...Read the attached article regarding new techniques for treating heart attack victims and identify the problem statement for a study among residents in the Minn. area where this new technique is being practiced. This study is to learn how the residents feel about the new technique being used. You might want to include survivors of this technique to learn of their assessment of the technique vs. the more commonly used techinque of clot busting. |PAGE ONE | | | | | | | | | | | |[pic] | |[pic] ...
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...A heart attack occurs when the blood supply to a portion of the heart muscle is severely reduced or stopped. This happens when one of the arteries that supply blood to the heart muscle is blocked by an obstruction. This blockage can be due to a condition called atherosclerosis (a buildup of fatty like substance along the wall of the artery), a blood clot or a coronary vessel spasm along with a total obstruction. If the blood supply to a portion of the heart stops, that area of the heart will no longer receive the oxygen or nutrients needed to carry out its function and will die. If it is a very small part of the heart involved, it will be able to work without it. If a large portion is damaged, irreversible damage will happen which can lead to death. Damage to the heart muscle may be so severe that it may cause abnormal heart rhythm, called arrhythmias. Most people who are of a myocardial infraction or a heart attack do so within a few hours due to a type of arrhythmia. The heart attack victim will complain of pressure, discomfort or a squeezing sensation in the center of the chest. There may be pain radiating to the arms or the neck. There may also be shortness of breath, weakness, fatigue, nausea, vomiting and or indigestion. The pain that occurs is the result of heart tissue ischemia (decreased blood supply). The area that is not receiving enough blood is literally crying out for help. When a person complains of any of the symptoms mentioned, they should be transported...
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...Case 2.1: Organizational Culture: Life or Death Questions: 1. What values appear to be driving the doctors and nurses in the hospitals to treat heart attack patients? From the case study, the eleven hospitals utilize 90 minutes or less to deliver therapy in order to restore blood flow to heart attack patients. The followings are the values that appear to drive the doctors and nurses in the hospitals to treat the heart attack patients: (a) The hospitals are well organized, they have ability to reward high quality performance, and are flexible enough to deal with setbacks. (b) Teamwork is another important value that drives doctors and nurses when treating heart attack patients. This is important because they need to work quickly. (c) All the hospitals shared the same core values, they were committed to reducing delays throughout their process, they provided real-time data feedback to measure success and had innovative protocols and flexibility in refining their protocols. (d) Effective communication and ethics is also critical. Doctors and nurses commit to their profession not only for financial gain, but also because they value human life and want to make a difference in the world by preserving life. They are also sensitive to their patients’ needs. Without these values it would not be feasible for the hospital to maintain their success and reputation of delivering therapy to restore blood flow to heart attack patients in only 90 minutes or less. This huge accomplishment...
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...8A1 This assignment lets you explore a quasi-experimental model using ANCOVA data analytical approach. By doing this data analysis project, you will understand a new quantitative research model when randomized sampling is not a choice. Specifically, you will develop analytical skills to use covariate to control for or partial out effects of pre-existing differences carried by sampling. To complete the assessment, answer each question, providing IBM SPSS analysis when necessary to support your answer. For this assignment, use the small batch of data provided by Warner's textbook on page 724. These are hypothetical data. We will imagine that a three-group quasi-experimental study was done to compare the effects of three treatments on the aggressive behavior of male children. Xc, the covariate, is a pretest measure of aggressiveness: the number of aggressive behaviors emitted by each child when the child is first placed in a neutral playroom situation. This measure was done prior to exposure to the treatment. Children could not be randomly assigned to treatment groups, so the groups did not start out exactly equivalent on aggressiveness. The dependent variable, Y, is a posttest measure: the number of aggressive behaviors emitted by each child after exposure to one of the three treatments. Treatment A consisted of three different films. The A1 group saw a cartoon animal behaving aggressively. The A2 group saw a human female model behaving aggressively. The A3group saw a human male...
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...Blood vessel Case study 1. Trace blood flow from the L popliteal vein to the lungs? Left popliteal vein to Left femoral vein to external iliac vein to common iliac vein to inferior vena cava to right atrium to tricuspid valve to right ventricle to pulmonary valve to pulmonary artery to lungs. 2. What is a DVT and why is heparin prescribed? A deep vein thrombosis (DVT) is a blood clot that forms in a vein deep inside the body which can lead to a serious condition. Typically, these blood clots form in your lower leg or thigh, but they can also form in other areas of the body. Heparin is an anticoagulant which will make her blood thinner and less of a risk for Jenny’s blood to clot. In Jenny’s case it will also keep her thrombus from growing in size and decrease her risk of developing more clots. 3. Explain what a PE is and why the physician is concerned that Jenny may develop this condition. A pulmonary embolism (PE) is a sudden blockage in a lung artery and is often a complication of a DVT. Which in Jenny’s case is a concern because her blood clot could break free and travel through the blood stream to the lungs and block an artery. If this was to happen and the clot was small, then Jenny could have some damage to her lungs. If the clot is large it could stop blood flow to the lungs and could cause death. 4. Jenny asks the physician if the DVT could lead to a heart attack and the physician says no. Explain why the physician is right. The physician...
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...Case 2.1: Organizational Culture: Life or Death Organizational Behavior MNGT 5590 Summary of Organizational Culture: Life or Death Organizational Culture is a pattern of shared basic assumptions invented, discovered, or developed by a given group as it learns to cope with its problems of external adaptation and internal integration that have worked well enough to be considered valid. Nevertheless, to be taught to new members as the correct way to perceive, think and feel in relation to those problems. Proceeding with Life or Death situation, individuals such as employees with the medical field, conduce to work with other employees where there is repetitive activities, strategies and rituals appearing on the job. Everyone must comprehend and know with certainty of their performance when dealing with Life or Death situations. Patients put their lives into the hands of these doctors, nurses, administrators, etc. It has been revealed that for employees to have success in the workplace is how closely an individual’s work habits match the culture in which different genders is employed. This case exemplifies success on the productivity and longevity. A research study was conducted on many top notch hospitals to see success of the hospitals that were involved in Life and Death aspects. The rapid, efficient and top quality treatment of heart attacks for survival consistently delivered therapy to restore blood flow to heart attack patients 90 min. or less, so researchers wanted...
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...treatments 12 Epidemiology. 13 Panic disorder in juveniles 14 Case Study. Definition Panic disorder is an anxiety disorder characterized by recurring severe panic attacks. It may also include significant behavioural changes lasting at least a month and of ongoing worry about the implications or concern about having other attacks. The latter are called anticipatory attacks (DSM-IVR). Panic disorder is not the same as agoraphobia (fear of public places), although many afflicted with panic disorder also suffer from agoraphobia. Panic attacks cannot be predicted, therefore an individual may become stressed, anxious or worried wondering when the next panic attack will occur. Panic disorder may be differentiated as a medical condition, or chemical imbalance. The DSM-IV-TR describes panic disorder and anxiety differently. Whereas anxiety is preceded by chronic stressors which build to reactions of moderate intensity that can last for days, weeks or months, panic attacks are acute events triggered by a sudden, out-of-the-blue cause: duration is short and symptoms are more intense. Panic attacks can occur in children, as well as adults. Panic in young people may be particularly distressing because children tend to have less insight about what is happening, and parents are also likely to experience distress when attacks occur. Screening tools like Panic Disorder Severity Scale can be used to detect possible cases of disorder, and suggest the need for a formal diagnostic assessment...
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...could lower risk of knee replacement surgery- Results from a new study actually showed that individuals who smoked had reduced risks of undergoing total joint replacement surgery than those who never smoked since the study revealed that nicotine in tobacco could prevent cartilage and joint deterioration. 2) Smoking helps the heart drug clopidogrel work better- a study by some researchers revealed that there was something in cigarette smoke that activates certain proteins called cytochromes, which convert clopidogrel into a more active state. 3) Smoking could lower risk of death after some heart attacks – in some research conducted, smokers that had experienced heart attacks compared to non-smokers had lower death rates and better responses to two kinds of therapy to remove plaque from their arteries. 4) Smoking reduces risk of obesity – since the nicotine in tobacco smoke can suppress appetite, smokers were likely to eat lesser. 5) Smoking lowers risk of Parkinson’s disease – studies have revealed that long-term smokers compared to non-smokers in the long run had lesser chances of contracting Parkinson’s disease. Disadvantages 1) Smoking causes lung cancer – studies have shown that a larger percentage of lung cancer cases in these patients is as a result of smoking. 2) Smoking causes death – hundreds of people die annually across the world as a result of smoking related diseases. 3) Smoking increases heart rate and blood pressure – from smoking cigarette a mixture of...
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...Coronary Artery Disease. Coronary artery disease is the narrowing or blockage of the coronary arteries, usually caused by atherosclerosis. Atherosclerosis (sometimes called “hardening” or “clogging” of the arteries) is the buildup of cholesterol and fatty deposits (called plaques) on the inner walls of the arteries. These plaques can restrict blood flow to the heart muscle by physically clogging the artery or by causing abnormal artery tone and function. Without an adequate blood supply, the heart becomes starved of oxygen and the vital nutrients it needs to work properly. This can cause chest pain called angina. If blood supply to a portion of the heart muscle is cut off entirely, or if the energy demands of the heart become much greater than its blood supply, a heart attack (injury to the heart muscle) may occur. Your coronary arteries are shaped like hollow tubes through which blood can flow freely. The muscular walls of the coronary arteries are normally smooth and elastic and are lined with a layer of cells called the endothelium. The endothelium provides a physical barrier between the blood stream and the coronary artery walls, while regulating the function of the artery by releasing chemical signals in response to various stimuli. Coronary artery disease starts when you are very young. Before your teen years, the blood vessel walls begin to show streaks of fat. As you get older, the fat builds up, causing slight injury to your blood vessel walls. Other substances traveling...
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...Superintendent Dr. W.A. White from Secretary of the Interior F.K. Lane suggested the use of dogs as companions for the psychiatric hospital's residents. From 1944 to 1945 at an Army Air Corps Convalescent Hospital at Pawling, New York was the earliest known extensive use of companion animals. Farm animals were used with patients that were recovering from war experiences. After the war, they began to use animals in outpatient psychotherapy. During the 1970's, case studies were reported of animals facilitating therapy with children and senior citizens. In our own time the urban population's often unsatisfied need for intimacy, and contact with nature may reflect the great increase in pet ownership. According to the article Live Longer- Own a Pet, no author, stated "the US Department of Health concluded that pets increased the survival rate of heart attack victims. The study revealed that 28% of heart patients with pets survived serious heart attacks, compared to only 6% of heart patients without pets." Medical studies on the human-animal bond reveal that pet owners are more likely to have reduced stress...
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...announced that it had prematurely ended a large national study of how best to treat people with high blood pressure because of its exceptional results. In this trial of more than 9,000 people age 50 and older with high blood pressure, an aggressive treatment strategy to keep systolic blood pressure below 120 was compared with a conventional one aimed at keeping it below 140. The subjects all had a high risk of heart attacks, stroke and heart failure. The N.I.H. concluded, six years into a planned eight-year study, that for these patients, pushing blood pressure down far below currently recommended levels was very beneficial. Ending a study early is rather unusual. In such cases, studies are stopped not by the investigators, but by an independent group of expert scientists who monitor the trial for evidence of unexpected harm or benefit that requires swift action. When a trial is halted early it is a surprise to the researchers who must not only move quickly to notify the participating doctors and subjects, but also decide how to communicate the results. The usual practice is to make a public announcement with an interpretation of the findings and then finalize the database and write the paper. The N.I.H. followed this playbook, and the media reported that the findings supported more vigorous treatment of high blood pressure, treatment that could be lifesaving. It was reported as major news. The problem is that many details of the study have not been released. It will be months before...
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...Cigarettes are the single-most traded item on the planet, with approximately 1 trillion being sold from country to country each year. At a global take of more than $400 billion, it’s one of the world’s largest industries (Listverse, 2011). Cigarette smoking in public places is a widely controversial topic. Many people are unaware of the actual history of smoking bans. People are also unaware who is affected by smoking regulation in public places, the effects on society, why it is important to solve the problem of cigarette smoking in public places in concern to regulation, and possible solutions that are out in the world to help solve this problem. The first known smoking ban occurred in 1590 and was given by Pope Urban VII during his short reign as pope. Anyone who was caught smoking or chewing tobacco near a church was excommunicated. It was not until the twentieth century that the health problems associated with tobacco use came to light in the public eye. This is the time when businesses provided smokers with their own separate locations, so they could smoke without exposing the rest of the customers to the dangers and annoyance of smoke (Reasons, pros, and cons, 2008). In the 1990s, California became the first state to issue a smoking ban, and this was in restaurants. Since that time, many cities have taken up the drive to ban cigarette smoking in public locations, particularly restaurants. In fact, recent estimates show that as many as thirty-four states have cities...
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...Symptom Presentation and Treatment for Women Experiencing Acute Coronary Syndromes: Do They Differ from Men? Symptom Presentation and Treatment for Women Experiencing Acute Coronary Syndromes: Do They Differ from Men? There is an overwhelming cultural perception in the United States that coronary artery disease and heart attacks are a disease affecting men and that they are most deadly to the male species. In fact, Acute Myocardial Infarctions, or heart attacks, kill more women then all cancers combined and a female experiencing a heart attack is more likely to die from it than a man (Shirato & Swan 2010). Is there a difference between the way women and men experience an Acute Coronary Syndrome (ACS) whether it is Unstable Angina or a true Acute Myocardial Infarction (AMI)? Numerous studies have identified the symptoms females experience when they are suffering from a cardiac event and compared them to males resulting in noteworthy trends identified in the female symptoms. It is also noted that the perception of female cardiac symptoms by the lay community, the health care community and the patients themselves, contribute to the increased death rate in women with AMI. With improved public health education focused on what we’ve learned about the prevalence and seriousness of women experiencing an ischemic cardiac event and their unique symptoms, along with improved training for health care providers that promotes early recognition and aggressive medical...
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...1. Introduction This assignment is a critique on the study published in The New England Journal of Medicine (NEJM) entitled ‘Homocysteine Lowering and Cardiovascular Events after Acute Myocardial Infarction’ by Bonaa et. al (2006) (also known as The NORVIT study). NEJM’s most recent impact factor was 51.296 (in 2006). NEJM boasts the largest paid circulation among medical journals, with close to 200,000 paying subscribers. It is printed weekly in the United States, Canada, the Netherlands, and Japan, and a range of translated articles reaches approximately 140,000 (New England Journal of Medicine.org, 2006). The NORVIT study was designed as a randomized, controlled, double-blind, intervention study. It included 3,749 men and women who had suffered and acute myocardial infarction within the last 7 days. The rationale behind the study was that high homocysteine levels are considered a risk factor for cardiovascular disease (Bonaa et al, 2006). The aim was to measure how effective lowering blood serum homocysteine levels with B vitamins was in preventing a secondary event. A collaborative meta-analysis published in The Journal of the American Medical Association, states that homocysteine levels are an independent predictor of ischemic heart disease and that studies on disease risk of genetic variants affecting homocysteine may help establish whether homocysteine is causally linked to vascular disease (2002: cited by Bonaa et al, 2006). The meta-analysis suggests that a large...
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...Case Analysis #1 Tuesday, January 22, 2013 Matt Janes Merck & Company, Inc: The Recall of Vioxx Introduction Geroge W. Merck stated once stated, “We try never to forget that medicine is for the people. It is not for the profits. The profits follow. Initially, Vioxx was the blockbuster drug that Merck needed due to the upcoming Zocor patent cliff in 2006. With an estimated 27,785 heart attacks and sudden cardiac deaths that could have been avoided if Celebrex had been used instead of Vioxx, Merck faces the possibility of not only having to pay enormous civil and criminal penalties, but also losing the trust of patients. Many parties are partially culpable, but Merck faces the severe uphill battle of regaining a reputation that once served as a market differentiator; in the 1980’s, Merck was voted the “Most Admired Company in American Business” for seven consecutive years. A critical issue in this case is to analyze the events listed in the case and propose an alternate course of action that may help prevent future deaths from other pharmaceutical drugs while not prohibitively restricting innovative research that could potentially save lives if tested properly. Critical Points and Issues Merck was relying on the success of Vioxx due to Zocor’s expiring patent and the direct competition Vioxx was engaged in with Celebrex, which had a first mover advantage. While Celebrex was also a Cox-2 inhibitor, Vioxx was the only Cox-2 inhibitor proven to be beneficial...
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