Discussion W11-12 652 – 2025 Instructions for Discussion Replies to 6 DQS DO NOT JUST REPEAT SAME INFORMATION DO NOT JUST SAY I

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Discussion W11-12 652 – 2025

  

Instructions for Discussion Replies to 6 DQS

DO NOT JUST REPEAT SAME INFORMATION, DO NOT JUST SAY I AGREE OR THINGS LIKE THAT. YOU NEED TO ADD NEW INFORMATION TO DISCUSSION.

1- Each reply should be at least 200 words.

2- Minimum One Peer reviewed/scholarly reference ( NO MAYO CLINIC/ AHA)

3- APA 7th edition style needs to be followed.

4- Each response should have reference at the end of each reply

5- Reference should be within last 4 years

Evidence Base Nursing Research Paper PICO Format – 2025 Hi Can you write an Evidence Based Practice and Applied Nursing Research paper In PICO format

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Evidence Base Nursing Research Paper PICO Format – 2025

Hi Can you write an Evidence Based Practice and Applied Nursing Research paper. In PICO format Must use 1 research article and 1 non research article.

Here is a list of topics to consider. Patient education OR Exercise and balance to prevent falls Music therapy OR Aromatherapy OR Guided Imagery OR art therapy to lower patient anxiety Palliative care education OR early use of palliative care to improve the quality of care at the end of life Early Skin to skin to promote breastfeeding compliance Skin to skin OR early skin to skin to improve temperature regulation of newborn Music therapy OR Aromatherapy OR Guided Imagery OR art therapy to lower patient anxiety Prophylactic/preventative dressings OR PU education to nurses to prevent pressure ulcer Heart failure education OR telehealth follow up to prevent 30 day HF readmissions Mindfulness education OR self-care education OR use of mindfulness to reduce nurse burnout Mindfulness education OR self-care education OR use of mindfulness to reduce turnover rates Opioid education OR prescription naloxone take home kits to lower opioid abuse Hand hygiene compliance OR Hand Hygiene education to patients to reduce HAI Care bundles OR external female catheters to reduce CAUTI

Attached is the requirements and course rubric

Questions Preparatoir – 2025 Find below are short answer questions no references needed Exam preparation Respiratory

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Questions Preparatoir – 2025

Find below are short answer questions , no references needed. Exam preparation:

  Respiratory:

1. Review respiratory anatomy. 

2. Describe the usual order of exam and normal exam findings.

3. What sounds would you anticipate hearing during a normal exam, and where would you expect to find them?

· Vesicular

· Bronchial

· Bronchovesicular

4. What are signs of respiratory distress?

5. Describe anatomical changes seen as a result of longstanding respiratory disorders.

6. Describe tactile fremitus

7. Describe sounds heard as you percuss the chest. What sounds do you expect to find in a normal exam, and where do you anticipating hearing them?

8. Describe adventitious breath sounds. Crackles fine/coarse, wheezes, rhonchi. Identify some conditions where you would hear these findings.

9. What is the significance of testing for egophony? Whispered pectoriloquy?

  Charting Pediatric milestone:

1. Describe what subjective data means. Identify examples.

2. Describe what objective data means. Identify examples.

3. What goes where in your note? Where would you document these findings?

· LCTAB

· Pt denies headache

· FSBS done in office 128

· 10 yo female c/o ear pain x 2 days

· A1C last month 6.4

4. Consider important pediatric developmental milestones. Arrange the following milestones in order of when they occur — earliest to latest. Be familiar with anticipated timeframes of developmental milestones.

· Imitate sounds

· Walk

· Sit up

· Ride bicycle

· Ride tricycle

· Smile

· Roll over

5. Normals for basic vitals measurements across the lifespan

6. T, P, R, BP, BMI

 HEENT: 

1. Review recording of subjective and objective findings for HEENT.

2. Consider the usual order of exam for HEENT. What changes in the usual order would you anticipate based on the age of the patient or based on the presenting complaint?

3. Review usual findings of the HEENT exam. What changes are seen for younger or older patients?

4. How do you perform the Weber test? What’s the normal result? Explain what changes to the normal findings would indicate.

5. How do you perform the Rinne test? What’s the normal result? Explain what changes to the normal findings would indicate.

6. Make a chart for grading tonsils. List the grade and what that grade represents.

7. Review anatomy of sinuses and where they are located.

8. Review Snellen test results. What does 20/20 mean? 20/40? 20/10?

9. What options are available instead of the Snellen to test visual acuity for younger children?

10. Review fundoscopic exam findings. What is normal? What might the absence of a red reflex indicate? 

11. Describe the appearance of a cataract.

T3Q1 – 2025 Compare vulnerable populations Describe an example of one of these groups in the United

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T3Q1 – 2025

Compare vulnerable populations. Describe an example of one of these groups in the United States or from another country. Explain why the population is designated as “vulnerable.” Include the number of individuals belonging to this group and the specific challenges or issues involved. Discuss why these populations are unable to advocate for themselves, the ethical issues that must be considered when working with these groups, and how nursing advocacy would be beneficial.  

Compare The Physical Assessment Of A Child To That Of An Adult. – 2025 Topic 2 DQ 2 Physical health assessment is a structured physical examination

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Compare The Physical Assessment Of A Child To That Of An Adult. – 2025

 Topic 2 DQ 2

Physical health assessment is a structured physical examination that allows a nurse to obtain a complete assessment of the patient’s health status. Typically, the techniques that should be applied to the physical assessment process: Are — inspection, palpation, percussion, and auscultation (Registered Nursing, 2021).

Before the actual physical assessment, the patient undergoes an interview to collect medical information. While this might be an easy process for adults and older children, getting information from a young child requires a lot of strategies and patience (Registered Nursing, 2021)

To get information from young children, the nurse would have to rely on their mothers to provide the data while at the same time engaging the child by talking to him/her through the interview process. The nurse must develop a good rapport with the child to gain his/her full Cooperations; listening and using appropriate communication techniques are essential in this process. A calm and reassuring manner of the nurse will help to gain a child’s confidence; use Suitable toys or other aids can be used to help the child interact with the nurse (Registered Nursing, 2021)

During the interview, the nurse can begin by asking the child trivial questions like his/her name, favorite food, cartoon character, etc., and then subtly lead to the questions that might help assess the child’s health status.

In the case of adults and older children, the interview can begin directly. When it comes to physical examination of the body, again, the approach will have to be different for a young child than an adult or older child. A child might not like someone else touches him/her. The nurse will have to win the trust, and the parent will have to be there to reassure the child. If the child is in pain, then examining that part of the body might be a bit more complicated, but again tactics and communication skills of the nurse will help (Registered Nursing, 2021).

For grown-ups, the physical examinations will be much easier because they know what is happening and why it is happening. On the other hand, a young child might be scared of the instruments used to examine them. The nurse should engage in active listening with an adult patient while paying attention to verbal and nonverbal cues. Ask open-ended questions that would allow the patient to detail the actual symptoms needed to ascertain what is happening to the patient. (Walden University, 2021) Be empathetic with an adult patient by saying you understand what he/she is going through so that you can gain his/her trust in the interview process. The nurse can also validate and reassure the patient that their problems would be addressed while in your care. Another strategy is transitions and empowerment of the patient in the interview process to help alleviate their fear of the unknown in the current health issues(Walden University, 2021).So, physical assessment of a child will differ from an adult intact, but the techniques are the same.

Respond to the above post using 200-300 words APA format with reference by supporting the discussion.

 Compare the physical assessment of a child to that of an adult. In addition to describing the similar/different aspects of the physical assessment, explain how the nurse would offer instruction during the assessment, how communication would be adapted to offer explanations, and what strategies the nurse would use to encourage engagement. 

Epidemiologic Measurement In Population Health Outcomes – 2025 Epidemiologic Principles and Measures Used to Address the Practice Problem Chronic obstructive pulmonary disease

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Epidemiologic Measurement In Population Health Outcomes – 2025

 

Epidemiologic Principles and Measures Used to Address the Practice Problem

     Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death on a global scale and in the United States (U.S.) (National Heart, Lung, and Blood Institute, 2021; Alwashmi et al., 2020; Bhansali et al., 2020; Ammary-Risch et al., 2019).  Between 2016 – 2017, the global prevalence of COPD was approximately 300 million (Ferguson et al., 2020; World Health Organization, 2017).  Identified as the fourth leading cause of death in the U.S., COPD claims the lives of 150,000 people every year (National Heart, Lung, and Blood Institute, 2021; Ammary-Risch et al., 2019).  Additionally, women are now found to be equally or more afflicted than their male counterparts and also make up almost 60% of COPD cases (National Heart, Lung, and Blood Institute, 2021; Centers for Disease Control and Prevention, 2018d; World Health Organization, 2017).  A significant risk factor often associated with COPD is smoking.  Cigarette smoking has been noted as the greatest factor in the development of COPD (Duan et al., 2020).  Air pollution has been noted as the second biggest contributor to COPD development (Duan et al., 2020). 

Use of Descriptive and/or Analytic Epidemiology to Address the Practice Problem

     The research consensus reveals that millions of people suffer from COPD in the U.S. and that number is expected to rise as many more suspected COPD sufferers remain undiagnosed, as well as those with continued exposure to toxins, an aging population, and others with long-term respiratory ailments (Ferguson et al., 2020; Ammary-Risch et al., 2019; Centers for Disease Control and Prevention, 2018d; World Health Organization, 2017). Age-adjusted death rates in women living in the U.S. have not changed greatly between 1999 and 2014 and are 35.6/100,000 from 35.3/100,000 (Center for Disease Control and Prevention, 2018b). Whereas the age-adjusted death rates in men living in the U.S. have decreased between 1999 and 2014, and are estimated at 44.3/100,000 from 57.0/100,000 (Center for Disease Control and Prevention, 2018b).

     Florida was ranked 33rd in the nation for the number of deaths caused by COPD in 2017 (National Center for Health Statistics, 2018).  Florida Department of Health’s Bureau of Tobacco Free Florida (TFF) program has made considerable improvements in reducing tobacco use rates from 21% in 2006 to 14.8% in 2019 (About Us | Tobacco Free Florida, 2020). As a result, there have been almost $18 billion saved in health care costs related to smoking during the years 2007 to 2015 (About Us | Tobacco Free Florida, 2020).  It is unfortunate to report that it has been estimated that with the current smoking rate, the children in Florida who are less than 18 years of age will die prematurely due to tobacco use (About Us | Tobacco Free Florida, 2020). To that end, in children between ages 11 and 17, there has been a reduction in cigarette smoking from 10.6% in 2006 to 2.2% in 2018; an estimated reduction greater than 75% since 2007 (About Us | Tobacco Free Florida, 2020). 

     The prevalence of global warming affects the COPD patient population. Damage to the human systems and body organs can be caused by exposure to pollution in ambient air (Duan et al., 2020). Respiratory tracts are particularly vulnerable to air pollution as exposure to external surroundings is direct (Duan et al., 2020). The complex mix of gases, vapors, and particles from synthetic and natural sources creates air pollution (Duan et al., 2020). Particulate matters (PM) form industrial emissions and aerosols in the atmosphere that when inhaled, can accumulate in the upper and lower respiratory tracts, therefore, affecting persons with COPD (Duan et al., 2020). Primary non-infectious elements include air pollution contributing to the increased COPD-related rate in mortality (Duan et al., 2020). 

     A comprehensive understanding of local barriers and challenges allows providers to understand and identify ways to prevent, diagnose, treat, and manage COPD (Ammary-Risch et al., 2019).  Some research has focused on the care of rural residents with chronic obstructive pulmonary disease (COPD).  The research discussed the difficulty in accessing care due to the unavailability of services, financial expenses, cultural perceptions, and distance of travel to seek specialty services (Croft et al., 2018).  The reported plans aimed to remove barriers and/or improve access to treatments such as oxygen therapy, pulmonary rehabilitation, and effective comprehensive self-care programs (Croft et al., 2018).

Recommend additional measures required to integrate proposed changes into practice

     Upon examination and review of several research articles, various interventions and prevention recommendations were revealed to manage and treat COPD.  Shared recommendations consisted of education regarding the prevention of exacerbations, prioritizing COPD management efforts to slow declining lung function, and increasing access to the appropriate treatments (National Heart, Lung, and Blood Institute, 2021; Ammary-Risch et al., 2019; Jang et al., 2019; Etminan et al., 2018; World Health Organization, 2017).  Current research assents that specific recommendations and policies to reduce exacerbation events and mortality are important and the use of predictive tests, statistical methodologies that aim to reveal the association between the severe COPD exacerbation occurrences and risk of subsequent severe COPD exacerbations; the use of various technological applications, and the use of pharmacological treatments will provide improvement of COPD exacerbation awareness, implementation of adept and integrated programs/policies, data collection and objective analysis necessary for a positive impact (National Heart, Lung, and Blood Institute, 2021; Alwashmi et al., 2020; Bhansali et al., 2020; Jang et al., 2019; Etminan et al., 2018; Centers for Disease Control and Prevention, 2018e; World Health Organization, 2017).

     Community partners and health care providers can promote collaboration and participation in positive interventions by encouraging the use of The COPD National Action Plan (Croft et al., 2018). The focus of this plan is on research to improve accessibility in limited geographical areas. Another focus is the development of clinical decision tools for providers who serve residents who live in rural areas (Croft et al., 2018).  Additionally, online community accessibility is also a focus of research as access to the internet in some areas is difficult (Croft et al., 2018).  The COPD National Action plan is attempting to overcome those barriers (Croft et al., 2018).  Plans aimed to remove barriers and/or improve access to treatments such as oxygen therapy, pulmonary rehabilitation, and effective comprehensive self-care programs (Croft et al., 2018).  Coordinated and collaborative efforts promoted by federal agencies are seeking to educate health care providers, patients, and the public about the importance of the prevention, treatment, and diagnosis of COPD (Croft et al., 2018). 

Share your professional experience related to the topic

     In my professional experience over the years, I have had many experiences in caring for patients with COPD.  Aside from patients experiencing typical COPD exacerbations, many patients also experience anxiety related to dyspnea, access to treatments, and managing oxygen therapy.  Depression is also an issue I have seen in patients who experience years of COPD burdens and negatively affects their quality of life.  These patients can become terse and seek to control what they can.  I have cared for patients who have passed from end-stage COPD and supported their families through the process.  It is an insidious disease that has become too common.  Based on the symptoms, the goals are to recommend strategies necessary to manage and monitor treatments to improve long-term outcomes (Bhansali et al., 2020). Many factors involve providing quality care and outcomes are affected by various aspects.  As COPD continues to play a significant role in the healthcare industry, accessible and integrative strategies must remain a top concern for the best outcome.      

-Isabel 

References

About Us | Tobacco Free Florida. (2020). About Us. https://tobaccofreeflorida.com/about-us/

Ammary-Risch, N., Atkins, G., Cramb, S., Croft, J., Davis, L., Dolor, R., Doyle, D., Elehwany, M., James, C., Johnson, L., Kiley, J., Knudson, A., Linnell, J., Mannino, D., Moore, P., Punturieri, P., Rommes, J., Sood, A., Stockton, E., . . . Yawn, B. (2019). COPD and Rural Health: A dialogue on the national action plan. The Journal of Rural Health, 35(4), 424-428. https://doi.org/10.1111/jrh.12346

Bhansali, A., Lee-Chiong, T., Peyerl, F., Riley, D., & Trout, D. (2020). A quality improvement initiative for COPD patients: A cost analysis. Public Library of Science, 15(7), 1-14. https://doi.org/10.1371/journal.pone.0235040

Center for Disease Control and Prevention. (2018b). COPD death rates in the United States. https://www.cdc.gov/copd/data.html

Croft, J., Cunningham, T., Holt, J., Liu, Y., Lu, H., Matthews, K., Wang, Y., Wheaton, A., & Lu, H. (2018, February 23). The Centers for Disease Control and Prevention. Morbidity and mortality weekly report: Urban-rural county and state differences in chronic obstructive pulmonary disease – United States, from 2015., 67(7), 205-211. http://dx.doi.org/10.15585/mmwr.mm6707a1

Duan, R.-R., Hao, K., & Yang, T. (2020). Air Pollution and Chronic Obstructive Pulmonary Disease. Chronic Diseases and Translational Medicine, 1-10. https://doi.org/10.1016/j.cdtm.2020.05.004

Ferguson, G., Han, M., Rodríguez-Roisin, R., Román-Rodríguez, M., Singh, D., & Vogelmeier, C. (2020). Goals of COPD treatment: Focus on symptoms and exacerbations. Respiratory Medicine, (166). https://doi.org/10.1016/j.rmed.2020.105938  

National Center for Health Statistics. (2018, April 13). Stats of the State of Florida. Centers for Disease Control and Prevention. https://www.cdc.gov/nchs/pressroom/states/florida/florida.htm

I NEED A COMMENT FOR THIS DISCUSSION BOARD WITH AT LEAST 2 PARAGRAPHS AND 3 SOURCES NO LATER THAN 5 YEARS.

T3Q1 – 2025 Compare vulnerable populations Describe an example of one of these groups in the

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T3Q1 – 2025

Compare vulnerable populations. Describe an example of one of these groups in the United States or from another country. Explain why the population is designated as “vulnerable.” Include the number of individuals belonging to this group and the specific challenges or issues involved. Discuss why these populations are unable to advocate for themselves, the ethical issues that must be considered when working with these groups, and how nursing advocacy would be beneficial.  

NU621-7C UNIT1 REPLY1 – 2025 Unit 1 Discussion Myocardial Infarction and Left Ventricular Heart Failure Heart failure is a clinical

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NU621-7C UNIT1 REPLY1 – 2025

 

Unit 1 Discussion: Myocardial Infarction and Left Ventricular Heart Failure

Heart failure is a clinical condition that occurs when there is a structural or functional dysfunction that interferes with the ability of the ventricle to fill in on pump-out blood. Left ventricular heart failure is when there is a dysfunction in the left ventricle. A myocardial infarction occurs when there is damage to the heart muscles (myocardium) as a result of obstructed blood flow (Cahill & Kharbanda, 2017). When these muscles lack oxygen, there is cardiomyocyte structural changes and edema and this injury activates the inflammatory cascade. About 3 days after the MI, there is tissue repair with progressive scar formation. The renin-angiotensin and sympathetic nervous systems are then activated as compensation mechanisms and this results in changes to the ventricular structure (Cahill & Kharbanda, 2017). The severity of LV failure may increase with prolonged hypertension, myocarditis, and heart muscle damage from infections, disease, and toxic drug use.

Manifestations and Management of DVT

Deep vein thrombosis involves blood clots in the veins in the legs, thighs, pelvis, or arms. Symptoms include pain, swelling, tenderness, and skin redness. Medical management of the condition involves anticoagulation therapy mainly involving oral anticoagulants (DOACs) or warfarin (CDC, 2020). However, patients with cancer, as well as pregnant patients, can be treated with low molecular weight heparin (LMWH). Prevention may also include the use of compression stockings which could also relieve pain and swelling. Severe cases of DVT may warrant a surgical removal of the clot

According to the video, DVT can happen to anyone but the risk increases after a recent surgery, recent serious injuries such as fractures, when one is sitting down or lying for low periods, and having active cancer (CDC, 2020). DVT could cause pulmonary embolism when bits of the blood clot breaks off and find their way to the lungs. When recognized early, both DVT and PE can be successfully treated.

Compare The Physical Assessment Of A Child To That Of An Adult. – 2025 Topic 2 DQ 2 Physical health assessment is a structured physical examination that allows a nurse to obtain a

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Compare The Physical Assessment Of A Child To That Of An Adult. – 2025

 Topic 2 DQ 2

Physical health assessment is a structured physical examination that allows a nurse to obtain a complete assessment of the patient’s health status. Typically, the techniques that should be applied to the physical assessment process: Are — inspection, palpation, percussion, and auscultation (Registered Nursing, 2021).

Before the actual physical assessment, the patient undergoes an interview to collect medical information. While this might be an easy process for adults and older children, getting information from a young child requires a lot of strategies and patience (Registered Nursing, 2021)

To get information from young children, the nurse would have to rely on their mothers to provide the data while at the same time engaging the child by talking to him/her through the interview process. The nurse must develop a good rapport with the child to gain his/her full Cooperations; listening and using appropriate communication techniques are essential in this process. A calm and reassuring manner of the nurse will help to gain a child’s confidence; use Suitable toys or other aids can be used to help the child interact with the nurse (Registered Nursing, 2021)

During the interview, the nurse can begin by asking the child trivial questions like his/her name, favorite food, cartoon character, etc., and then subtly lead to the questions that might help assess the child’s health status.

In the case of adults and older children, the interview can begin directly. When it comes to physical examination of the body, again, the approach will have to be different for a young child than an adult or older child. A child might not like someone else touches him/her. The nurse will have to win the trust, and the parent will have to be there to reassure the child. If the child is in pain, then examining that part of the body might be a bit more complicated, but again tactics and communication skills of the nurse will help (Registered Nursing, 2021).

For grown-ups, the physical examinations will be much easier because they know what is happening and why it is happening. On the other hand, a young child might be scared of the instruments used to examine them. The nurse should engage in active listening with an adult patient while paying attention to verbal and nonverbal cues. Ask open-ended questions that would allow the patient to detail the actual symptoms needed to ascertain what is happening to the patient. (Walden University, 2021) Be empathetic with an adult patient by saying you understand what he/she is going through so that you can gain his/her trust in the interview process. The nurse can also validate and reassure the patient that their problems would be addressed while in your care. Another strategy is transitions and empowerment of the patient in the interview process to help alleviate their fear of the unknown in the current health issues(Walden University, 2021).So, physical assessment of a child will differ from an adult intact, but the techniques are the same.

Respond to the above post using 200-300 words APA format with reference by supporting the discussion.

 Compare the physical assessment of a child to that of an adult. In addition to describing the similar/different aspects of the physical assessment, explain how the nurse would offer instruction during the assessment, how communication would be adapted to offer explanations, and what strategies the nurse would use to encourage engagement. 

Nstructions: Read The Following Case Study And Answer The Reflective Questions. Please Provide Rationales For Your Answers With Appropriate Citations And References, Following APA Format. Due Saturday By 23:59 P.m. – 2025 Read the following case study and answer the reflective questions Please provide rationales for your answers Make sure to

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Nstructions: Read The Following Case Study And Answer The Reflective Questions. Please Provide Rationales For Your Answers With Appropriate Citations And References, Following APA Format. Due Saturday By 23:59 P.m. – 2025

 Read the following case study and answer the reflective questions. Please provide rationales for your answers. Make sure to provide a citation for your answers. . 

CASE STUDY: An Older Immigrant Couple: Mr. and Mrs. Arahan Mr. and Mrs. Arahan, an older couple in their seventies, have been living with their oldest daughter, her husband of 15 years, and their two children, ages 12 and 14. They all live in a middle-income neighborhood in a suburb of a metropolitan city. Mr. and Mrs. Arahan are both college educated and worked full-time while they were in their native country. In addition, Mr. Arahan, the only offspring of wealthy parents, inherited a substantial amount of money and real estate. Their daughter came to the United States as a registered nurse and met her husband, a drug company representative. The older couple moved to the United States when their daughter became a U.S. citizen and petitioned them as immigrants. Since the couple was facing retirement, they welcomed the opportunity to come to the United States. The Arahans found life in the United States different from that in their home country, but their adjustment was not as difficult because both were healthy and spoke English fluently. Most of their time was spent taking care of their two grandchildren and the house. As the grandchildren grew older, the older couple found that they had more spare time. The daughter and her husband advanced in their careers and spent a great deal more time at their jobs. There were few family dinners during the week. On weekends, the daughter, her husband, and their children socialized with their own friends. The couple began to feel isolated and longed for a more active life. Mr. and Mrs. Arahan began to think that perhaps they should return to the home country, where they still had relatives and friends. However, political and economic issues would have made it difficult for them to live there. Besides, they had become accustomed to the way of life in the United States with all the modern conveniences and abundance of goods that were difficult to obtain in their country. However, they also became concerned that they might not be able to tolerate the winter months and that minor health problems might worsen as they aged. They wondered who would take care of them if they became very frail and where they would live, knowing that their daughter had only saved money for their grandchildren’s college education. They expressed their sentiments to their daughter, who became very concerned about how her parents were feeling. This older couple had been attending church on a regular basis, but had never been active in other church-related activities. The church bulletin announced the establishment of parish nursing with two retired registered nurses as volunteers. The couple attended the first opening of the parish clinic. Here, they met one of the registered nurses, who had a short discussion with them about the services offered. The registered nurse had spent a great deal of her working years as a community health  nurse. She informed Mr. and Mrs. Arahan of her availability to help them resolve any health-related issues.

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