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Mothers of Infants with Heart Defects and Increased Long-Term Risk of Cardiovascular Disease
No full textBackground: Cardiovascular disease (CVD) is responsible for approximately 1 in every 3 deaths of women in the United States. Recognizing the symptoms and predicting presentation is extremely difficult, particularly for women. If providers are able to determine risk factors early on, preventative measures or treatment can be initiated. This review assesses the evidence of whether having an infant with heart defects increases a woman’s long-term risk of developing CVD. Methods: A comprehensive literature search was conducted using MEDLINE-PubMed, Web of Science, and CINAHL. The following keywords were utilized in the search: women, maternal health, mothers, cohort study, mortality, cardiovascular, infant, long term and congenital. These articles were assessed for quality using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) guidelines. Results: Two studies that met inclusion criteria were included in this literature review. One retrospective observational study found that there was an increased risk of mothers of infants with critical or noncritical heart defects had an increased risk of developing CVD when compared to mothers of infants without heart defects. The other retrospective observational study concluded that mothers of infants born with a major congenital anomaly had a minor but statistically significant increased risk of mortality when compared to mothers of infants born without congenital anomalies. Conclusion: Mothers of infants with heart defects have an increased long-term risk of CVD. This information can be utilized to help increase screening and adjust treatment plans for women in this category who are at an increased risk for CVD. Additional research would determine if the risk further increased in post-menopausal women who are already at a higher risk of developing CVD
The Incompatibility of Democracy and Equal Freedom
Full text linkIt is commonly believed that democracies are freedom preserving. In a limited, consequentialist sense, this presumption may be correct. However, if someone were to look critically at an application of liberal democracy, she would discover that democracy is not as consistent with freedom as it appears to be. This paper argues that democracy is incompatible with equal freedom as realistic applications of democracy undermine liberty on both a practical and structural level. To accomplish this task, this paper discusses the role of group agents in a democratic political system. While voting allows citizens to express their opinions, voting cannot—in practical or theoretical terms—preserve equal freedom as a result of an individual vote’s lack of efficacy. By forcing individuals to act as groups, democracy undermines equal freedom
The Impact of Racism on Asthma in Minority Pediatric Populations
Full text linkBackground: Asthma is one of the most common chronic diseases diagnosed in children today, and some minority populations constitute a much higher incidence of asthma than others. Many factors are known to play into the development of asthma, including genetics, smoking history, and psychosocial stress. Experiencing childhood racism may be one type of stressor that contributes to the development of asthma and poor asthma outcomes. This study aims to identify the effect of experienced racism on asthma outcomes in minority children.
Methods: An exhaustive search of available medical literature was conducted using the databases MEDLINE – PubMed, CINAHL, and Web of Science. An age filter was applied in all databases encompassing children from birth to 21 years old. The key terms used were asthma and racism. Eligibility criteria included English language and human-only studies. Articles must also have included at least one measured asthma outcome and involved minority participants. Studies were assessed for quality using GRADE criteria.
Results: The search produced 2 available studies that met search criteria, both being case-control studies. Although measuring different asthma outcomes, the studies suggested that African American children who report experiencing racism to any degree have a higher incidence of asthma, and are more likely to have poorly controlled asthma. Data on other minorities showed mixed results. The overall quality of evidence provided is low for asthma incidence and very low for poor asthma control.
Conclusion: The data suggested that for African American children, those who reported experiencing racism were more likely to have asthma, more likely to have poorly controlled asthma, and had a higher bronchodilator (BDR) response. One study’s data on other minority children showed mixed results, and different asthma phenotypes may also play a role in susceptibility. Further studies are needed, particularly cohort studies, to further determine the effects of racism on asthma in different minority populations, and to increase our confidence in the results. This may help us understand if additional screening is needed for children who may be at risk for asthma and poor asthma outcomes, and to help aid in treatment plans
Interprofessional Training for Optometric Learners
Full text linkHealthcare systems have become increasingly complex due to technology, medical advances, socioeconomic divides, and provider specialization. With these changes, there is a growing need for collaborative healthcare practice to avoid gaps in care delivery.
In order to best train future providers, interprofessional models have been proposed as a method of bridging healthcare gaps. Optometry is one of many professions that is starting to embrace interprofessional care. The purpose of this review is to assess the viability of interprofessional education as part of a core optometry curriculum based on substantiated data that such efforts are necessary in healthcare delivery
The Influence of Organizational Culture on Lean Implementation in Healthcare
Full text linkA stable organizational culture is necessary to sustain operations in healthcare organizations. In this paper, I explore the value of the Toyota Production System (TPS), also known as Lean Management, in healthcare organizations. Extant literature and empirical evidence have shown that lean has the potential to positively change the culture of a healthcare organization because it creates a foundational level of “Lean Thinking.” That said, my goals are to determine whether: 1) there is resistance to Lean implementation; and 2) a positive effect occurs in an organizational culture with a Lean environment and the specific mechanisms of this change. This literature review examines Lean thinking with lean resistance and opportunities, the idea of culture capability, and a new concept referred to as “systems approach.” Three views on lean thinking in healthcare are prevalent in the literature; 1) the idea that every person in the organization is of equal importance; 2) arguments for success are factors of engagement; and 3) resistance to Lean’s implementation. A more comprehensive review of this literature is needed to understand the topic, subtopics and questions
The Impact of Embeddedness, Leadership, and Succession on Technology Initiative Perceptions of Success (TIPS) in American International Schools
Full text linkThe purpose of this study is to learn how embeddedness, leadership style, and succession in an American international school setting affects perceptions of success related to technology initiative implementation. This study will use both case study and survey data methods. The goal of the study is to identify aspects that play a role in faculty perceptions in order to better plan out new initiatives. The results can help leaders to increase the likelihood that their future initiatives are perceived as successful
