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Hello, would someone help to complete an assignment paper?

Hello, would someone help to complete an assignment paper?
Week 5 final paper instructions Informal Logic: Prior to beginning work on this assignment, read Chapter 9 in your textbook. In this paper, you get to demonstrate the skills you have learned in this class as you strive to manifest the ability to arrive at conclusions based upon a fair-minded analysis of the best reasoning on both sides of issues. This includes presenting and evaluating the best arguments on each side, followed by a presentation of your own argument for your thesis. You will go on to support this argument using evidence from scholarly sources and addressing the strongest objection to it. Integrate the work you did in the Week 3 Scholarly Arguments on Both Sides assignment. See the attachment for an example of how the paper needs to be formatted and written. Also, please make sure the word length for each section is correct. Paper sample. Please include premises 1 and 2, according to the example paper. Opposing Argument (approximately 200 words) Present the best argument on the other side of the issue (same as above, but on the opposite side). Develop your argument in standard form, with sources cited to support your statements (as above). Analysis of the Arguments (approximately 300 words) Evaluate the quality of the two arguments given above. This can include addressing whether key premises are true (or well supported) and how strongly the conclusion logically follows from them. Explain any fallacies, biases, or rhetorical tricks committed by any of them. Analyze why one is stronger than the other. Justify your position not with opinion but with your analysis of the quality of the arguments. Presentation of your own argument on the topic (approximately 200 words) Construct your own argument on the topic. Present your argument in standard form. Of course, this argument will be influenced and supported by the research you have done, but this is to be your own argument in your own words supporting your thesis. For any premises that are based on research, include a citation of the relevant source (even though the premise is in your own words). Addressing an objection to your argument (approximately 300 words) Present what you would consider to be the best possible objection to your argument (you may address more than one if you prefer). Present what you would take to be the best reply to this objection and defense of your argument. Cite a scholarly source in this section as well (either in your presentation of the objection or in your response to it). Conclusion (approximately 150 words) Summarize the evidence for all points of view. Evaluate how controversial topics should be addressed by critical thinkers Opposing Argument (approximately 200 words) Present the best argument on the other side of the issue (same as above, but on the opposite side). Develop your argument in standard form, with sources cited to support your statements (as above). Analysis of the Arguments (approximately 300 words) Evaluate the quality of the two arguments given above. This can include addressing whether key premises are true (or well supported) and how strongly the conclusion logically follows from them. Explain any fallacies, biases, or rhetorical tricks committed by any of them. Analyze why one is stronger than the other. Justify your position not with opinion but with your analysis of the quality of the arguments. Presentation of your own argument on the topic (approximately 200 words) Construct your own argument on the topic. Present your argument in standard form. Of course, this argument will be influenced and supported by the research you have done, but this is to be your own argument in your own words supporting your thesis. For any premises that are based on research, include a citation of the relevant source (even though the premise is in your own words). Addressing an objection to your argument (approximately 300 words) Present what you would consider to be the best possible objection to your argument (you may address more than one if you prefer). Present what you would take to be the best reply to this objection and defense of your argument. Cite a scholarly source in this section as well (either in your presentation of the objection or in your response to it). Conclusion (approximately 150 words) Summarize the evidence for all points of view. Evaluate how controversial topics should be addressed by critical thinkers The Fair-Minded Reasoning Final Paper, Must be five to seven double-spaced pages in length (not including title and references) and formatted according to APA StyleLinks to an external site. as outlined in the Writing Center’s APA Formatting for Microsoft WordLinks to an external site. Must include a separate title page with the following: Title of paper in bold font Space should appear between the title and the rest of the information on the title page. Student’s name Name of institution (University of Arizona Global Campus) Course name and number Instructor’s name Due date Must utilize academic voice. See the Academic VoiceLinks to an external site. resource for additional guidance. Must include an introduction and conclusion paragraph. Your introduction paragraph needs to end with a clear thesis statement that indicates the purpose of your paper. For assistance on writing Introductions & ConclusionsLinks to an external site. as well as Writing a Thesis StatementLinks to an external site., refer to the Writing Center resources. Must use at least three scholarly sources in addition to the course text. The Scholarly, Peer-Reviewed, and Other Credible SourcesLinks to an external site. table offers additional guidance on appropriate source types. If you have questions about whether a specific source is appropriate for this assignment, please contact your instructor. Your instructor has the final say about the appropriateness of a specific source for the final paper. To assist you in completing the research required for this assignment, view The University of Arizona Global Campus Library Quick ‘n’ DirtyLinks to an external site. tutorial, which introduces the University of Arizona Global Campus Library and the research process, and provides some library search tips. Must document any information used from sources in APA Style as outlined in the Writing Center’s APA: Citing Within Your PaperLinks to an external site. Must include a separate references page that is formatted according to APA Style as outlined in the Writing Center. See the APA: Formatting Your References ListLinks to an external site. resource in the Writing Center for specifications.  
Hello, would someone help to complete an assignment paper?
References for week 5 final paper: B., I. U. (2020). Diet, physical activity, and emotional health: what works, what doesn’t, and why we need integrated solutions for total worker health. BMC Public Health, 20(1), 1–9. https://doi.org/10.1186/s12889-020-8288-6 Jaye, C., Young, J., Egan, R., Llewellyn, R., Cunningham, W., & Radue, P. (2018). The healthy lifestyle in longevity narratives. Social Theory & Health, 16(4), 361–378. https://doi.org/https://doi.org/10.1057/s41285-018-0062-9 While, A. (2023). Is a healthy diet enough? British Journal of Community Nursing, 28(4), 164–166. https://doi.org/10.12968/bjcn.2023.28.4.164
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R E S E A R C H A R T I C L E Open Access Diet, physical activity, and emotional health: what works, what doesn ’t, and why we need integrated solutions for total worker health Iffath U. B. Syed Abstract Background: Current research advocates lifestyle factors to manage workers ’health issues, such as obesity, metabolic syndrome, and type II diabetes mellitus, among other things (World Health Organization (WHO) Obesity: preventing and managing the global epidemic, 2000; World Health Organization (WHO) Obesity and overweight, 2016), though little is known about employees ’lifestyle factors in high-stress, high turnover environments, such as in the long term care (LTC) sector. Methods: Drawing on qualitative single-case study in Ontario, Canada, this paper investigates an under-researched area consisting of the health practices of health care workers from high-stress, high turnover environments. In particular, it identifies LTC worker ’s mechanisms for maintaining physical, emotional, and social wellbeing. Results: The findings suggest that while particular mechanisms were prevalent, such as through diet and exercise, they were often conducted in group settings or tied to emotional health, suggesting important social and mental health contexts to these behaviors. Furthermore, there were financial barriers that prevented workers from participating in these activities and achieving health benefits, suggesting that structurally, social determinants of health (SDoH), such as income and income distribution, are contextually important. Conclusions: Accordingly, given that workplace health promotion and protection must be addressed at the individual, organizational, and structural levels, this study advocates integrated, total worker health (TWH) initiatives that consider social determinants of health approaches, recognizing the wider socio-economic impacts of workers ’ health and wellbeing. Keywords: Immigrant health, Visible minorities, Public health, Social determinants of health, Total worker health What is already known about this subject? Current research advocates lifestyle factors to manage health issues of workers, such as managing obesity, metabolic syndrome, and type II diabetes mellitus, among other things [ 50,51], though little is known about employees ’lifestyle factors in high-stress, high turnover environments, such as in the long term care (LTC) sector. What are the new findings? The findings suggest that LTC workers typically main- tained health and wellbeing through self-care measures conducted in group settings or tied to proxies of relax- ation and emotional health, however, a few indicated that finances were barriers to practicing healthy behaviors. How might this study impact policy or practice in the foreseeable future? This study impacts policy such that it advocates inte- grated, total worker health (TWH) initiatives that con- sider social determinants of health approaches, © The Author(s). 2020 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/ ), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link tothe Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver( http://creativecommons.org/publicdomain/zero/1.0/ ) applies to the data made available in this article, unless otherwise stated. Correspondence: [email protected] School of Health Policy and Management, York University, Stong College, 3rdFloor, 4700 Keele Street, Toronto, Ontario M3J 1P3, Canada Syed BMC Public Health (2020) 20:152 https://doi.org/10.1186/s12889-020-8288-6 recognizing the wider socio-economic impacts of workers ’physical, mental, and social wellbeing. Background A broad set of public health interventions have been ad- vocated in the occupational health literature. These are generally accepted principles and practices that often in- clude interventions that focus on prevention of accidents and occupational diseases, and also health promotion ac- tivities such as enabling workers to become more skilled to improve their lifestyles, quality of diets, sleep, and physical fitness [ 23]. For example, there is evidence that workers who experience high stress and job strain, as measured by the Siegrist effort rendered imbalance (ERI) model, have higher odds of having metabolic syndrome [ 25]. Furthermore, occupational stress, as measured by the psychological injury risk indicator (PIRI), is associ- ated with metabolic syndrome components such as hypertriglyceridemia and high blood pressure [ 22]. Sleep hygiene is also important for workers ’health, safety, well-being, and productivity [ 24]. It is beneficial for emotional health, and it may reduce cardiovascular risk from metabolic syndrome [ 24]. Indeed, sleep problems are associated with: an increase in the incident cases of metabolic syndrome in high-stress occupational groups, such as police officers, in a prospective 5-year study [ 17], as well as workplace violence [ 24]. Other researchers have specifically advocated for the following: smoking cessation, consuming limited or no amount of alcohol, medical surveillance and screening of high risk and vulnerable groups; reducing chemical, physical, ergonomic and emotional exposures; increasing research and development of appropriate drugs and therapeutic products; and advocating interventions that include urban environmental interventions like building safe walkways, bicycle paths, and improving building de- sign to encourage stairwell use [ 18,35,36]. The rationale for implementing workplace health promotion and pro- tection interventions is because they provide intangible benefits such as increased job satisfaction and worker wellbeing [ 23]. As indicated by Magnavita [ 23]; workplace health pro- motion programs are designed so that they can help workers become more skilled in managing their chronic conditions; and proactive in their health-care by improv- ing their lifestyles, quality of diet, and physical activity, among other things. Given that there is an increasing body of evidence which supports that employment and working conditions contribute to health problems previ- ously considered unrelated to work, such as obesity [ 21, 30 ,46], metabolic syndrome [ 22,25], cardiovascular dis- ease [ 20], sleep disorders [ 5,17,24], and depression [ 40], this study aimed to explore a new and under-researched area of health behaviors in high-stress, high-turnover work environments, such as in the long term care (LTC) sector. Previous studies of Canadian LTC have focused on: structural and physical violence [ 3,9]; work-related in- juries and illness [ 1]; and presence of other health- limiting circumstances such as job stress, high work- loads, labor intensification, task orientation, assembly- line style of work, work hierarchies, and strict divisions of labor [ 2,10,47]. However, no studies to date have ex- amined the reporting of diet and physical activity among Canadian LTC workers. For this study, the research questions asked: To what extent do LTC workers report diet and physical activity as mechanisms to maintain their health and wellbeing? How do LTC workers main- tain emotional health? The rationale for this study ’s focus on diet and physical activity is to establish a start- ing point given that such health protection and promo- tion efforts are under-researched areas in Canadian LTC. Methods This study used a single-case design, and relied on an ethnography, in which the sources of evidence were from direct observations and in-depth, key informant in- terviews. Observations and interviews were carried out at a LTC site in Toronto, Canada between the hours of 6:30 am am to midnight, which were opportunistic times to observe the workers ’scheduled shift changes that oc- curred at 7 am, 3 pm, and 11 pm. Observations were conducted in secure, locked and unlocked units/ wings at the site; in public spaces within the facility, and at the reception area. These spaces included: hallways and din- ing areas on the individual units, the recreation space of the atrium located on the ground floor, the employee break room located at the mezzanine level, and outside the meeting rooms in the basement-level. Forty-two face-to-face, in-depth, semi-structured interviews were conducted with participants, and digitally recorded using Sony ICDPX440 recorders. Fieldnotes were generated during observations, which documented preliminary thoughts, assumptions, and the physical setting. Multiple units of analysis were organized by worker characteris- tics such as sex, job titles or roles, visible minority (VM) status, full time (F/T) status, and part-time (P/T) work status, among other things (Table 1). Fieldnotes and interview transcripts were analyzed with thematic ana- lysis for the study using a coding system with the aid of NVivo computer software program to organize and sort data. Results The findings indicate that typically, LTC workers main- tained health and wellbeing through self-care measures such as healthy eating and exercise, including walking, Syed BMC Public Health (2020) 20:152 Page 2 of 9 Table 1 Interview participants ’characteristics Participant No. Job Title/Role Visible minority Sex Work status – F/T or P/T 1 Trainee Y F F/T 2 Allied Health Y F F/T 3 Allied Health Y F F/T 4 Nurse Y F F/T 5 Manager N M F/T 6 Manager Y F F/T 7 Nurse Y F P/T 8 Support Staff N F F/T 9 Ancillary N F P/T 10 Nurse N F F/T 11 Trainee Y F F/T 12 Ancillary Y M F/T 13 Nurse Y F F/T 14 Allied Health N F P/T 15 Allied Health Y F P/T 16 PSW Y F F/T 17 Nurse Y F F/T 18 Trainee Y F F/T 19 Allied Health N F F/T 20 PSW N F P/T 21 Ancillary N F F/T 22 Support Staff N F F/T 23 Nurse Y M F/T 24 PSW Y F P/T 25 Allied Health Y M F/T 26 Support Staff N M F/T 27 Support Staff Y F F/T 28 Support Staff Y F P/T 29 Manager N F F/T 30 Nurse Y F F/T 31 PSW Y F F/T 32 Manager Y F F/T 33 PSW Y F F/T 34 PSW Y F F/T 35 Allied Health Y F F/T 36 PSW Y F F/T 37 Support Staff N F F/T 38 Nurse Y F F/T 39 Ancillary Y M P/T 40 Ancillary Y F P/T 41 Nurse Y F P/T 42 Ancillary Y M F/T Syed BMC Public Health (2020) 20:152 Page 3 of 9 yoga, swimming, and going to the gym. Thirty-five out of 42 participants (83.3%) reported self-care measures that included exercise, healthy eating, and so forth. These measures were often conducted in group settings or tied to emotional health, suggesting important social and mental health contexts to these behaviors. Some participants also reported that they had the time and re- sources to grow their own food, and used consumption as a proxy for relaxation and emotional health. However, there were other workers who said that finances were barriers to practicing healthy behaviors. Self-care –healthy eating A few key responses summarize the extent to which healthy eating was practiced, along with the rationale for practicing such self-care, such as coping with work be- cause of how it spilled over into domestic life. For ex- ample, a female ancillary worker reported that she had hypertension and pre-diabetes. While this worker attrib- uted her medical conditions to family history, more interestingly, her physician suggested they were likely from her “job ”, suggesting that employment and working conditions were responsible for this metabolic syndrome component. Accordingly, in order to cope with this type of work-related stress, she reported that she stopped tak- ing her “work home ”. She also practiced healthy eating by making her own food from scratch: A: “High blood pressure and I think that was my doctor said it ’s probably from the nerve from your job. That ’s why I decided to separate my –no lon- ger take my work home with me because I think that ’s how I must have gotten it. But yeah, I have a high blood pressure. And I ’m borderline diabetic but that runs in the family. Hopefully, I won ’t get the disease but I probably will because most of the people in my family have gotten it. ” I: “Do you try to eat healthy? ” A: “Oh yeah, I grow my own. I make everything from scratch. I don ’t buy any processed food at all because processed food has sugar and it has salt in it. They ’re both real bad for you. They have apple ingredients and half of those, they just have funny names for them. But it ’s still the same thing. It ’s salt and sugar. They just have fancy names for them that ’s all. Just call a spade a spade. You don ’t have to have 60 trillion names for it. So there ’s people who don ’t understand what the hell you ’re talking about unless you happen to be a professor or a scientist that know all about the stuff. And I ’m skinny. ”(Participant 9, Ancillary Worker, Female, Non-VM, P/T). The above participant went on to state that she would go home after work and have a cup of tea, possibly al- luding to a relaxation strategy. As another health- conscious practice, she also grew her own food: A: “I usually just go home and just have a cup of tea and just sit down and think about nice things. The work that I have to do at home. I like to cook and I like to garden [ …] every day I do my cooking. [name of family member] says, ‘Where are you going? ’‘I’m going to go enjoy myself. ’‘ Oh, you ’re going to cook. ’ I: “Oh, what about in the winter? If you ’re not able to garden, what do you do if you ’re not able to? ” A: “Oh, I grow all my fruits –all my vegetables all year long. [ …] Like I have my green peppers, my green pepper tree I brought in from outside. It ’s still growing. [ …] I enjoy it. ”(Participant 9, Ancillary Worker, Female, Non-VM, P/T). One quote demonstrates how some workers practiced self-care because they were conditioned to it, and they considered it to be important. For example a Trainee in- dicated that she engaged in regular physical activity, ad- equate sleep, and healthy eating habits because she considered them to be really important and; therefore, prioritized these things to the point where she shifted her life around them: “ I’ve always been conditioned– I guess to like –for exercise and stuff like that. Eating well, sleeping well. That to me is really important. So I make time for that. I sort of shifted my life with it though be- cause now I go to bed super early and I wake up earlier so I get some school work done before I start here because I find it ’s just easier for me to do ra- ther than come home to do it because I ’m tired. ” (Participant 11, Trainee, Female, VM, F/T). Another participant stated that she tried to eat healthy, but she admitted that she also ate junk food sometimes: “ I am trying [to eat healthy] technically. I’m trying, because I can see, even me, I’ve never had any prob- lem until 45, I ate anything I wanted, I did anything. But now, I need to watch [it …], but sometimes Syed BMC Public Health (2020) 20:152 Page 4 of 9 we’re just eating some junk as well. ”(Participant 37, Support Staff Worker, Female, Non-VM, F/T) Although the above participants indicated they ate somewhat health-consciously, a few indicated that they had income and budgeting challenges: “ So it has extended over to where we live, it ’s defin- itely the cost of living is astronomical, you ’re going from –I had [dependents] also live with us, so we ’re a family of four and groceries can be expensive, es- pecially if you want to eat healthy, right ”(Partici- pant 10, Nurse, Female, Non-VM, F/T) One participant ’s response succinctly summarizes how she was sometimes unable to eat healthy exclusively due to costs: “ I’ve tried to like eat like salad and like going to like the store to buy salad in a box. It’s like so expensive. So sometimes, it’s like, oh, I don’t have the money for that right now. So yeah, it’s expensive. ”(Partici- pant 15, Allied Health, Female, VM, P/T). One PSW attributed the inadequacy of the pay to the stagnation of wages and described the effect of this inad- equacy upon the quality and variability in the food she was able to serve to her family. In particular, she gave an example of how junk food, such as a bag of fries, is eas- ier and cheaper to purchase than healthy food, such as salad: A: “[T]he cost of living has gone up, and we haven ’t gotten a raise in so many years. I don ’tevenknow.I just — I don ’t even keep track. And it also makes a lot of people mad, because I started six years ago. They ’ve worked here 20 years ago, and the pay is the same. ”(Participant 20, PSW, Female, Non-VM, P/T). The same participant went on to state: A: “The other day, my kids were like, “Oh, mom. Chicken again? ”“ Well, chicken ’s on sale right now. So yeah, that ’s what you ’re having. “And I just try and differ it up a little bit. But yeah, for sure. It ’s easier to buy a bag of fries than it is a whole salad. Salad ’s expensive, but you do what you ’ve got to do. ”(Participant 20, PSW, Female, Non-VM, P/T). Self-care –physical activity Although a few participants did not participate in phys- ical activity and attributed their thin physique to their metabolism, many routinely reported engaging in phys- ical activity as a form of self-care. This was done in groups or individually. For instance, one worker stated in the interview that she engaged in regular exercise as a social activity with her friends: A: “So I work out with my friends like every three days. ” I: “In the gym? ” A: “Yeah, in the gym. We do like different [activ- ities on different] days. So like Mondays, we would work on our stomach or something, and then Wednesday, our legs, and then — and then, like, Friday, we just jog. ”(Participant 15, Allied Health, Female, VM, P/T). Another worker indicated that she engaged in regular, vigorous exercise to clear her mind, and this was done in group sessions, such as in a class: A: “I’m just going. I like classes. You don ’tneedto think and you don ’t have time to think because it ’s the music loud. Everyone jumping and someone, you don ’t even … That is why I love classes because you are in, that is, what, 45 minutes, one hour, you are not thinking about anything. If there ’s no clas- ses, then treadmills is the other one. Whenever you ’re running or you, or just sometimes I ’m just listening a book. On my phone, I have books and then I listen and then I ’m not thinking about some- thing else [sic]. ” (Participant 37, Support Staff Worker, Female, Non-VM, F/T). Another worker said she used walking, listening to music, and swimming as coping strategies to relax and destress herself, despite environmental barriers such as extremely cold weather conditions (which were the con- ditions in which the interview took place with this worker): A: “I’m really into music. [ …] I love music. I ’m al- ways listening to music — when I walk to work, walk home. I swim, too. [ …]It ’s really relaxing. ”[…] And I go for really long walks. Sometimes I ’ll go for a walk for 3 h if I need to just clear my mind. [ …]I just find walking and listening to music is just a good way to clear your mind. ” I: “Okay. Even in the weather like –? ” Syed BMC Public Health (2020) 20:152 Page 5 of 9 A: “Yeah. Yeah. [ …] I don ’t mind. As long as I ’m warm, I ’m good. ”(Participant 14, Allied Health, Fe- male, Non-VM, P/T). A Personal Support Worker (PSW) reported using ex- ercise after waking up in the morning and before coming in to work: I: “And you ’re on your feet all day. Are you able to — you ’re — I ’m guessing you ’re very tired. Are you able to do any [ …] walking moderately or physical activity? ” A: “Well, what I do in the morning, I get up and I do exercise. I exercise for 45 minutes. [ …] I do car- dio. I have my exercise tapes, so — and I do it three to four times a week. [ …] When I go on my break, I try to walk the stairs. But that ’s — sometimes the feet tired, so I forget that. ”(Participant 16, PSW, Fe- male, VM, F/T). One worker described regular exercise as a recre- ational activity which was pursued during the weekdays, and called it a form of entertainment: A: “I mean, Monday to Friday I go to the gym. So, like, that ’s[ …]That ’s entertainment to me, I guess. That makes it seem like I don ’tdoany- thingduringtheweekbutit ’s, like, my own choosing, right? [ …] Yeah, I weight train, Monday to Friday. ”(Participant 26, Support Staff Worker, Male, Non-VM, F/T). Discussion ThedatasuggeststhattheLTCworkersintheurban region of study typically reported consumption of healthy diet and participation in physical activity in order to influence their health and wellbeing. This study also supports evidence that physical activity participation also occurred in group or social settings, suggesting they are important factors for behavior modification. The findings reveal that the majority of front line health care workers, many of whom were racialized per- sons, immigrants, and/or women, relied on particular mechanisms for self-care such as healthy eating and ex- ercise, including walking, yoga, swimming, and going to the gym. While the data suggests that participants rou- tinely engaged in these activities, a few participants re- ported they did not do so, which was explained by cost- related barriers. The evidence from this study demonstrates several im- portant points. Firstly, the findings shed light on under- researched areas of how workers engage with health- conscious behaviors in order to access their preferred health and wellness practices and maintain emotional health. This study also provides interesting perspectives as to what care workers perceived as healthy or un- healthy. For instance, processed foods, sugar, and salt were considered unhealthy by some participants while salad was considered healthy by others. Thirdly, the findings demonstrate that many of the workers must rely upon their own resources to achieve their optimal health and wellbeing, including costs. This is an important point because behavioral interventions are modulated by social and material circumstances which could otherwise impact morbidity and mortality [ 13]. Occupational health and safety issues among vul- nerable groups, such as racialized and immigrant workers in Canada for example, are often associated with particular working conditions, work exposures, or ergonomics issues [ 45]; however, there might be add- itional factors that influence patterns of sickness in workers, such as income and social status [ 13]. Indeed, the work of Magnavita [ 23] indicates that low wages can drastically reduce the motivation of employees to partici- pate in workplace health promotion. Magnavita [ 23] fur- ther advises that at the level of the organization, time constraints, financial and human resource shortages, lack of flexibility in work organization such as job rotation, as well as attitudes of employees and managers (e.g. re- luctance to change work habits and practices) were ob- stacles in carrying out workplace health promotion for older workers. Thus, it is imperative that workplace health promotion interventions should be addressed from both collective and individual points of view that improve working conditions, the occupational environ- ment, work organization, family, community, and social contexts [ 23]. Canadian research suggests that (im)migrants, racialized populations, and women are vulnerable to poverty, illness, and diseases related to low income, psycho-social/ chronic stress, and socioeconomic status disparities ([ 8,14,15,28, 29 ,32,33,41,47,48]). The literature also shows that ra- cialized and immigrant workers are vulnerable to both acute and chronic health problems because of structural issues in the labour market [ 11,12,48] that lead to major health risks such as work-related accidents or illness, men- tal stress, as well as income inequalities and health inequi- ties [ 4,8,15,16,42,45,48,49,52]. Accordingly, it is imperative that these groups are targeted in order to re- duce health inequities. How might this research impact on policy or clinical practice in the foreseeable future? Given the above literature, the findings from this study contribute new information to interdisciplinary Syed BMC Public Health (2020) 20:152 Page 6 of 9 occupational health scholarship and contextualize health-conscious behavioral practices from one of the most highly intensive work environments and sectors of employment. The findings are important because the knowledge of personal health practices among workers could reflect resistance and resilience strategies, demon- strate how agency is expressed, as well as illuminating any barriers or limitations. It is increasingly recognized that work influences health and disease in a number of ways, including job-related factors such as income and wages, hours of work, work-load and stress levels, inter- actions with coworkers, access to paid or unpaid sick leave, and work environments, among other things, all of which impact not only the health and well-being of workers but also their families and communities [ 19, 47 ]. Consequently, policies may be introduced to minimize barriers and improve access to these interven- tions. Magnavita [ 23] suggests that there are also struc- tural barriers that would need to be addressed. For example, workplace health promotion for older workers is less common in small companies than larger ones due to financial and human resource shortages (ibid). While this study contributes new knowledge, more work can be done. For instance, there are a number of opportunities for further research, such as examining in- comes, income distribution, and as well as factors that impact emotional health, such as reporting of workplace violence, or sleep hygiene. The latter two are important given the nature of Canadian LTC work, which is often carried out in shifts, and where exposures to workplace violence have also been reported. Research further sug- gests that work-related stress and workloads in the LTC sector can be overwhelming [ 47]; however, strategies to address these issues are often limited, and would require a holistic approach which considers income, employ- ment, education, i.e. socioeconomic status, and other so- cial determinants of health (SDoH). For example, diet and physical activity are just a few interventions that can modulate worker health and wellbeing. There are also more integrated interventions which seek to collectively address worker safety, health, and well-being, known as total worker health (TWH) initiatives [ 19]. TWH involve work-related environmental, organizational, and psycho- social factors [ 6], and include the control of physical, biological, and psychosocial hazards and exposures; organization of work; compensation and benefits; built environment supports; and work-life integration [ 19]. The TWH initiatives have been advocated through the National Institute for Occupational Safety and Health (NIOSH), the Centers for Disease Control and Preven- tion (CDC), and various researchers, including those at the Harvard School of Public Health and elsewhere [ 26, 27 ,35,36,44]. TWH explores opportunities to protect workers and advance their health and well-being, and that of their families by improving working conditions through workplace programs, practices, and policies [ 19]. The rationale for the above measures is to reduce the burden on the workforce, and control health care costs and economic costs to society [ 31]. In order to improve management of care work, such as in the case of the LTC sector selected for this study, there needs to be commitment to total worker health and wellbeing, which involves the home, family, and community of the workers. While individual, behavioral factors were addressed in this study, it would be beyond the scope and scale of this study to investigate structural factors such as work organization, family, community, and social contexts; although these factors would be good starting points of further investigation for future studies. Furthermore, given the diversity of care workers in the region of study, such approaches would need to be cul- turally appropriate, and adequate supports must be pro- vided to the workers. This means that not only do services and provisions need to exist, but they also need to be available, affordable, and accessible to the workers who require them. When such services and support sys- tems are made available to workers, they can perform the work better, safely, with less of a personal toll on their health and wellbeing, and with better outcomes for the recipients of care. Additional approaches that would be beneficial if they were to be applied to this and other sectors of employment include: allocating limited re- sources for provisions of good, stable jobs; decent in- come; poverty-reduction strategies; and advocating the SDoH ([ 38,39]; [ 7,34];). Conclusions Behaviour modification such as diet and physical activity are embedded in social, political, and economic realities. More research needs to be done to explore health be- haviors in highly stressful occupations, while also advo- cating for holistic approaches that also improve social and material circumstances for workers. While biomed- ical interventions often reinforce medicalized, positivist solutions, such as diet, physical activity, and screening/ surveillance of vulnerable workers, these interventions are limited unless they include integrated approaches. Workplace health promotion interventions should con- tinue to implement occupational risk prevention; how- ever, it is better if the interventions are participatory and inclusive of workers through a bottom-up approach as opposed to exclusively top-down approaches [ 23]. Ac- cordingly, an alternative framework that considers emo- tional health, TWH, and SDoH is needed because there are various structural, organizational, community, social, cultural, and policy factors that play a role in the devel- opment of illness and health in workers. Indeed, as Syed BMC Public Health (2020) 20:152 Page 7 of 9 Sorensen and Barbeau [ 43] recognize, commitment to worker safety and health throughout all levels of an organization is critical, and organizational leaders should acknowledge, prioritize, and communicate widely the worker safety and health on the same level as quality of services and products that are delivered by that organization. Abbreviations CDC: Centers for Disease Control and Prevention; ERI: Effort Rendered Imbalance; F/T: Full Time; LTC: Long Term Care; NIOSH: Occupational Safetyand Health; ORE: Office of Research Ethics; P/T: Part Time; PIRI: Psychological Injury Risk Indicator; PSW: Personal Support Worker; SDoH: Social Determinants of Health; TWH: Total Worker Health; VM: Visible Minority;WHO: World Health Organization Acknowledgements Many thanks to the editor, Dr. Els Clays, and Dr. Rachel Gorman, Dr. Nikola Magnavita, and Dr. Abigail Katz for their guidance and feedback. Author ’s contributions IS analyzed and interpreted the data, and is the main author and contributorin writing the manuscript who has read and approved the final manuscript. Funding York University funded fieldwork costs for data collection. Availability of data and materials The datasets generated and/or analyzed during the current study are notpublicly available due to copyrights, large and multiple file sizes, andbecause they are being used for further analysis for separate, distinct studies, but are available from the corresponding author on reasonable request. Ethics approval and consent to participate This research was approved by the Office of Research Ethics (ORE) at YorkUniversity, and participants ’consent to participate in the study was received in writing and signed by the participants. Consent for publication Participants ’consent to participate in the study and for research publication/ dissemination was received in writing and signed by the participants. 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While’s words 16 4 British Journal of Community Nursing April 202 3 Vol 28, No 4 Is a healthy diet enough? Alison While , Emeritus Professor of Community Nursing, Florence Nightingale Faculty of Nursing, K ing’s College London and Midwifer y and Fellow of the Queen’s Nursing Institute P opulation ageing is a global phenomenon. While ‘developed’ countries, such as the UK show the most rapidly ageing populations, it is also evident in China and South America (Office of National Statistics (ONS), 2018). Much has been said about the increasing health needs of the UK’s ageing population and the demands that it places upon the NHS. In particular, the cost of healthcare notably increases when people reach 65 years of age, due, in part, to hospital admissions (ONS, 2018). An ageing population is also accompanied by a changing population structure (due to an increase in life expectancy, decrease in fertility and a delay in childrearing), which has implications for the economy, services and society (ONS, 2018). The challenge of global ageing was recognised by the World Health Organization (WHO) in 2016. It created the Global Strategy and Action Plan on Ageing and Health 2016–2020 (World Health Assembly, 2016), which focused on healthy ageing, alongside the preparation for the ‘Decade of Healthy Ageing 2021–2030’ (WHO, 2020) that aims to optimise older people’s functional ability over the decade. The plan has four areas of action to promote health, prevent disease and maintain capacities, namely: changing attitudes to age and ageing; fostering the abilities of older people; the provision of responsive person-centred primary health services and integrated care; and the creation of access to long-term care for those who need it. Therefore, the varying health needs of people as they age are recognised, but more importantly, so are the imperatives of promoting health and preventing disease by offering choices and influencing behaviours to maximise health gain. Diet, among other lifestyle factors, plays a key role in the maintenance of a good health status as people age. The ‘Mediterranean diet’, characterised by lots of vegetables, fruits, whole grains, nuts, olive oil, fish, meat or diary, red wine and few eggs or sweets, has positive health outcomes, including healthy longevity (Hsiao and Chen, 2022). More recently, dietary variety has been advocated, with Professor Tim Spector (2022), co-founder of the COVID-19 Zoe app, recommending a diet with 30 different plants a week to maximise gut health. The benefit of dietary diversity has been demonstrated in a large cohort study (Chinese Longitudinal Healthy Longevity Study; n=17 959 participants; mean age of 84.8 years old at baseline), with those with the highest dietary diversity scores having the lowest mortality rate. Those participants who maintained a high dietary diversity had a decreased risk of mortality, in contrast to those with a lower dietary diversity or whose dietary diversity declined, having an increased mortality risk as older adults (Liu et al, 2021). Liu et al (2021) suggested that the unexpected finding regarding ‘extreme’ improvement in dietary diversity and increased mortality risk was due to participants’ characteristics, including unhealthy behaviours, higher presence of long-term conditions such as cardiovascular diseases, and poor family care (Chinese law requires families to care for their elders (filial duty)). Hsiao et al (2022) also found an association between higher dietary diversity and healthy ageing in their 4-year cohort study (Taiwan Longitudinal Study of Aging; n=3213 (n=1296, aged 50-64 years; n=1224, aged 65-74 years; n=693, aged 65 years and over)). Another approach focuses on particular nutrients, such as the anti-inflammatory and anti- oxidant properties of dark coloured fruit and vegetables, and protein intake to maintain muscle health, retain muscle mass and strength, and promote healthy ageing (Hsiao and Chen, 2022). Robinson et al (2018) have argued that there is growing evidence that there is an association between nutrition and muscle mass, strength and function in older adults. This review highlights the importance of the quality of a diet with sufficient intakes of protein, vitamin D, antioxidant nutrients and long-chain fatty acids. Robinson et al (2018) noted that ‘healthier’ diets that have greater fruit and vegetable content are usually also characterised by higher intakes of a range of key nutrients. In other words, dietary intakes, which include a range of fruits and vegetables tends to also include the other key dietary components. ‘Diet, among lifestyle factors, plays a key role in the maintenance of a good health status as people age. ’ Alison While 008_164_166_While’s Words.indd 164008_164_166_While’s Words.indd 164 22/03/2023 15:54:5522/03/2023 15:54:55 2023 MA Healthcare Ltd While’s words 166 British Journal of Community Nursing April 202 3 Vol 28, No 4 However, a healthy diet on its own is not sufficient and needs to be accompanied by other healthy behaviours, such as remaining physically active and socially connected, thereby ‘adding life to years’ (UK Research and Innovation (UKRI), 2022). Furthermore, there is evidence that social factors, like living or eating alone, are associated with simpler food choices and lower dietary diversity and subsequent poorer health outcomes (Hsiao and Chen, 2022). To this end, UKRI (2022) are sponsoring a range of projects to promote active leisure, the health and well- being of vulnerable people as they age through physical activity, social connectivity, healthier working lives as people age, and solutions for independent living as people age. The Centre for Ageing Better (2021) noted that low physical activity levels were a contributor to poor health outcomes before the COVID-19 pandemic; however, physical activity levels are lower than before the pandemic, with some people remaining as inactive as they were pre-pandemic. Physical activity reduces as people age. There is evidence that people know that being active physically is good for them, but there can be a complex range of barriers that stop people from becoming physically active (Centre for Ageing Better, 2021). Examples of psychological barriers/motivators include how the individual perceives themselves (as sporty or non-sporty), negative role models, desire to maintain independence, weight management and confidence. Examples of practical barriers/motivators include peer and family support, financial costs and access to facilities, long-term conditions and caring obligations. In this study, people identified retirement as a watershed moment, with some planning to increase their physical activity but many had not considered how they would achieve their ambitions, while some who had retired had adopted specific routines, which lead to them being very physically active. However, having more time and desire to exercise in retirement does not necessarily mean that a person will be physically active. At a local level, people need a variety of opportunities for physical activity that align with their preferences but also encouragement to try out various strategies to incorporate physical activity in to their daily lives. This may include everyday activities such a walking to the shops or gardening. Community nurses are in an excellent position to be health promoters and role models both to their clients, their carers and families. ‘Making Every Contact Count’ (Public Health England, 2016) offers the opportunity to contribute to healthy ageing. BJCN Centre for Ageing Better. Keeping on the move: understanding physical inactivity among 50-70 year olds. 2021. https:// ageing-better.org.uk/resources/keep-on-moving-understanding-physical-inactivity-among-50-70-year-olds (accessed 28 February 2023) Hsiao FY, Chen LK. What constitutes healthy diet in healthy longevity. Arch Gerontol Geriatr. 2022;102:104761. https://doi. org/10.1016/j.archger.2022.104761 Hsiao FY, Peng LN, Lee WJ, Chen LK. Higher dietary diversity and better healthy aging: a 4-year study of community-dwelling middle-aged and older adults from the Taiwan Longitudinal Study of Aging. Exp Gerontol. 2022;168:111929. https://doi.org/10.1016/j.exger.2022.111929 Liu D, Zhang XR, Li ZH et al. Association of dietary diversity changes and mortality among older people: a prospective cohort study. Clin Nutr. 2021;40(5):2620-2629. https://doi.org/10.1016/j.clnu.2021.04.012 Office of National Statistics. Living longer. 2018. https://www.ons.gov.uk/peoplepopulationandcommunity/ birthsdeathsandmarriages/ageing/articles/livinglongerhowourpopulationischangingandwhyitmatters/2018-08-13 (accessed 28 February 2023) Public Health England. Making Every Contact Count (MECC): consensus statement. 2016. https://www.england.nhs.uk/ wp-content/uploads/2016/04/making-every-contact-count.pdf (accessed 28 February 2023) Robinson SM, Reginster JY, Rizzoli R et al. ESCEO working group. Does nutrition play a role in the prevention and management of sarcopenia? Clin Nutr. 2018;37(4):1121-1132. https://doi.org/10.1016/j.clnu.2017.08.016 Spector T. Professor Tim Spector’s top five tips for a healthier gut microbiome. 2022. https://tinyurl.com/sx55zz3j (accessed 28 February 2023) UK Research and Innovation. Our story so far: healthy ageing challenge report 2022. 2022. https://www.ukri.org/ publications/our-story-so-far-healthy-ageing-challenge-report-2022/ (accessed 28 February 2023) World Health Assembly. The global strategy and action plan on ageing and health 2016–2020: towards a world in which everyone can live a long and healthy life. 2016. https://apps.who.int/iris/handle/10665/252783 (accessed 1 March 2023) World Health Organization. Decade of healthy ageing: baseline report. 2020. https://www.who.int/initiatives/decade-of- healthy-ageing (accessed 28 February 2023) 008_164_166_While’s Words.indd 166008_164_166_While’s Words.indd 166 22/03/2023 15:54:5522/03/2023 15:54:55 2023 MA Healthcare Ltd Copyright ofBritish Journal ofCommunity Nursingisthe property ofMark Allen Publishing Ltd and itscontent maynotbecopied oremailed tomultiple sitesorposted toalistserv without thecopyright holder’sexpresswrittenpermission. However,usersmayprint, download, oremail articles forindividual use.

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