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.)
Incorporate a minimum of 2 current (published within the last five years) scholarly journal articles or primary legal sources
Caring for American Eskimo, Japanese, and Russian Populations
Bermadean Mends
St Thomas University
NUR-505-AP2
Dr. Marcia Derby-Davis
1/25/2023
Caring for American Eskimo, Japanese, and Russian Populations
The role of nurses in the healthcare industry is of great importance as we offer vital services such as compassionate care, advocacy, and health education to patients. As a nurse, I am dedicated to providing culturally competent, empathetic care that considers each patient’s needs. Cultural sensitivity is a fundamental aspect of nursing practice that emphasizes the importance of compassionate and patient-centered care. Especially as a nurse, it is imperative to acknowledge and respect patients’ diverse cultural backgrounds to ensure positive health outcomes. Providing culturally sensitive care involves an in-depth understanding of individuals’ health perceptions and behaviors influenced by their values, beliefs, and traditions.
List factors that predispose Eskimos to risk as a result of the consumption of large quantities of sugar.
The traditional Eskimo diet, which mainly consisted of fish, meat, and fat, has undergone significant modifications in recent times. Nowadays, the Eskimo population relies more heavily on processed and sugary foods, which can harm their health diets (DiNicolantonio, 2016). This is particularly concerning because the Eskimo community has a genetic predisposition that makes it difficult to adapt to high-sugar diets (DiNicolantonio, 2016). Eskimos have historically had high exposure to sugary foods, and this, combined with genetic variations in metabolic pathways, may increase their risk of developing obesity, type 2 diabetes, and cardiovascular diseases (DiNicolantonio, 2016). Therefore, promoting healthier eating habits among the Eskimo communities is essential to improve their overall health and well-being.
Analyze different strategies useful in communicating with the Japanese American family.
When interacting with Japanese American families, it is crucial to acknowledge and honor any cultural subtleties that may be present. These families prioritize maintaining familial unity and may communicate respectfully (Miyawaki, 2016). As a nurse, it is critical to actively listen, remain non-confrontational, and employ indirect communication techniques to establish trust and encourage open dialogue. By recognizing the importance of family dynamics and incorporating them into the care plan, nursing practice can become more culturally competent and effective. When working with Japanese American families, it is essential to understand and respect the cultural subtleties that may be present (Miyawaki, 2016).
In Japanese American families, the eldest male member often serves as the head of the household and makes decisions on behalf of the family (Miyawaki, 2016). Therefore, involving him in the care plan and seeking his input is essential. Japanese American families also emphasize respect, humility, and politeness. It is necessary to avoid interrupting or contradicting them and always address them with appropriate honorifics. In addition, Japanese American families may have unique health beliefs and practices that must be considered when developing a care plan (Miyawaki, 2016). For example, they may prefer traditional herbal and acupuncture treatments. It is important to understand these preferences and work with the family to incorporate them into the care plan whenever possible.
When caring for a Russian American client, for the most part, at what distance would a Russian patient feel at most ease?
When caring for Russian American patients, paying particular attention to their personal space and comfort zones is crucial. Unlike some Western cultures, Russians tend to prefer a closer interpersonal distance (Ivanov & ???????, 2021). As a nurse, it is important to understand and respect these preferences to establish a positive relationship. When interacting with a Russian American client, it is advisable to maintain a moderate distance and prioritize their comfort. It is crucial to be mindful of their nonverbal cues and signals and to let them determine the appropriate distance based on their personal preferences. If you are unsure, it is appropriate to ask if the distance feels comfortable for them politely (Ivanov & ???????, 2021). Nurses can create an environment that promotes ease and comfort during care interactions by being mindful of the patient’s nonverbal cues and adjusting physical proximity accordingly. This cultural sensitivity improves patient satisfaction and fosters trust between the nurse and Russian American patients, ultimately enhancing the overall quality of care.
Nurses play a multifaceted role that goes beyond their medical knowledge. They are expected to possess cultural competence, which allows them to interact effectively with patients from diverse backgrounds. Effective communication is another critical aspect of their job, as it helps them to establish meaningful connections with patients. Additionally, personalized care is a crucial factor that nurses consider while interacting with patients. By embracing these aspects, nurses can navigate the complex landscape of patient populations and promote positive health outcomes.
References
DiNicolantonio, J. J. (2016). An increased intake of refined carbohydrates and sugar may have led to the health decline of the Greenland Eskimos: Table 1. Open Heart, 3(2), e000444. https://doi.org/10.1136/openhrt-2016-000444
Miyawaki, C. E. (2016). Association of filial responsibility, ethnicity, and acculturation among Japanese American family caregivers of older adults. Journal of Applied Gerontology, 36(3), 296319. https://doi.org/10.1177/0733464815581484
Ivanov, V. G., & ???????, ?. ?. (2021). Modern Development Problems of Russian Healthcare (Part 1). Studies on Russian Economic Development, 32(6), 631639. https://doi.org/10.1134/s1075700721060058
Caring for American Eskimo, Japanese, & Russian Populations
Viviana Maleno
St. Thomas University
NUR505: Diversity in Advanced Health Practice
Professor Marcia Derby-Davis
January 25, 2024
Caring for American Eskimo, Japanese, & Russian Populations
Multiple factors create amplified vulnerability for Eskimos to diabetes and obesity when incorporating diets high in sugar and refined carbohydrates. These include genetic predispositions exaggerated by dietary changes, decreases in traditional livelihood activities, and a hasty nutrition transition in recent decades from traditional foods to processed, store-bought foods (Johnson et al., 2021). Research shows Native groups like Alaskan Eskimos have a higher prevalence of variations in genes related to diabetes risk, insulin resistance, and fat metabolism compared to Caucasian populations. For centuries, the traditional Eskimo diet consisted mainly of protein and fat-dense animal foods including fish, whale blubber, seal, caribou, and birds with very little sugars or refined carbs; the glycemic level was low.
Key factors that predispose Eskimos to health risks resulting from high sugar consumption according to Howard et al. (2021):
Genetic predisposition to diabetes – Native groups like Eskimos have a higher prevalence of genetic variants that increase diabetes risk. Consuming high amounts of sugar and refined carbs can expose this genetic susceptibility.
Transition from traditional to Western diet – Traditionally, Eskimos relied on protein/fat-rich animal foods with limited refined carbs. A nutrition transition to refined, processed foods high in sugar has occurred in recent decades (Johnson et al., 2021). This drastic change to high glycemic load diet increases diabetes risk.
Decreased dependence on livelihood activities – More sedentary lifestyles due to less time spent on hunting/fishing decreases physical activity levels. Less activity plus high sugar intake noticeably raises diabetes likelihood.
Strategies for Communicating with Japanese American Families
Effective communication strategies with Japanese American families, as outlined by Leininger and McFarland (2019), include several key considerations. Firstly, it is central to demonstrate respect for family hierarchy and roles. This involves recognizing the authority of elderly family members in decision-making and engaging the head of the household as a representative. Secondly, practitioners should approach non-verbal communication cautiously, taking into consideration cultural sensitivities. Mannerisms such as direct eye contact or noticeable facial expressions may be perceived as rude or aggressive, highlighting the need for cautious use of non-verbal cues. Lastly, the discussion with extended family members is emphasized. In Japanese American culture, important healthcare decisions often involve input from broader family and community connections. Enabling and respecting this group-oriented choice process is essential for effective communication in this context.
Preferred Personal Space for Russian American Clients
Russian American patients would be comfortable with an intimate personal space distance of around 1.5 to 2.5 feet, and this conveys involvement on their part during patient-provider interactions. The further away one is standing, the more impressions of emotionlessness or disinterest are felt but coming closer may feel intrusive. This reflects Russian culturally embedded customs of close spaces, compared to the larger private distance usually favored by Americans (NarioSee, 2022). Position yourself near patients to demonstrate your interests, care, and attention. Similarly, slightly leaning forward indicates participation. There is also the element of touch, such as gently tapping someone on the arm or back when possible and appropriate to the context and relationship. It is also good, especially with Russian American patients to invite conversation and address the emotional aspects of health, not just physical. Being intimately close while not overstepping boundaries and involving verbal and nonverbal cues will aid in building a therapeutic rapport.
References
Howard, B. V., Lee, E. T., Cowan, L. D., Devereux, R. B., Galloway, J. M., Go, O. T., Howard, W. J., Rhoades, E. R., Robbins, D. C., Sievers, M. L., & Welty, T. K. (1999).
Rising tide of cardiovascular disease in American Indians. The Strong Heart Study. Circulation, 99(18), 23892395. https://doi.org/10.1161/01.cir.99.18.2389
Johnson, J. S., Nobmann, E. D., & Asay, E. (2021). Factors related to adiposity in Alaskan Eskimos of Northwest Alaska. International journal of circumpolar health,
71(1), 1700425. https://doi.org/10.1080/22423982.2020.1700425
NarioSee, J. (2022). Doing business in Russian: Everything you need to know about Russian business culture. Language Trainers USA Blog.
https://www.languagetrainers.com/blog/russian-busi…
Leininger, M. M., & McFarland, M. R. (2019). Culture care diversity and universality: A worldwide nursing theory. Jones & Bartlett Learning.
Module 3 Discussion- Affordable Care Act (ACA)
Ana Miller
St. Thomas University
NUR 506: Influencing Health Policy
Dr. Oliveira
January 22, 2024
Affordable Care Act (ACA)
The Affordable Care Act (ACA) was enacted in 2010 to expand coverage and improve the quality and the cost of healthcare. Also, it was aimed to improve healthcare value, reduce unnecessary spending, increase access to care, and enforce strategic investments in public health (Walker et al., 2022). The ACA is also known as Obamacare. It aims to make healthcare more accessible and affordable in the United States. The ACA has components that have a positive effect on improving healthcare outcomes and decreasing costs.
The Patient Protection and ACA was signed in 2010 to improve access to healthcare through expanding insurance options, including the expansion of Medicaid (Le & Holmes, 2023). The expansion of Medicaid helps more low-income individuals obtain access to healthcare services. The ACA protects these individuals by preventing insurance companies from denying coverage or charging higher premiums based on any pre-existing health conditions. This expansion aimed at providing Medicaid to low-income individuals who may have not qualified or gained access to essential healthcare services. While the ACA, as passed, required all states to expand Medicaid, a 2012 Supreme Court decision allowed states to opt out of the expansion, providing a natural experiment permitting examination of the downstream effects of health insurance on health, health care, and social well-being (Himmelstein, 2019). Each State had a choice to expand Medicaid and the goal was to reduce the level of uninsured Americans.
The ACA emphasized the strong importance of preventative care so that early detection of health issues could be identified and lead to better health outcomes. Regular primary care appointments keep people healthier and benefit patients, which also benefits the health system in terms of decreasing cost and utilization (Hostetter et al., 2020). This preventative approach leads to cost savings by reducing the need for more expensive treatments in the future. The ACA also includes a set of essential health benefits that insurance plans must cover. This promotes comprehensive healthcare as individuals have access to necessary services and reduces potential long-term costs related to untreated conditions.
The ACA promotes the formation of accountable care organizations (ACOs). This encourages healthcare providers to coordinate care with each other more effectively. This team effort can lead to better management of their mutual patients. This can further decrease costs as these patients may experience better management of chronic illnesses which reduces hospital readmissions. The formation of ACOs ultimately focuses on care coordination and avoids unnecessary and expensive medical interventions. Furthermore, the ACA supports reimbursing healthcare providers based on the quality and outcomes of care rather than the quantity of services provided.
Although the ACA aimed at expanding healthcare insurance and coverage for low-income Americans, many individuals faced increased healthcare costs and higher premiums. A third of adults purchasing health insurance through the ACAs marketplaces reported difficulty affording insurance premiums, as did over one-sixth with employer-based insurance (Persad, 2023). The ACA required most Americans to have health insurance, or they faced paying a penalty. The ACA had positive intentions of expanding coverage and improving healthcare access, but it was a very controversial law that not everybody benefited from.
References
Himmelstein, G. (2019). Effect of the Affordable Care Acts Medicaid expansions on food security, 20102016. American Journal of Public Health, 109(9), 12431248. https://doi.org/10.2105/AJPH.2019.305168
Hostetter, J., Schwarz, N., Klug, M., Wynne, J., & Basson, M. D. (2020). Primary care visits increase utilization of evidence-based preventative health measures. BMC Family Practice, 21(1), 110. https://doi.org/10.1186/s12875-020-01216-8
Le, A., & Holmes, J. A. (2023). Changes in receipt of adjuvant brachytherapy for endometrial cancer patients before and after Affordable Care Act: The impact of Medicaid expansion. Journal of Contemporary Brachytherapy, 15(3), 206211. https://doi.org/10.5114/jcb.2023.127838
Persad, G. (2023). Defining health affordability. Iowa Law Review, 109(1), 241297. https://search.ebscohost.com/login.aspx?direct=tru…
Walker, V., Ruley, M., Nelson, L., Layton, W., & Coustasse, A. (2022). The effect of the Affordable Care Act on Medicaid payments in long-term care facilities. International Journal of Healthcare Management, 15(1), 6269. https://doi.org/10.1080/20479700.2020.1843886
Week 3 Discussion Post
Alexandra Perkins
St. Thomas University
NUR 506: Influencing Health Policy
January 25, 2023
The Affordable Care Act, also known as Obama Care, came into effect on March 23, 2010. The Affordable Care Act is a United States healthcare reform law that is aimed at increasing the affordability of healthcare for US citizens. The main goals of the Affordable Care Act are to provide affordable health insurance plans for more people, provide coverage for pre-existing conditions and Medicaid expansion (Ercia, 2021).
There are many key components that are a part of the Affordable Care Act that can improve healthcare outcomes and decrease costs. This first component is the health insurance mandate that required United States citizens to obtain health insurance, or they pay a penalty come tax time. Mandating US citizens to have health insurance takes the load off the community when paying for uninsured persons medical bills.
Another component of the ACA is the online marketplace. Individuals and businesses can shop around online and compare different plans and coverages. This provides transparency among health insurance companies and allows for consumers to make the best choice possible for coverage. Preventative services are also required to be covered by insurance. This promotes early detection for diseases such as cancer, which allows for early treatment. Early cancer treatment is often much cheaper than chemotherapy or surgery when the disease process is detected much later. This also leads to better outcomes as catching cancer early leads to more effective treatment and remission.
One of the most beneficial aspects of the Affordable Care Act is the mandating of coverage for pre-existing conditions. This component of the ACA covers those citizens who have pre-existing conditions such as diabetes or cancer. These patients may not have had coverage during their diagnosis and now are trying to obtain insurance to cover their treatment. This aspect of the ACA prevents health insurance companies from denying coverage or increasing premiums for these patients soley based on their pre-existing diagnoses (Huguet et al., 2021).
The Affordable Care Act allows dependents to stay on their parents health insurance plans until the age of 26. Especially in the current economic position that we are in today, allowing young adults to stay insured under their parents ensures that these young adults have coverage. Most people under the age of 26 are starting out in their careers and do not have the extra funding to pay for health insurance coverage. They also may forgo health insurance, seeing it as an unnecessary expense due to them viewing themselves as healthy. This leads to a complicated situation in the case of an accident or diagnosis of an illness that was not expected.
References
Ercia, A. (2021). The impact of the Affordable Care Act on patient coverage and access to care: perspectives from FQHC administrators in Arizona, California and Texas. BMC Health Services Research, 21(1). https://doi.org/10.1186/s12913-021-06961-9Links to an external site.
Huguet, N., Schmidt, T., Larson, A. E., OMalley, J., Hoopes, M., Angier, H., Marino, M., & DeVoe, J. E. (2021). Prevalence of pre-existing conditions among community health center patients with COVID-19: Implications for the Patient Protection and Affordable Care Act. Journal of the American Board of Family Medicine, 34(Supplement), S247S249. https://doi.org/10.3122/jabfm.2021.s1.200571Links to an external site.
