that converts fibrinogen into fibrin, which aids in coagulation through platelets and other factors. 

  1. How does a lymphatic capillary differ from a continuous capillary? 

The lymphatic capillaries are slightly bigger than continuous capillaries. They have close ends, while blood capillaries have loop structures. They only allow an inward flow of interstitial fluids. Lymphatic capillaries have their endothelial cells on the walls overlapping, unlike the continuous capillaries. 

  1. How does blood flow velocity in a large artery compare with that in a large vein?

In large arteries, blood is under high velocity as it is being pumped by the heart to reach all parts of the body. In the veins, the velocity is slowed by capillaries during the exchange and thus flows slowly back to the heart. 

  1. Briefly describe what happens to the iron in hemoglobin when a red blood cell is broken down. 

When a red blood cell is broken down, the iron in it is collected by protein transferrin and taken to the bone marrow. In the bone marrow, the iron is reused for the production of new red blood cells.  

  1. Why is the SA node the pacemaker of the heart? 

Cells in the SA node are able to naturally generate electric impulses. The continuous generation of the electric impulses helps in the formation of a normal rhythm of the heart at a constant rate when healthy. This is why the SA node is referred to as the pacemaker of the heart. 

  1. Why not a location within the ventricles? 

This is because the ventricles in the heart are not used in the pumping of blood as all the work of contraction and expansion is found in the articles. The sinoatrial node is located in the right atrium, where it produces electric impulses to aid in the pumping of blood. 

  1. Cardiac tamponade occurs when fluid and pressure build up in the pericardial cavity. Briefly explain how cardiac tamponade would affect end-diastolic volume. 

Cardiac tamponade would result in decreasing cardiac output. This is due to a decrease in the return flow in the venous, and the diastolic volume in the chambers is reduced. 

  1. Briefly describe the structure of a red blood cell. 

The red blood cells or erythrocytes have a disk-shape/biconcave appearance. They are circular with a thin center and thick periphery. 

  1. How does this structure help the red blood cell with its function? 

The biconcave shape helps erythrocytes in creating more space for hemoglobin molecules, which are used in the transportation of gases in the body. The shape also helps in increasing the surface area for gas exchange.

  1. Briefly compare and contrast the properties of monocytes and neutrophils. 

Bothe monocytes and neutrophils are phagocytes. They are essential in fighting diseases. When they get into tissues, they can be turned into macrophages, which eat things. In contrast, neutrophils are phagocytes and not antigens, while monocytes act as antigens. Neutrophils have a busy nucleus and granules, while monocytes have a horseshoe-shape nucleus and greyish cytoplasm. 

  1. Briefly describe the mechanism of platelet plug formation. 

Platelet plug formation happens before fibrin mesh for clotting is created but after vasoconstriction of blood vessels. It causes blood to coagulate when there is an injury resulting in a clot. 

  1. Briefly explain why the heart can’t normally undergo a tetanic contraction, while skeletal muscle can. 

This is because the heart is made of cardiac muscles whose cell membrane is different from that of skeletal muscle fiber. The cardiac muscles are unable to undergo tetanic contraction, and this is advantageous to the heart to keep it pumping blood. 

  1. Briefly explain why vessel diameter is a better mechanism for controlling blood pressure than vessel length. 

Vessel diameter helps in controlling blood pressure, where it increases pressure as it decreases in size. In the capillaries, there is more pressure to increase exchange. An increase in length only lowers pressure

  1. How is the structure and function of the spleen similar to that of a lymph node? 

The spleen filters old blood cells from the blood similarly to how the lymph node filters the lymph. Structurally, the spleen is like a giant lymph node but contains only the efferent lymph vessels. 

  1. Briefly describe the flow of lymph through a lymph node.

The lymph enters the lymph node via the afferent vessels. This is taken through the cortex, paracortex, and the medulla of the lymph node before exiting on the other side through the efferent vessels. There are more afferent lymphatic vessels entering the lymph nodes than the efferent lymphatic vessels leaving. 

 

Assessment Paper for Community Health Nursing

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Submission should be a 2000 words in length and should completely answer the proposed questions/items as listed under “Overview″. You should have a minimum of three (3) references. APA formatting is required and all responses should be combined into a single document for submission. Use the rubric as a guide for the evaluation method of the project.
I live in New York City  FYI because i know it is a community assessment  

Answer

 

Community Assessment of New York City

 

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Community Assessment of New York City

Different individuals and communities across the globe experience various issues based on their location, political, economic and social conditions as well as the availability or access to public support services. Community assessment defines the process conducted to identify the assets, strengths, needs and challenges of a specific community within a city or region (Smathers and Lobb, 2020). Assets, in this case, refer to the talents, skills, and abilities of different individuals and also resources that local institutions and organizations provide for the community. By assessing the community needs, an individual or a leader understands the sectors that should be improved and how and which area need more resources, whether it is the entire city or one neighborhood. It also helps to engage the community members and potentially establish new community partnerships. This case will focus on assessing the community needs, mainly health needs, in the community in New York City.

Defining the Community

 New York City (NYC) or simply New York is one of the largest and most populous cities in the United States. By 2019, it had an estimated population of almost 9 million individuals, though this number has significantly dropped because of the coronavirus infections. The city occupies about 302.6 square miles or 784 kilometres squared. It is located in the Southern tip of U.S. state of New York and is at the centre of New York metropolitan area, the biggest metro area globally by urban mass. According to Kang et al. (2020), the city has five counties and 59 community districts, and demographics and health disparities vary significantly across the city. Some neighborhoods are wealthy with better houses and facilities, while some are poorly managed and developed.   The city has been described as the financial, culture, and media capital worldwide profoundly influencing entertainment, commerce, technology, research, education, art, tourism, sports, and fashion. The headquarters of the United Nations is also in New York. The city has a diverse population with multiple ethnic groups with whites as the main residents in New York, with over 10 million individuals. Hispanics and Latinos are about 3.7 million, while African Americans are approximately 2.7 million (Duffin, 2020). There are also about 1.6 million Asians and approximately 42,000 America Indians. 

Education in New York is provided in a vast number of public and private schools, where some schools offer scholarships to students from all over the world. It has some of the best schools, libraries, universities and research centres globally. These are many well educated with Bachelors and Masters degrees. Thus, they can get good positions in some of the biggest companies in the city. The birth rate in the city by 2016 was at 58.6 per 1,000 women between 15 to 44 years. There were 117,013 live births in 2017, according to the New York Department of Health and Mental Hygiene (2017). The death rates decreased from 575.4 to 545.7 per 100,000 individuals. Currently, the city is experiencing higher death rates because of Covid-19, especially among individuals between 45 to 74 years old (Elflein, 2020). A significant number of individuals in the city have health insurance as long as they have different documents such as social security members to show that they are residents in New York City and citizens of the United States of America. The city offers low-cost health insurance programs, including Medicaid for individuals and families with low income and Child Health Plus insurance for children under 19 years. There Qualified Health Plans is private insurance, for individuals in New York State who are not eligible for Medicaid. New York has a large population, and the minimality of resources could lead to various health problems for different individuals. The community assessment, in this case, aims to assess the health needs in the community in New York City. This assessment can be used to inform decisions made for the health sector in the city. The information will be obtained from online sources and also from research through windscreen surveys and focus groups. 

Assessment

New York City is one of the most expensive cities in the world where living standards and health costs are significantly high. Sales of homes in the United States has increased, especially in big cities such as New York. This leads to financial constraints for individuals with low incomes leading to many individuals not gaining access to certain health care services which results in more chronic illnesses and minimal functioning in the community. In essence, the environment in which individuals are born into, lives and works profoundly influences their health and overall life expectancy. The populations in New York contain some of the most marginalized groups most likely to experience poverty. Individuals living in poverty experience continued exposure to harmful substances which lead to cycle-driven health equity challenges and illnesses, including poor birth outcomes, diabetes, airways problems, heart diseases and hypertension. 

More precisely, according to the Centres of Disease Control and Prevention (CDC), 2019), heart disease and cancer are some of the leading causes of deaths in the population in New York followed by accidents and chronic diseases including diabetes and hypertension. In 2017, 44,092 individuals died from heart disease while 34,956 died from cancer (CDC, 2019). More individuals also die from stroke, pneumonia, Alzheimer’s disease and septicemia. Currently, the leading cause of deaths is the coronavirus with thousands dying from the disease every day. Nevertheless, the United States had been working on the Healthy People 2020 initiative, which aims to improve and build a healthier nation (Centres for Disease Control and Prevention, 2018). This initiative could help to solve some of the leading health issues in New York. 

One of the airways or respiratory issues experienced by the people in New York is asthma. Asthma is also chronic and affects about 170,000 children in the city (DiNapoli, 2014). It is the leading cause of inpatient admissions. Nonetheless, there are barriers to treating asthma, especially among homeless or undocumented individuals. Mental disorders are also common health issues in this community caused by genetic or environmental factors such as trauma and stress. As a highly developed and expensive urban area, some of the common problems contributing to the increased mental health issues include poverty, discrimination due to gender, race, or socioeconomic status and noise and air pollution. There are over one million individuals with mental illnesses, collective of general anxiety disorder, schizophrenia, bipolar disorder, major depressive disorder, and obsessive-compulsive disorder. These issues significantly affect the health, lives and overall wellbeing of the community. Increased stress and poverty levels have also driven many New Yorkers to abuse drugs and alcohol. This behavior has increased homelessness, poverty, violence both at home and on the streets and various substance use disorders. 

Additionally, more than a third of the overall adult population in New York has pre-diabetes or Type 2 diabetes, and the numbers increase yearly. This health problem is common in the city due to the increased number of the aged population, obesity and inadequate physical activities among New Yorkers (Thorpe et al., 2018). The disease is most common among Hispanics and Blacks who pay little attention to their lifestyle, mainly their eating behaviors. Another health concern is the rapidly increasing ageing population in New York. By the age of 65, most of the individuals in this group have chronic illnesses which increase the risk for mobility and cognitive decline. Older individuals also experience other complexities around their financial and living situations that may significantly impact their health. The above health concerns create the need for the city and community to develop strategies to improve the overall health of individuals and reduce mortality rates in the city. Public health agencies in the U.S. find it challenging to allocate funding and resources in different cities and neighborhoods. Resource allocation is crucial to public health policy since it involves managing and improving the health of individuals. It is even more difficult for bigger cities like New York, where funds are minimal but more health concerns. According to Kang et al., 2020), the NYC Department of Health and Mental Hygiene (DOHMH) uses a local approach to address public health concerns at the neighborhood level. The above data and severity of specific health concerns inform on the allocation of resources in the community districts. 

Assessed Community Health Needs

The increasing aging population continues to be a health concern for the community in New York City as it leads to other issues including diabetes, hypertension, decreased mobility, cognitive decline and other physical conditions that hinder individual normal functioning. As illustrated above, other health concerns in New York City include heart diseases, obesity, alcohol and substance abuse disorder, cancer, asthma, diabetes, stroke, accidents, pneumonia, hypertension, diabetes, Alzheimer’s diseases, mental disorders and septicemia. Though birth rates are relatively high, death rates are much higher due to the increased health problems and different kinds of accidents that cause injuries and death. Also, populations in New York experiencing most of the health problems are adolescents and youths, individuals with food insecurities, domestic violence survivors, homeless individuals, immigrants with no insurance or access to health care services, incarcerated individuals and gender variant individuals facing discrimination in the community. The city must address the above issues impacting the lives of individuals in the community to improve the overall health in the community. Facilities such as the NYC Health + Hospitals can help to identify and address the health issues experienced in the community.

Data Generation

Windshield Survey

A windshield survey refers to an informal survey where health professionals drive around a specific community they are researching and record their observations. A windshield survey was used to collect relevant data on the growing and already developed neighborhoods in New York City. From the observations, there are many ongoing construction sites within the city, with new neighborhoods, apartments and homes being built. Buildings, including office and apartment buildings, are closely built in modern styles and materials such as glass and bricks. The streets are well maintained, but some neighborhoods have more wastes, mainly near manufacturing industries, hospitals and factories. Burning these waste materials have led to air pollution, causing asthma. There are also liquor stores and food trucks within the city. Thus, how can individuals experience healthy changes when they are only exposed to alcohol, bad quality food and cigarettes. 

From the observations, there are more wheelchairs on the driveways than bicycles. This means that at least one individual in a home uses a wheelchair due to deteriorated health or from aging. Lack of enough exercises through running and cycling has also led to poor health in the community. The city is also densely populated with many unemployed and homeless individuals seen sleeping on the streets and shelters. Most of these individuals cannot afford health care costs, leading to more chronic and mental health cases from stress and unhealthy diets. The survey showed that there are multiple health care facilities, including general hospitals and private clinics. Nonetheless, health care is costly, and the many low-income families cannot afford it worsening their health conditions. These facilities, however, greatly helps to improve the overall health of the community through charity programs and accepting low-cost insurance programs, including Medicaid.

Focus Groups

The research used focus groups of seven individuals from different neighborhoods within the city to get clear insights into the issues affecting the community and how the authorities have responded to those issues. From the findings, about 50% of the participants complained of being in poor health in most time of the year. The research shows that some of the significant health issues include obesity in youths and adults, which leads to other problems such as diabetes and heart diseases. Hence, many individuals are using canes and walkers by the time they reach 60 years. Many children are also obese, which significantly affects their health and functioning. About 70 percent of the participants in the focus groups complained of the increased asthma cases in the city caused by air pollution from increased construction sites and waste gases from the factories. Asthma patients are treated in the hospitals and discharged, but when they go back home, they are exposed to dust and other triggers, making the condition even worse. Also, economic pressures experienced by many New Yorkers from job loss leads to stress and other mental issues and ultimately violence and family breakdown since the household cannot keep up with the increasing living expenditures and expensive housing. The participants claim that they have seen their neighbors becoming homeless after losing their jobs. Homelessness is also another factor that substantially influences the health of individuals, mostly psychologically or mentally and emotionally.

Conclusion 

New York City is one of the biggest cities, not only in the United States but also the world. Although there have been great advancements in the health of New Yorkers, not all individuals or groups have access to quality health services, leading to poor health outcomes in the overall community. Some of the common problems affecting the community include heart disease, asthma, hypertension, diabetes, obesity, substance use disorders, mental illnesses, cancer and different kind of accidents. Nevertheless, these conditions can be prevented and managed to improve the community’s health outcomes. The city should raise awareness on the importance of maintaining healthy lifestyles to avoid health issues such as obesity and diabetes. Also, it should provide free health care services to enable homeless and low-income families to gain access to quality health care services to reduce the occurrence rates of chronic illnesses to reduce the mortality rates in the city. In a time when the city is highly affected by coronavirus disease, the public health facilities backed up by the CDC should provide sufficient protective gears such as face masks to minimize the spread of the virus. Fundamentally, the state should develop better strategies to improve the health of individuals from different neighborhoods within the city regardless of their socio-economic backgrounds or ethnicity.

 

References

Centres for Disease Control and Prevention. (2018, October 31). Healthy people 2020. Centres for Disease Control and Prevention. https://www.cdc.gov/dhdsp/hp2020.htm

Centres for Disease Control and Prevention. (2019, September 12). Stats of the State of New York. Centres for Disease Control and Prevention. https://www.cdc.gov/nchs/pressroom/states/newyork/newyork.htm

DiNapoli, T. P. (2014). The Prevalence and Cost of Asthma in New York State. New York State Comptroller.

Duffin, E. (2020, September 15). New York: Population, by race and ethnicity 2019. Statista. https://www.statista.com/statistics/306042/new-york-population-ethnicity-race/

Elflein, J. (2020, November 8). New York: COVID-19 death rate by age group. Statista. https://www.statista.com/statistics/1109867/coronavirus-death-rates-by-age-new-york-city/

Kang, J. X., Seligson, A. L., & Dragan, K. L. (2020). Peer-Reviewed: Identifying New York City Neighborhoods at Risk of Being Overlooked for Interventions. Preventing Chronic Disease, 17.

New York City Department of Health and Mental Hygiene, Bureau of Vital Statistics, Summary of Vital Statistics (2000-2017); retrieved from https://www1.nyc.gov/assets/doh/downloads/pdf/vs/2017sum.pdf

Smathers, C., & Lobb, J. (2020). Community assessment. Ohioline. https://ohioline.osu.edu/factsheet/CDFS-7#

Thorpe, L. E., Kanchi, R., Chamany, S., Rodriguez-Lopez, J. S., Chernov, C., Freeman, A., & Perlman, S. E. (2018). Change in diabetes prevalence and control among New York City adults: NYC Health and Nutrition Examination Surveys 2004–2014. Journal of Urban Health, 95(6), 826-831.

 

Financial Projections: Descriptions

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Yummy’s Financial Projections: Descriptions

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Financial Projections: 5 Year Profit Projection

In the next five years, sales for yummy are expected to increase gradually from $1,500,000 in 2021 to $2,120,965 in 2025, while gross profit will follow the same growth trend. Operating expenses will be averagely at the same level with an increase and decrease at the same pace. However, in 2022, the total expenses are predicted to surpass other prior and preceding years. In 2022 the total expenses will be $552,875 due to a massive salary increase (office and overhead). Salary might increase due to inflation, and interest rates rise caused by economic downtowns and recovery injection from COVID-19 pandemic. Overall, the net operating income will increase gradually but will be higher in 2024 than in other years. The five-year financial projection for Yummy holds a lot of expansion and feasibility hopes. 

Balance Sheet (projected)

In the balance sheet, Yummy’s current assets, fixed assets, other assets, and liabilities and equities will increase by more than 80% from 2021 to 2025. The increase is related to Yummy continuous acquisition of physical and liquid assets, efficient repayment of long term and short term debts, reduction of debts, and increase in revenue and net profit as the company hosts more investor and expand internationally by 2025. 

Cash Flow Statement (12 months)

The cash flow statement for 12 months represents an illustration of how the money will flow in and out with different expenses and inventory costs. In the cash flow, cash sales will record a continuous growth trend from the initial startup date to the end of 2025. There are numerous fluctuations in the cash flow for cash paid out since the cash flow statement represents monthly transactions, which are harder to use when making predictions than quarterly cash flow statements. However, the monthly presentation is relevant so that financial and investor can study the forested circulation of liquid assets in and out of the organization. This will aid them in decision making amid investing since monthly statements show a more precise and convincing picture. In conclusion, the financial projection shows both negative a positive financial side of Yummy in the next five years. However, the positive side of the financial projections is very feasible. 

Health Promotion

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 Please see attached instructions. Apa format, I need 600 words, and one reference from the Kaakinen book, and 3 peer reviewed articles, no older than 2015. I also need an intro paragraph about what the paper is about, and then a conclusion please.

Answer

Health Promotion

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Health Promotion

Health promotion is an essential part of nursing. Through health promotion, patients suffering from chronic diseases can be able to cope with the illness. Diabetes is one of the chronic illnesses that records a high percentage of patients, especially from the ageing population (Pham & Ziegert, 2016). It is a disease that results in high blood sugar. People who have diabetes have difficulty producing insulin in their bodies, or their bodies fail to utilize it efficiently. This paper will look into three ways in which to promote the health of a patient who has diabetes and the family dealing with the special illness. 

The health of patients with diabetes can be promoted by educating patients and relatives. They require education from nurses on maintaining difficult lifestyle changes. Patients who have diabetes need encouragement to maintain a healthy diet and engage in physical activity. Family of the patient can promote the health of the patient by changing their diet (Kaakinen e al., 2018). The patient can also be encouraged to follow their prescriptions and follow the doctor’s advice. The family dealing with the special illness can also be educated on the health of the patient and self-care. According to Martire & Helgeson (2017), family members are influential in managing the chronic illness of the patient. Therefore, they require the proper education on how to assist the patient manage the disease, such as the patient adhering to medical regiments.

Creating a positive relationship with the patient can promote the health of the patient. It is essential to practice personalized, patient-centred psychological care through effective communications and interaction (Young-Hyman, 2016). Having a close relationship with the patient makes it possible to connect to the patient and facilitate communication. Through such a positive relationship with the patient, it is possible to understand the mental and physical health conditions of the patient, which makes it easier to address each needs to promote health. The right approach can also be taken on how to deal with family members. It includes how they can play a part in promoting the health of the patient.

Supporting the patient to take part in their social context can promote health (Pham & Ziegert, 2016). it involves encouraging the patient to get close to the community and engage in conversations with other patients who are suffering from diabetes. The patient will be able to take part in activities that allow them to be active such as joining clubs. Such clubs can bring together diabetes patients and engage in conversations that will give them hope and encouragement as they continue with their treatment. Support from society therefore plays a vital role in health promotion. Relatives can also be encouraged to engage the patient to take part in activities within the community to promote the health of the patient. Families of patients who have diabetes can also participate in social activities alongside the patient, especially since most of the diabetic patients are the elderly.  

In conclusion, nurses play an essential role in health promotion of patients suffering from chronic illnesses. Health promotion in a patent suffering from diabetes is essential to ensure that the patient records and improvement in their health. The families of patients with diabetes require proper education since they spend most of the time with the patient. Because most diabetic patients are the elderly, relatives require guidance on how to promote the health of the patient. Diabetic patients, as well as their families, need encouragement and support to cope with the illness. It is also important to create a positive relationship with the patient for effective health promotion. For diabetic patients, it is vital to maintain a healthy diet and engage in physical activities.

References

Kaakinen, J. R., Coehlo, D. P., Steele, R., & Robinson, M. (2018). Family health care nursing: Theory, practice, and research. ISBN 978-0803661660. F.A.Davis Company, 2018, 6th edition.

Martire, L. M., & Helgeson, V. S. (2017). Close relationships and the management of chronic illness: Associations and interventions. American Psychologist, 72(6), 601.

Pham, L., & Ziegert, K. (2016). Ways of promoting health to patients with diabetes and chronic kidney disease from a nursing perspective in Vietnam: A phenomenographic study. International journal of qualitative studies on health and well-being, 11(1), 30722.

 Young-Hyman, D., De Groot, M., Hill-Briggs, F., Gonzalez, J. S., Hood, K., & Peyrot, M. (2016). Psychosocial care for people with diabetes: a position statement of the American Diabetes Association. Diabetes care, 39(12), 2126-2140.

BYD Case Study Analysis Homework help

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QSO 300 Milestone One: BYD Case Study

 

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Southern New Hampshire University

 

Date


Milestone One: BYD Case Study

Introduction 

The BYD case reflects the company strive towards dominating the electric automobile industry through its revolutionary battery innovations. The Chinese company is focused on becoming the leading and the largest electric automakers in the world. It has presented the market competition by other battery manufacturers and the issues they are facing in their operations. The case is fairly simple for a middle-level student to easily read and understand within a single lecture. 

Generating Value

  1. Evaluate how the company in the case study uses operations management functions to provide products and generate value for its customers. Support your claims with examples from the case study or outside sources.   

Through reverse engineering of the Japanese batteries, the founder of BYD came up with a more cost-efficient battery. The company is able to produce batteries at a lower cost of production, thus enhancing operations. Its customers benefit from cheaper but good batteries for their electric vehicles. Through its operations management, BYD has been able to produce ferrous lithium-ion batteries, which are safer to the environment than other lithium batteries. This is beneficial to the customers as they keep their environment cleaner. The company planned to produce cheaper electric cars that have higher mileage. For instance, the cheaper version is expected to be between $23,000-$25,000 with a 100-mile range, which will save a lot for the consumers (Rarick et al., 2011). The operation management managed to develop products that were cost-effective to both the company and its customers. 

  1. Assess how this company achieves a competitive advantage using operations management. Provide examples found in the case study or outside sources to support your reasoning. 

The BYD company achieved its competitive advantage through several ways aided by its operations management. First, it was able to make cheaper ferrous lithium-ion batteries that its competitors were unable. This made it easier for the company to move a bit faster in the production of electric cars. Another reason is because of using the public stock offering on the Hong Kong Stock Exchange, which helped in the rapid growth of the battery business due to adequate capital (Rarick et al., 2011). The production of dual-mode cars boosted the company’s competitiveness. The cars could run on electricity up to approximately sixty miles before switching to gasoline, and this was a cost-saving to consumers. 

  1. Compare and contrast service operations and manufacturing operations at the company in the case study. How are they the same? How do they differ? How does each of these operations provide value for their customers? 

Manufacturing operations deal with the production of goods and their storage before being delivered to the consumers. Service operations focus on facilitating the production and consumption of services, and they cannot be stored for future use. Both the service and manufacturing operations fall under operation management (Olsen, 2011). Some of the manufacturing operations at BYD include the manufacture of ferrous lithium-ion batteries and electric cars such as the F3DM and e6 (Rarick et al., 2011). The service operations are offered by the company through its headquarter in Shenzhen and the two offices in America. Customers can reach out to the company through the offices and get assistance. 

Theories and Techniques

  1. Compare and contrast the critical path method (CPM) and the program evaluation and review technique (PERT). What types of projects at this 
company would favor PERT over CPM? Why? What types of projects at this company would favor CPM over PERT? Why? 

Program evaluation and review technique (PERT) is used in projects that have no definite time for the completion of given activities. Pert analysis is calculated while considering optimism (O), pessimism (P), and most likely (M) factors. The formula for calculating time, in this case, is (P+4M+O) (Liu, 2013). BYD should use PERT in the battery production project. It cannot be determined exactly when there will be the most efficient battery for the car. The critical path method (CPM) is used in projects which have recurring events that can be predicted when to end. CPM follows several steps, which include specifying every activity, develop activity sequence or dependencies, draw a network diagram, estimate completion time for each activity, identification of the critical path, and finally updating the critical path diagram (Moghayedi, 2016). All the steps must be followed, respectively. CPM can be used in the production of the e6 car model, which was estimated to be completed by the end of 2009. 

  1. Explain the steps used to develop a forecasting system. How would these steps be specifically utilized by this company? What do you predict 
would be the result of implementing a forecasting system for the top-selling product line at this company? 

The first step in a forecasting system is the identification of the problem. The company has to identify a market gap where there is a need to be satisfied (Von Plate et al., 2020). The collection of information step follows, and where the data may not be available and hence the need to gather information. If the data is available, it can be analyzed. BYD must venture into the market and listen to what the consumers want. The next step is a preliminary analysis of the data. This will help BYD to determine its viability in the project. Then, a forecasting model is chosen. This model can either be qualitative or quantitative to determine the possible outcomes. Data analysis follows where a suitable method can be used. The next step is a validation of results where the forecast is compared to the actual data. Lastly is the utilization of the forecast if it is in line with the actual data (Von Plate et al., 2020). This gives the company the green light to proceed.

List the major categories of supply chain risk and associated risk-reduction tactics. How could the company mitigate exposure to supply chain 
disruptions caused by natural disasters? For example, consider the 2011 earthquake and tsunami that devastated parts of Japan. 

  • Strategic risk: This involves determining the appropriate supply chain management strategy (Ritchie, 2005). It can be mitigated by forming the right upfront strategy and identification of the right suppliers. 
  • Market risk: Involves factors such as the brand, compliance with regulations, capital, and exposure to the market. It can be mitigated by strategically identifying a product demand in the market, its quality regulations, impact anticipated, and the requirements needed to introduce the product (Khan & Zsidisin, 2012). 
  • Performance risk: Entails the financial and supplier issues that face the company. Choosing a supplier is one thing as progress is what matters most (Ritchie, 2005). The company must ensure that it constantly monitors the suppliers so that they do not cause any disruptions to the production line. 
  • Implementation risk: This involves the enactment of the agreement with the suppliers and performance incline. It is important to evaluate the suppliers early to determine any risks that may arise due to their performance (Khan & Zsidisin, 2012). 
  • Demand risk: It involves the challenges and fluctuations in the demand and inventory of the company. The market demand may fluctuate, and this should be in consideration when planning. Some suppliers may be enthusiastic but be opportunistic and fail to deliver (Khan & Zsidisin, 2012). Therefore, there needs a closer watch at their performance and regular check of the inventory to prevent losses. 

Supply chain disruptions by natural disasters are difficult to control. However, with proper early planning for any eventualities, the company would be in a better position to handle the challenge. Proper inventory keeping and regular monitoring of the suppliers would ensure that natural disasters have a lower impact on their performance. 

Conclusion 

The BYD company had a great vision of becoming the leading manufacturers of electric cars in the world. Their operations management enabled them to overcome the competition by developing cheaper batteries that were efficient. With strong financial support, they were able to grow rapidly and come up with better and cheaper cars. Its future is promising as it continues to employ newer and advanced technology in the batteries for electric vehicles. 

 

References

Khan, O., & Zsidisin, G. (2012). Handbook for supply chain risk management. J. Ross Pub.

Liu, M. (2013). Program Evaluation and Review Technique (PERT) in Construction Risk Analysis. Applied Mechanics And Materials, 357-360, 2334-2337. https://doi.org/10.4028/www.scientific.net/amm.357-360.2334

Moghayedi, A. (2016). Improving Critical Path Method (CPM) by Applying Safety Factor to Manage Delays. Scientia Iranica, 23(3), 815-826. https://doi.org/10.24200/sci.2016.2161

Olsen, T. (2011). The manufacturing and service operations management (MSOM) society. Wiley Encyclopedia of Operations Research and Management Science. https://doi.org/10.1002/9780470400531.eorms0894

 Rarick, C. A., Firlej, K., & Angriawan, A. (2011). BYD of China: Electrifying the World’s Automotive Market. Journal of the International Academy for Case Studies, 17(1), 19-27.

 Ritchie, B. (2005). Supply Chain Risk Management. The International Conference On Business & Technology Transfer, 2004.2(0), 8-23. https://doi.org/10.1299/jsmeicbtt.2004.2.0_8

Von Plate, M., Kirschnick, F., & Heggemann, J. (2020). Get Ready for Forecasting! The 7 Steps for Success with Prognostics. Findanyanswer.com. Retrieved 2020, from https://findanyanswer.com/goto/174462.

 

Marketing Presentation Speakers notes

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  Based on Order 2817821 , the paper and Presentation done, I need full speakers notes for. They need to be thorough and discuss each point. Make sure it is not a matter of just reading off the slide. Plus I need a conclusion slide added in the last slide The slides that will need notes speakers notes for are: – Technology – Branding and Marketing – Restaurant Set up and Design – Shareholder Info – Competitors Strategy in the Last 4 years  – Competitor – PESTEL

Answer

 

 

 

Chipotle Mexican Grill, Inc. – with speaker notes

Portfolio cover letter

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Student’s Name

Professor’s Name

Course

Date

 

Dear UB Writing Program Facility,

I am writing in advance about an upcoming course, WRIT 300. Throughout the fall, I have been taking WRIT 200, with one lesson every week, for the past two to three months. Many issues and materials were covered in this course including analyzing various writing genres to developing in-depth citations, to meet the intended learning outcomes. This is a rather important course that most students should take to get critical skills in learning. Being an introductory course, WRIT 200 helps students, such as myself, develop certain skills, employ critical reading and thinking, and learn how to use different texts to acquire relevant knowledge for a specific subject. More importantly, we had several assignments to complete, each aiming to meet certain objectives and learning outcomes. 

The first assignment in the WRIT 200 course was about discourse community. Particularly, students analyzed and described the discourse community of their chosen professions to know about their professions and succeed. My discourse community is insurance. More precisely, my discourse community involves giving insurance policies to different people where they pay as individuals or businesses to receive financial protection or reimbursements during a crisis or disaster from an insurance company. In this assignment, students were asked to demonstrate extensive knowledge and understanding of their discourse community through continuous reading, writing, and thinking. The knowledge required in this case went beyond the definition but to the specific activities performed by the discourse community. Here, the assignment presented some questions that needed further explanations on how an individual can become an exclusive member of a particular discourse community, the values and attitudes needed to succeed, and how to associate with individuals in that particular discourse community. This assignment introduced the course and each student’s profession, similar to the foundation for the course and the final portfolio. For the first assignment, we were also asked to develop a training guide or handbook for new members in specific professions or careers to prepare individuals in the discourse community more efficiently. It helped me to familiarize with the course and improve my critical thinking and general writing styles. 

The second assignment in WRIT 200 involved writing a rhetorical analysis report. More precisely, it involved finding and rhetorically analyzing two different articles about a similar topic. This assignment was quite challenging. We had to look for two articles where one was intended to be read by the general public and the other by experts or professionals in a particular profession. In my experience, getting the article specifically intended for professionals in the insurance discourse community was rather difficult, but I was successful in the end. This task was challenging, but it showed me that determination and dedication are crucial factors that help individuals get what they want and succeed in their studies. In this assignment, we were to identify and analyze each of the selected articles using the rhetorical categories, which included the purpose, audience, tone, genre, and context. More importantly, we explored these categories and showed how writing to specific experts varies from writing to a general audience. Through this assignment, I achieved certain learning outcomes and learned how to read, write and analyze various texts written for different purposes, audiences and genres. Typically, this course’s second assignment was to help students identify, analyze, and compare the rhetorical features of different sources within and outside an individual’s profession. It helped students and readers know and understand the writing conventions used in different fields. More importantly, it furthered my understanding of multiple rhetorical situations and enhanced my writing and public speaking skills when addressing different audiences.

In my view, WRIT 200 is a challenging class but also an important course in the learning process. It has introduced us to critical ways of researching, thinking, analyzing, and reviewing different texts. Another difficult task in the course was creating an annotated bibliography and an executive summary. This assignment specifically was six pages, where I wrote four pages for the annotated bibliography and one single-spaced page or two double-spaced pages for the executive summary. Particularly, the assignment involved choosing any current issues or problems within our discourse community. My annotated bibliography focused on articles about the challenges facing the success of insurance services. I used five reliable articles from different sources, two of which gave an overall background about the topic. The rest gave specific details about the challenges facing the success of insurance services. I summarized and analyzed each article illustrating each source’s rhetorical situation, including the audience, purpose, and context. We also reflected on how the sources fit into the research purpose and the rhetorical situation context of an individual’s discourse community. This assignment was time-consuming and difficult since it required in-depth research and analysis. Nonetheless, it helped me to significantly prepare for the next course, WRIT 300, by enabling me to meet certain learning outcomes including writing, reading, and research and discovery. Through this assignment, I enhanced my skills and knowledge on how to cite different sources appropriately for different sources, and it improved my research skills, especially on the internet.

Fundamentally, WRIT 200 introduced students to different learning outcomes met by the end of the course. One of the learning outcomes that I acquired during this course was reading and writing, which are crucial in different social processes. I also learned how to give critical feedback to other students using various strategies for ethical incorporation. Students from the same discourse communities attended workshops. Feedback was also provided in the workshops and after every assignment—this improved communication between students and the instructors. Giving and receiving feedback helped me reflect on the skills that I have attained and those I need to improve. Working in groups improved student interactions and enhanced individuals’ understanding, knowledge, and learning outcomes. Consequently, this course has helped me improve my interaction and teamwork skills, and now I can work well with other students to achieve different learning outcomes.

My experiences and achievements in WRIT 200 make me an ideal candidate for the WRIT 200 course. In essence, my experiences at schools and learning outcomes achieved in different courses, mainly WRIT 200, gives me confidence that I am ready to start WRIT 300 as soon as possible. The skills and knowledge challenged and tested in this course have prepared me to be a suitable candidate for WRIT 300. Also, I believe that my current knowledge and skills will help me to participate accordingly and succeed in WRIT 300 as well as create a strong foundation for my career. With this in mind, I look forward to being in WRIT 300, where I will deal with various challenges encountered in the course using my current knowledge and skills.

In case you have any questions or want more information about my skills, experience and career achievements, you can contact me any time through (e-mail).

 

                                                                                                               Sincerely (Name)

Psychology Child Obesity Guam

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American Medical Association (AMA) writing and citation format a. Spacing: single-space b. Margins: 1” c. Font: Size 12, Times New Roman d. Indents: ½ e. Page numbering: Each page, beginning with title page, should be numbered consecutively at the upper right corner f. References: Reference entries should be listed and numbered in the order they are cited in your paper. If the citation extends to a second line, do not indent (as in APA). Example below. II. 7-8 pages (not including title page) III. Minimum of 10 resources/references IV. Title page format Please look at pdf as well for further details.

Answer

 

Child Obesity Guam

Student’s Name

Institutional Affiliation

Instructor

Course

Date

 

Child Obesity Guam

Introduction

As the world fights child malnutrition, and the number of children faced by malnutrition is reducing, childhood obesity is turning into a global issue. Globally, more than half a billion adults with the prevalence rate being 10% men and 14% in women. In the year 2008, compared to the 1980 prevalence, which was 5% in men and 8% in women1. In the US, it is estimated that child obesity is around 17%. According to a study by the University of Guam, more than 27% of kids aged between 2 and 8 were obese or overweight by August 2020. Children who are obese are at a higher risk of becoming overweight adolescents and adults, putting them at a higher risk of developing chronic diseases such as hypertension and diabetes in their life later on2. Many causes of child obesity are preventable and changeable, and they include physical inactivity and unhealthy eating habits. Other factors that are not preventable include genetic factors and medical conditions, including hormonal problems. Medical tests and sample blood tests are effective in testing for medical conditions as a cause of obesity. Suppose a combined effort by various stakeholders is not put in place. In that case, the cases of childhood obesity will continue to rise, and the prevalence of chronic infections will also increase among children and young adults in Guam.

Description of The Issue

Guam is a territory of the US that is located in the Northwestern Pacific Ocean. Chamorros are considered the native ethnic group of Guam, although Guam consists of various ethnic groups3.  A large study was undertaken to look at the intensity of childhood obesity in Guam.  The study, which was named “Overweight and Obesity Prevalence Among Public School Children in Guam,” was conducted by John Hopkins University after law 28-87 in 2005 was passed, allowing the department of health to take the BMI measurements of all school-going children in Guam. The five-year study results indicate that Guam has a higher obesity rate compared to the rest of the US. Researchers in this study indicated that Guam was a center of interest in childhood obesity and overweight, bearing in mind that globally, 10% of the children are overweight. In comparison, 2-3% are obsessed4. Guam is far from the worldwide and national statistics as with 15-16% of the childhood overweight and an overwhelming 19-27% rate of obesity. Even though the average of obesity among children declined from 23.6% to 22.6%, it is still too high3. Later on, in 2015, the University of Guam conducted another study that indicated that the child obesity rate was 27%, which was still high.

EXPOSURES:

 Physical Inactivity

Technology has changed how things used to be done in the past, which has greatly affected how people associate. In the past, people used to visit each other and go for walks with their children. During their free time, children also used to go out and play, which would make them physically active5. The current society of computers and smartphones has changed this. Children now spend all their days on the couch, their eyes stuck on the TV or computer, playing computer games and watch movies and other entertainment materials. However, what parents fail to recognize is that they put their children at risk of becoming obese. According to the CDC, a child between the age of 3-5 years should be active throughout the day for growth and development. Children and adolescents aged 6-17 years should be active for one hour or more6. CDC posits that children and adolescents between the ages of 6-17 should spend around 1 hour in moderate to vigorous physical activities. Other activities such as running and jumping, which strengthen the bones, should be incorporated for their days a week. Other activities such as climbing and doing push-ups should be done three days a week as they strengthen the muscles and cut the number of cholesterols in the body significantly.

The study by the University of Guam found that 85% of Guam children spend more than the tow hour recommended screen time. The averages screen time was 5 hours, which was also comparable with other regions in the US. Inadequate physical excises could cause a high rate of obesity in Guam and other parts of the world5. The neighborhood’s traditional view has been eliminated, and now children do not share playgrounds as they used to do before. In this case, parents are required to ensure that their children are physically active by encouraging them and engaging them in those activities such as going for a walk, hiking, and playing. However, most parents are busy at work, and when they arrive home, they have no time to play with the children or enquire if the children played during the day. Therefore, children spend all day doing their days doing their favorite things, which are mostly physically inactive6. It is also argued that the more time children spend in the house and close to food, the more they are prone to eating a lot of food, which contributes to them getting overweight.

Poor Diet 

One factor that researchers from the University of Guam fear could be the high cases of obesity in Guam among the children involved in the study is unhealthy eating habits. It is established that the number of calories that a person eats impacts their weight directly7. If a person consumes enough calories that the body can burn out, then that person’s bodyweight stays stable. However, if a person takes more calories than the body requires, then the bodyweight goes up. The type of food also determines the weight of a person. Some foods that prevent people from getting chronic diseases such as diabetes and hypertension are also believed to be good in weight control, and they include foods such as whole grain and vegetable fruits and nuts1. Some other types of foods are known to increase the weight of a person and, at the same time, increase the chances of developing a chronic infection, and they include processed foods and sugary foods.

Among the children involved in the study, 83% of them consumed sweet and sugary beverages, while the recommended consumption is zero6.  80% of the population in Guam considers itself as westernized. The children who participated in the study and hailed from these families consumed high fats and sugars, and processed foods. In the study’s findings, this eating behavior increased the chances of becoming overweight for these children.

Low Socioeconomic Status 

 Healthy foods are usually priced higher than unhealthy foods, and this poses a major challenge to poor families in the US and the western world in general. As a result, the rate of obesity is increasing rapidly among the poor who are being forced to eat unhealthy foods due to pricing. On the other hand, the rich afford healthier food such as fresh vegetables and fruits and enjoy food that is homecooked2. The poor cannot afford the fruits and vegetables and thus opt for processed foods and beverages. According to a study carried out in 2010, the poverty levels in Guam were 22.50%, and this meant that the number of people living below the poverty line of 5.55% was also high. It means that in this population of 22.50% of the total Guam population cannot afford to put healthy food on their tables. As a result, more than 58% of the children who the University of Guam study established had bad eating habits were from poor backgrounds, and around 80% of them were under government aid3. 

Dietary Factors

Children are dependent on their parents for their diet, and when parents give them anything, children get used to it, and it becomes daily food. Parents in the western world are too busy making money to forget that they are the guardians of what their children eat. Children have, therefore, become dependent on packed foods for most of their meals8. Research has indicated that over the past four decades, consuming fast foods outside the home has increased significantly. Even when children go out with their parents, they always tend to eat fast food, which is unhealthy and puts them at the risk of obesity due to the increased energy density of fast foods.

In relation to poverty, the parents in Guam find themselves trapped by poverty to take foods that they can afford, which are processed foods. They cannot afford natural and healthy foods to cook for their families, and thus they have no option but to feed their children on fast foods, which increase their BMI5. With the high levels of poverty in Guam, children are more likely to be fed on donated packed foods, and when parents buy food, they buy them packed foods also, which could be the cause of the high rate of obesity.

Environmental Factors

Food availability is linked to the availability of food stores in an area. In this line, if the only food stores in an area only serve fast foods, then the area’s population may be forced to opt for the available fast foods. The term food deserts have been used to describe the areas that do not have places such as supermarkets to access healthy foods9. Food deserts vary significantly depending on the neighborhood, social, economic status of an area, and racial composition. Fast foods have been attributed to the rising levels of obesity both in children and in adults. Some areas in Guam that are affected by poverty could be possible food deserts, which could also be another factor leading to the high rate of childhood obesity.

Significance

If no control measures are put in place, then the numbers of childhood obesity will continue to rise. Childhood obesity comes with several risks, such as developing chronic infections such as high blood pressure and diabetes. A child who is obese could get some breathing problems and asthma9. Sleep apnea, which disturbs the child’s sleeping process, has also been linked to obesity. Children who are obese are also more likely joint and muscle problems as they struggle to maintain a large bodyweight. Several psychological problems have also been linked to obesity, including anxiety, low self-esteem, stress, and depression resulting from bullying and stigma by other children7. If the children in Guam are allowed to continue with the unhealthy lifestyles, they are more likely to jump into adulthood with obesity increasing the number of adults with obesity. Even if the child does not develop any complications as a child, the chances of developing the same as an adult are also high. Therefore, the situation of child obesity in Guam must be taken seriously, and affirmative action is taken.

Proposals

Children’s Healthy Living Program for Remote Underserved Minority Populations in the Pacific Region, which is sponsored by the government of Guam, University of Guam, and all schools, is a program that aims at identifying children with a weight problem and formulating possible interventions for them 10. Under this project, Guam’s government coordinated the walk for the wellness program, which was aimed at instilling the walking habit among Guam residents, which would also have a direct impact on the children.

Guam’s government can also help in a significant way as far as the issue of child obesity is concerned. Schools could be offered lunch which could be made of healthy foods. In a similar vein, schools could initiate physical exercise classes for all students. As this issue goes beyond the school, it is important that the community is educated about child obesity, how to prevent it, how to help children already affected, and its effects. With awareness, people are more likely to put measures that will help curb the rate of childhood obesity.

Conclusion

Childhood obesity is an issue that requires a multifaceted solution, and thus various stakeholders need to chip in and do their part. Childhood obesity in Guam is more worrying as it is higher than the national and global rates. Various causes, such as genetics, unhealthy lifestyles, and medical conditions. However, key among the causes of childhood obesity is an unhealthy lifestyle. Children in Guan are exposed to obesity due to physical inactivity due to more screen time and less play. Poor diet leading to accumulation of calories. Poverty, environmental, and dietary factors are also probable causes of childhood obesity. If no action is taken, there is a possibility of the children affected. Those that will be affected in the future will develop some complications either as children or later in life. Therefore, a program to create awareness on the issue should be initiated, and the people educated on it.

 

      

 

    References

  1. https://www.guampdn.com/story/life/2020/10/05/uog-study-more-than-25-guam-kids-obese-overweight/5892189002/
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4503469/
  3. https://medicalxpress.com/news/2020-10-underreported-overlooked-severity-childhood-obesity.html
  4. http://sf-nutrition.org/wp-content/uploads/2017/12/stateofobesity2017.pdf
  5. https://www.uog.edu/news-announcements/2018-2019/2019-uog-program-to-prevent-childhood-obesity-in-guam-earns-award.php
  6. https://www.cdc.gov/physicalactivity/basics/children/index.htm
  7. https://www.uog.edu/news-announcements/2018-2019/2019-uog-program-to-prevent-childhood-obesity-in-guam-earns-award.php
  8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3005637/
  9. https://www.euro.who.int/__data/assets/pdf_file/0004/98302/WS_115_2000FE.pdf?ua=1
  10. https://www.kuam.com/story/29261453/2015/06/Monday/guams-child-obesity-rate-higher-than-national-average