...death for women and men worldwide. Women are more vulnerable to myocardial infarction because of the size of their coronary arteries. They have unique risk factors such as a high level of cholesterol, hypertension, and smoking that cause heart disease, which leads to the high mortality rate. To reduce the high mortality rate among women, nurses must play their roles as educators because they interact frequently with patient, moreso than any other health care workers. Nurses must educate their patients on how to prevent the risk factors of heart disease. In order to reduce the high mortality rate due to MI in women, the Obama administration implemented the Patient Protection and Affordable Care Act (PPACA), popularly called t "Obama Care". This policy has mandated that insurance companies cover important preventive care at no cost, which will help eliminate the expensive bills that would have been incurred. As a future nurse, I would address the issue of heart disease by providing qualitative education and creating awareness of the causes and preventive measures of heart diseases. Keywords: Affordable Care Act, Heart Disease, Myocardial Infarction, "Obama Care", and Women's Health. Introduction Although both men and women have increased mortality rates due to heart disease in the United States, women have the higher rate and carry a heavier cardiovascular burden due to their worse prognosis. Before discussing the details about heart disease, it is very important to shed...
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...from an acute ST-Elevation Myocardial Infarction (STEMI). His risk factors include obesity, Type II diabetes mellitus, and family history. Upon exam the patient asks why he has not been started on a beta blocker yet. He explains further that when his brother had a “heart attack” in 2005, he was immediately placed on a beta blocker because the cardiologist reported how beta blockers reduce mortality after myocardial infarction (MI). The patient wants to know if a beta blocker would reduce his chance of mortality? Using the Patient-Intervention-Comparator-Outcome (PICO) format we formulated the following question. In a 67-year-old male with multiple co-morbidities with MI (P), does treatment with a beta blocker (I), compared with no beta blocker or placebo (O), reduce mortality rate (O)? Risk Factors, Incidence and Prevalence of Disease * US incidence rates of cardiovascular disease, including MI, are seen in men more than women (Alexander et al., 2007). This trend is also true in Utah ("Impact of heart," 2007). * The incidence rates of cardiovascular disease increase with age (Alexander et al., 2007). * Risk factors for cardiovascular disease include not eating enough fruits and vegetables, lack of physical exercise, smoking cigarettes and the co-morbidities of diabetes, hypertension, hyperlipidemia, and obesity ("CDC national heart," 2010). * The clinical scenario patient was at high MI risk being male, over 65, diabetic and obese. Article Critiques ...
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...Forum met in May 2000 to conclude a two-year consultation process covering issues such as poverty eradication, environmental protection, human rights and protection of the vulnerable. A major conference was held at UN headquarters in New York on 20–22 September 2010 to review progress to date, with five years left to the 2015 deadline. The conference concluded with the adoption of a global action plan to achieve the eight anti-poverty goals by their 2015 target date. There were also major new commitments on women's and children's health, and major new initiatives in the worldwide battle against poverty, hunger and disease. Child mortality continues to decline worldwide. The total number of deaths of children below five years of age fell from 12.4 million in 1990 to 7.7 million in 2010. Mortality in children below five years of age (under-five mortality) has fallen from 89 per 1000 live births in 1990 to 60 per 1000 live births in 2009, representing a reduction of...
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...Evidence Based Nursing Practice Morise Oluwole Walden University Nurs 4000- Research and Scholarship for Evidence -Based Practice September 6, 2015 PRESSURE ULCERS An essential part of nursing care of hospitalized patients is skin integrity maintenance. As markers of the values or products of care most affected by the assessment and interventions delivered by nurses, the rate of PUs is being screened thoroughly now than ever before (Manning, 2015). Pressure ulcers (PUs) are preventable, but PU rates persist to increase disturbingly fast, according to an article by Gary and Hampton published in 2015, the incidence of PUs has increased in the US between 1995 and 2008. The purpose of this paper is to review the incidence of PUs and how to prevent its occurrence and nurses’ responsibility. Practice Setting Problem Pressure ulcer occurs when part of the skin and the tissues underneath are impaired as a result of being placed under enough pressure to impair blood supply. Immobility-related pressure ulcers are defined as localized areas of tissue damage that develops when soft tissue is compressed between a bony prominence and an external surface for a prolonged time. The most common sites were the sacrum, the heel, the ischium and the trochanter. Pressure is where the weight of the body squeezes the tissues between a bony prominence (such as heel, elbow, sacrum or ischials etc) and a hard surface (such as bed, chair or, in the case of heels, the floor). There are four...
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...a child with asthma equaling $1039. The burden of asthma falls disproportionately on some minorities and particularly on children (“Asthma Facts”). The burden of asthma falls disproportionately on children under age 18. For the period 2008–2010, asthma prevalence was higher among children than adults. This is evidenced in the rates of asthma-related use of health care services, which are two to three times higher for children than for adults. . Asthma is the third leading cause of hospitalization among children under the age of 15. Only the asthma mortality rate is lower for children (“Asthma Facts”) Asthma Disparities and...
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...LUCK ABSTRACT Objective: To review the findings of safe motherhood intervention studies conducted in African settings. Data sources: Published literature regarding interventions designed to reduce maternal mortality in African settings. Study selection: Studies conducted in sub-Saharan Africa to assess the effects of interventions designed to reduce maternal mortality. Data extraction: Search of Medline database for the years 1988 to 1998 with additional manual search of references cited in Medline-referenced studies. Data synthesis: Few of the 34 intervention studies identified used a double-blind, randomized controlled trial design (4/34), or outcome measures directly related to maternal mortality or maternal health (7/34). Six of the studies produced reasonably convincing evidence of a positive effect on maternal health outcomes. Of these, three showed that changes in delivery practices brought about improved maternal outcomes, two found that a combined intervention consisting of upgrading of emergency obstetric services and community education increased the number of major obstetric complications treated, and one showed that a range of improvements in hospital equipment and management reduced facility-based maternal mortality ratios. No study sought to reduce maternal mortality associated with unsafe termination of pregnancy. Conclusions: More than a decade after the launching of the Safe Motherhood Initiative, there exists little evidence regarding which interventions...
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...(SES), health and survival rates have been firmly established by social epidemiologists. Nevertheless, in spite of improving western living conditions and wide access to health services and information, social inequalities in health and mortality still prevail. In some instances, wide accessibility to health care appears only to deepen socioeconomic divisions of health and mortality rates (Gottfredson, 2004). Why this should be the case has led researchers to seek out further predictors of morbidity and mortality across the social spectrum. From these efforts a new field of study, cognitive epidemiology (Deary & Der 2005) is seeking to establish general intelligence scores as risk factors for mortality and certain health outcomes. This is a comparatively new field of research, and findings with regard to the extent and exact causal mechanisms of an association between intelligence, health and longevity remain far from conclusive. For instance, some researchers claim that intelligence is the ‘elusive fundamental cause’ of health inequalities (Gottfredson, 2004); whilst others negate the impact of intelligence once SES factors and education are controlled for (Singh-Manoux & Kivimaki, 2009; Hauser & Palloni, 2008). Intelligence tests are long established as valid predictors of occupational success and educational attainment, both of which have a direct bearing on health outcomes. The question is to what extent, if at all, SES and other risk factors, are proxies of...
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...death more than any condition in women over the age of 50, including cancer (1) and in fact is responsible for more than a third of all deaths in women (2). It is estimated that 370,000 women in the United States die from heart disease each year. However, our knowledge base regarding CVD in African American (AA) women has not kept pace with the accumulation of data on white females. Thus, there is a deficit of information about this subgroup and the prevalence of CVD despite the fact that black women have more risk factors for CVD than do white women (3). The purpose of this paper is to review the subject of CVD in African American women and to focus upon four principal CVD categories: Coronary artery disease (CAD), hypertension, stroke, and congestive heart failure (CHF).The impact of gender and race on each of these entities will be examined in comparison to white women, and a determination will be made as to whether a different approach to the management of these disorders should be made based on ethnicity and sex. Coronary Artery Disease It has long been held that men have much more of a problem with CAD than women do; the belief has been that men are more susceptible to the disease, whereas...
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...INTRODUCTION Placenta previa is generally defined as the implantation of the placenta over or near the internal os of the cervix. There are four types of placenta previa; total, low-lying, partial, and marginal. The higher incidence of low-lying placenta and placenta previa is sonographically diagnosed in the second trimester and ranges from 6% to 46%. This rate, however, decreases to as low as 0.5 % at delivery (11). Despite advances in blood transfusion techniques and surgical procedures, abnormal placentation still remains a difficult challenge for obstetricians. Intrapartum maternal hemorrhage and the need for emergency cesarean section or hysterectomy related to abnormal placentation are main causes of maternal-fetal morbidity and mortality. The overall incidence of placenta previa at delivery is reported as 0.5 % in most studies (3, 5) and the risk factors for placenta previa include advanced maternal age (above 35 years), parity, smoking, and, most importantly, prior cesarean delivery. Placenta previa with prior cesarean delivery increases risk up to 1% - 4%. As the number of previous cesarean deliveries increases, the incidence of placenta previa and abnormal placentation shows a linear increase (3). Vaginal ultrasound is the most accurate method for localizing and diagnosing placenta previa, because it can provide a better resolution in the lower margin of the placenta (4, 6, 11). There is a little increase in congenital anomalies associated with placenta previa...
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...conducted in Britain shows that the 40% mortality rate among men and 10% mortality rate among women between the ages of 45 and 65 years are due to coronary heart disease (Brennan, 1997). In Europe 22% of deaths are related to coronary heart disease. Most heart attack survivors are not receiving enough systematic help with rehabilitation, which results in anxiety, stress, depression and finally poor outcomes (Brennan, 1997). Living with these symptoms causes increased rate of morbidity and mortality after the infarction. One of the goals of cardiac rehabilitation is the reduction of morbidity and mortality through exercise training, dietary changes, smoking cessation and type A behavior modification. The second goal is amelioration of distress associated with cardiac pathology through the use of new coping strategies such as behavioral and cognitive techniques and stress management programs and anger control (Brennan, 1997). Exercise program is the most important intervention by researchers and clinicians. But the other form of intervention, like the effectiveness of smoking cessation programs, has received little attention. This article reviews the evidence for the efficiency of different forms of intervention that are focused on reducing distress and limiting risks during the post-infarction period. Exercise programs in cardiac rehabilitation studies prove their impact on the recurrence of myocardial infarction (Brennan, 1997). The stress management programs help to reduce psychological...
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...Management of Diabetes in Adults Age 65 and Older: An Evolving Concept Analysis Yaounde Ross University of Texas at Arlington College of Nursing In partial fulfillment of the requirements of N5327 Analysis of Theories in Nursing Ronda Mintz-Binder, RN, MN, DNP June 4, 2012 Management of Diabetes in Adults Age 65 and Older: An Evolving Concept Analysis Managing chronic illnesses like diabetes is becoming progressively essential in high-risk groups. The concept of managing diabetes in persons 65 and older, carry much responsibility by those who provide care and those receiving care. With marvel surrounding the first set of baby boomers who turned age 65 in January of 2011; it became evident that this country would embark upon its greatest challenge yet in managing the care of older adults. With this in mind, the management of chronic illnesses like diabetes and its associated complications is expected to become even more complex and difficult, with the realization that much is to be considered in preparation to care for this age group. In this analysis using the term management, as it relates to the older adult, implies direct guidance to treatment that is both accessible and practical. Review of Literature To better understand management of diabetes as a concept in adults age 65 and older, a review of disciplines is necessary to offer clarity in obtaining a greater sense of knowledge of the burden this disease places on the patient. In examining this concept...
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...Ethiopia i Abstract summary Background: Sepsis is a final pathway of infectious disease in critically ill patients. It is highly fatal condition. Though many researches are undertake in pathophysiology, epidemiology and management of sepsis in developed nation ,very limited information is available in low incomes countries where infections are prevalent. Objective: The objective of the study was to determine the prevalence and outcome of sepsis and its prognostic factors in patients admitted to Jimma University Specialized Hospital. Method: Patients with systemic inflammatory response due to infections were studied using prospective cohort study design for four month period in Jimma University hospital. A structured questioner was used to collect data on socio demographic feature of the patient and clinical feature, outcome and prognostic factors . Data was cleaned, edited and entered to SPSS window for analysis. The survival analysis and determination of prognostic factors was done using Cox regression model. The value of p < 0.05 was considered statistically significant. Result: The prevalence of sepsis, severe sepsis, septic and refractory shock in the study population was 14%.7.8%,2.1% and 1.4% with their associated all cause mortality of at the end of 28 days are 35.8%,44.1%,68.8% and 88.9% respectively. The clinical variables that...
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...Medical Cannabis Laws and Opioid Analgesic Overdose Mortality in the United States, 1999–2010 Author Manuscript Marcus A. Bachhuber, MD, Brendan Saloner, PhD, Chinazo O. Cunningham, MD, MS, and Colleen L. Barry, PhD, MPP Center for Health Equity Research and Promotion, Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania (Bachhuber); Robert Wood Johnson Foundation Clinical Scholars Program, University of Pennsylvania, Philadelphia (Bachhuber); Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia (Bachhuber, Saloner, Barry); Robert Wood Johnson Health and Society Scholars Program, University of Pennsylvania, Philadelphia (Saloner); Division of General Internal Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York (Cunningham); Department of Health Policy and Management, the Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (Barry) Abstract Author Manuscript IMPORTANCE—Opioid analgesic overdose mortality continues to rise in the United States, driven by increases in prescribing for chronic pain. Because chronic pain is a major indication for medical cannabis, laws that establish access to medical cannabis may change overdose mortality related to opioid analgesics in states that have enacted them. OBJECTIVE—To determine the association between the presence of state medical cannabis laws and opioid analgesic overdose mortality. DESIGN, SETTING, AND PARTICIPANTS—A time-series...
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...1 Health Care Issues in the United States Ashley Barnes Dr. George Ojie-Ahamiojie Health Services Organization Management July 15, 2010 2 Describe how health is affected by behaviors, economics and social structure. When it comes to our health, there are numerous factors that play a part in whether or not we stay healthy or not; some factors we can control(physical activity & nutrition), while others are not always up to us to decide (poverty level, income). There are six key factors identified by the Centers for Disease Control(CDC) (2010) that affect the health of individuals: alcohol and drug use, smoking, injury and violence, physical activity and sexual risk behaviors. A majority of these factors an individual can chose to engage in or not, however, economic situation and social structure can impact those decisions as well. For people who are in a less affluent status, they may not be able to purchase the more nutritious option in a grocery store and will have to resort to buying enriched and over processed food products that are less expensive. These types of groceries do not provide the necessary nutrition and with prolonged consumption of these goods, can lead to adverse health effects such as obesity and diabetes. Engaging in behaviors such as drinking, risky sex and violence can lead to issues later in life if started at a young age, and contribute to education and social problems that the United States currently faces (CDC, 2010). Certain...
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... The access to quality healthcare is at risk due to the healthcare workforce shortages. The shortages include all members of the hospital work staff from nurses to primary care physicians to highly trained surgeons. Many hospitals do not have enough nurses to tend to the patients. The United States is projected to have a nursing shortage that is expected to intensify as baby boomers age and the need for health care grows. Compounding the problem is the fact that nursing colleges and universities across the country are struggling to expand enrollment levels to meet the rising demand for nursing care. ("AACN") The enrollment in for educational programs for medical professions whether hospital-based or in colleges and universities has declined significantly. There are simply not enough graduates to fill existing or anticipated vacancies. There are other issues that add to the shortages of nurses in the healthcare workforce. Such as; insufficient staffing which is raising the stress level of nurses, impacting job satisfaction, and driving many nurses to leave the profession. The high turnover and vacancy rates have an impact on healthcare. Insufficient nurse staffing is related to higher patient mortality rates. The mortality risk for patients was about 6% higher on units that were understaffed as compared with fully staffed units. (Clark) The mortality risks also increases when the nurse’s workload increased due to high patient turnover...
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