Category Archives: Medslat

Public Health: What’s Societal Support Got To Do With Your Health

Patients Environment, Health Practices and Public Health

Health is more than not being sick. Health is a resource for everyday living. It’s the ability to realize hopes, satisfy needs, change or cope with life experiences, and participate fully in society. Health is influenced by important factors such as the physical environment, health practices and coping skills, biology, health care service and the social and economic environment in which people live their daily lives.

Patient’s Environment, Health Practices and Public Health

Although it may be quite easy to see how a patient’s physical environment, health practices and coping skills can affect their condition and how they handle it; the socio-economic aspect of it might not be so obvious. The importance of social and economic support is essential for everyone to lead a healthy life; and according to a new study, for people diagnosed with a type of cancer called Acute Myelogenous Leukemia (AML), it can also significantly affect the odds of their survival.

Researchers who conducted this new study where able to discover from the database of more than 5000 people, all under the age of 65, that socioeconomic factors not directly related to their medical care or condition often played a significant role in the outcome of their treatment. Also putting their age and the progression of their disease into consideration, it appears to be that the research experts have been able to establish a pattern that reveals just how important societal support is for those suffering from one disease or the other –in this case, AML.

A lot was revealed in the study that give credence to the fact that although drugs, medications, therapy and other medically related solutions may go a long way in affecting a patients struggles with a disease; interpersonal relationships, interactions and economic supports that may or may not be closely related to the disease, can also be of an immense help as well.

Patients Environment, Health Practices and Public HealthIn relation to AML patients, the study revealed that specifically, certain people were at much greater risk of dying early, including those who were single or divorced. Also, people who were uninsured, on Medicaid or living in lower income areas were also more likely to die prematurely. The results of this study were published online Sept. 14 in the journal Cancer. And it certainly brings to light some sense of hope for those who suffer from AML and other chronic illnesses, as it shows that they could fight the disease effectively with both fiscal and emotional support from family, friends, and cooperate well wishers.

Though more research is still needed to understand exactly how these factors affect health and health disparities, studies have been conducted that point to such conclusions as:

  • Social and economic factors can influence decisions and behaviors that promote or threaten health, can offer a broad array of opportunities to improve health, and can have negative or positive health effects.
  • Discrimination and racism play a crucial role in explaining health status and health disparities, through factors such as restricted employment and educational opportunities and mobility, limited access to and bias in medical care, limited access to safe recreation and healthful food, residential segregation, and chronic stress.
  • High risk personal behaviors such as cigarette smoking, alcohol use, and physical inactivity are not the major cause of health disparities, explaining less than 20% of the difference in death rates across income groups.

Based on the case study on AML patients that could invariably be generalized, medical practitioners and experts can quite easily arrive at a simpler conclusion, which is to encourage and help facilitate the bridging of any societal gaps; create policies that get patients more involved in outdoor interactive activities; and basically get people to realize the immense health benefits of societal support for those with chronic illnesses.

Nurses Race Against Providing Timely Efficient Patient Care

Nurses and patient management system

A nurse is a trained professional, who gives care –mostly medical– to people who are sick or injured. Nurses are highly skilled health care experts with years of medical and ethical training to master the art of caring. Combining this art with scientific and medical knowledge, nurses often stand as professional assistants to Doctors in any medical institution under any desired medical field. They also help patients with the administration of drugs and medications. And in addition to that, they are often tasked with being medical watch-dogs over patients with chronic health issues.

Importance of Nurses and Nurses Code of Ethics

The importance of nurses and nursing staffs can never be overemphasized. Without mincing words, this can be said assuredly based on the fact that nurses are most often the closest health care professionals to patients. In a way that is more pronounced than subtle a good Patient-Nurse relationship often goes a long way to aid in quick and speedy recovery. A nurse is involved in the education of patients around health and disease processes whilst providing quality health care assistance to such patients.

Unfortunately though, many nurses are faced daily with the tedious task of caring for numerous patients with very little assistance, as they also try hard to stay within the tenets of medical and health care efficiency. Although, some might argue that this is just one of the many perks that comes with their service to humanity –a service they have sworn to uphold– it is however necessary to remember that nurses, like patients are also human and as such can be prone to errors and mistakes; only such mistakes could often be on a life threatening scale.

Nirsing and patient management systemAccording to page 1 of the International Council of Nurses Code of Ethics for Nurses, it states that “Nurses have four fundamental responsibilities: to promote health, to prevent illness, to restore health, and to alleviate suffering”. Although all medical professional are guided by a similar Code of Ethics, those of the nurses are much more centered on a very direct patient care. This means that, when it comes to administering drugs to a patient, it is the nurse’s duty.

It would seem as not much of a task until one goes to add, say, 50 patients to the roster of a particular nurse and anticipate the possibility of him/her being able to attend to each and every one of them effectively and efficiently. Such an outcome would be most unlikely and it is then that a clearer picture of one of the pressing issues plaguing the profession comes to light.

For decades there has been a rule that required that nursing staffs were to administer medications and drugs to patients within 30-minutes of the scheduled administration time. In 2008, the Centers for Medicare & Medicaid Services (CMS) issued Appendix A, Survey Protocol, Regulations and Interpretive Guidance for Hospitals, which spells out the conditions of participation for hospitals to receive Medicare or Medicaid payments; The effective adherence to the 30-minutes rule was one of the conditions.

In late September 2010, a survey was conducted by the non-profit organization ISMP (Institute for Safe Medication Practices) that elicited responses from almost 18,000 Nurses.According to their survey, most of the respondents made it clear that changes to drug delivery methods, plus the gradually increasing complexity of care and other factors, made the long-standing CMS “30-minutes rule” impossible to follow. Many of the nurses, the survey reveals, reportedly felt pressured to take a couple of shortcuts just to comply with the CMS rule. Some of the shortcuts include:

  • Not thinking critically about drug administration while rushing through verification of new orders and actual drug administration
  • Leaving medications in the room for the patient to take at the right time.
  • Documenting administration at the scheduled time, but actually giving the drug early or late
  • Altering drug administration schedules to avoid documenting late administration
  • Skipping important double-checks due to time constraints
  • Borrowing medications from one patient to administer to another patient and so on.

Although a lot of the shortcuts that many nurses who partook of the survey revealed may very well go against the tenets of the ICN Code of Ethics, there is no doubt, that many of these nurses do intend well for their patients. Nonetheless, these at-risk behaviors are often unintended consequences of attempting to comply with a rule that aims to optimize the efficiency of nursing staffs, but succeeds in only pushing them to taking routes that often leads to harmful errors.

The organizers of the survey have indicated intent on going to the CMS leaders to discuss concerns regarding the rule’s unintended effects on patient safety. And one would think the best outcome of such a meeting or interaction would only result in a temporary solution to a growing condition that plagues nursing staffs. However the question is: could there be a more definite solution to these concerns? And if there could be from whence can one expect such a solution to emanate?

We currently live in a digital and technological age. And although there are some innovations that have proven more harmful than good over time, it appears as though; technology may very well house the solution to the health care plight of nursing staffs in the effective and efficient dissemination of their duties. One would feel the time has definitely come for the medical and health care sector to usher in an innovative era that will aid Nurses and nursing staff in being able to provide timely and quality care for patients.

It would appear it has come to time when Nurses can instead of just being assistants to the Doctors, can also get assisted by the far reaching hands of a cutting-edge technological innovation that would assure them of the fact that they can stick to their sworn Code Of Ethics without compromising the health and safety of the patients under their care.


  • Laura A. Stokowski. Timely Medication Administration Guidelines for Nurses: Fewer Wrong-Time Errors? Medscape. Oct 16, 2012.
  • International Council of Nurses (ICN) code of ethics for nurses 2005
  • Guidelines for timely medication administration Response to the CMS “30-minute rule” Jan 13, 2011.

Is Cardiovascular and Closely Related Disease Steadily Becoming Pandemic?

Cardiovascular disease

A pandemic is defined as almost anything that increased in and appeared to spread within or among groups of people, such as smoking, traffic accidents, factory closings, and even fear (Moren, Folkers and Fauci). The proliferation of cardiovascular related diseases around the globe is indeed a cause for great concern, several reasons are adduced for this marked increase in occurrence of these life-threatening health conditions.

Cardiovascular disease can take several forms: high blood pressure, coronary artery disease, valvular heart disease, stroke, or arrhythmias (irregular heartbeat). According to the World Health Organization, cardiovascular disease causes more than 17 million deaths in the world each year. The figures are indeed alarming and shows no sign of slowing down any moment soon.

A worrisome report detailing hard facts and figures on the extent of the devastation wreaked by these set of diseases, which was compiled at the behest of the American Heart Association gives a graphic insight to the magnitude of the sad development.

Facts and Figures on Heart Disease, Stroke and other Cardiovascular Diseases

  • Cardiovascular disease is the leading global cause of death, accounting for 17.3 million deaths per year, a number that is expected to grow to more than 23.6 million by 2030.
  • In 2008, cardiovascular deaths represented 30 percent of all global deaths, with 80 percent of those deaths taking place in low- and middle-income countries.
  • Nearly 787,000 people in the U.S. died from heart disease, stroke and other cardiovascular diseases in 2011. That’s about one of every three deaths in America.
  • About 2,150 Americans die each day from these diseases, one every 40 seconds.
  • Cardiovascular diseases claim more lives than all forms of cancer combined.
  • About 85.6 million Americans are living with some form of cardiovascular disease or the after-effects of stroke.
  • Direct and indirect costs of cardiovascular diseases and stroke total more than $320.1 billion. That includes health expenditures and lost productivity.
  • Nearly half of all African-American adults have some form of cardiovascular disease, 48 percent of women and 46 percent of men.
  • Heart disease is the No. 1 cause of death in the world and the leading cause of death in the United States, killing over 375,000 Americans a year.
  • Heart disease accounts for 1 in 7 deaths in the U.S.
  • Someone in the U.S. dies from heart disease about once every 90 seconds.


Heart Disease

  • From 2001 to 2011, the death rate from heart disease has fallen about 39 percent – but the burden and risk factors remain alarmingly high.
  • Heart disease strikes someone in the U.S. about once every 43 seconds.
  • Heart disease is the No. 1 cause of death in the United States, killing over 375,000 people a year.
  • Heart disease is the No. 1 killer of women, taking more lives than all forms of cancer combined.
  • Over 39,000 African-Americans died from heart disease in 2011.
  • Cardiovascular operations and procedures increased about 28 percent from 2000 to 2010, according to federal data, totaling about 7.6 million in 2010.
  • About 735,000 people in the U.S. have heart attacks each year. Of those, about 120,000 die.
  • About 635,000 people in the U.S. have a first-time heart attack each year, and about 300,000 have recurrent heart attacks.



  • In 2010, worldwide prevalence of stroke was 33 million, with 16.9 million people having a first stroke. Stroke was the second-leading global cause of death behind heart disease, accounting for 11.13% of total deaths worldwide.
  • Stroke is the No. 5 cause of death in the United States, killing nearly 129,000 people a year.
  • Stroke kills someone in the U.S. about once every four minutes.
  • African-Americans have nearly twice the risk for a first-ever stroke than white people, and a much higher death rate from stroke.
  • Over the past 10 years, the death rate from stroke has fallen about 35 percent and the number of stroke deaths has dropped about 21 percent.
  • About 795,000 people have a stroke every year.
  • Someone in the U.S. has a stroke about once every 40 seconds.
  • Stroke causes 1 of every 20 deaths in the U.S.
  • Stroke is a leading cause of disability.
  • Stroke is the leading preventable cause of disability.


Sudden Cardiac Arrest

  • In 2011, about 326,200 people experienced out-of-hospital cardiac arrests in the United States. Of those treated by emergency medical services, 10.6 percent survived. Of the 19,300 bystander-witnessed out-of-hospital cardiac arrests in 2011, 31.4 percent survived.
  • Each year, about 209,000 people have a cardiac arrest while in the hospital.


Heart Disease, Stroke and Cardiovascular Disease Risk Factors

Cardiovascular disease


The American Heart Association gauges the cardiovascular health of the nation by tracking seven key health factors and behaviors that increase risks for heart disease and stroke. We call these “Life’s Simple 7” and we measure them to track progress toward our 2020 Impact

Goal: to improve the cardiovascular health of all Americans by 20 percent and reduce deaths from cardiovascular diseases and stroke by 20 percent, by the year 2020.

Life’s Simple 7 are: not smoking, physical activity, healthy diet, body weight, and control of cholesterol, blood pressure and blood sugar. Here are key facts related to these factors:



  • Worldwide, tobacco smoking (including secondhand smoke) was one of the top three leading risk factors for disease and contributed to an estimated 6.2 million deaths in 2010.
  • 16 percent of students grades 9-12 report being current smokers. Among adults, 20 percent of men and 16 percent of women are smokers.
  • Among adults, those most likely to smoke were American Indian or Alaska Native men (26 percent), white men (22 percent), African-American men (21 percent), white women (19 percent), American Indian or Alaska Native women (17 percent), Hispanic men (17 percent), African-American women (15 percent), Asian men (15 percent), Hispanic women (7 percent), and Asian women (5 percent).
  • In 2012 there were approximately 6,300 new cigarette smokers every day.


Physical Activity

  • About one in every three U.S. adults – 31 percent – reports participating in no leisure time physical activity.
  • Among students in grades 9-12, only about 27 percent meet the American Heart Association recommendation of 60 minutes of exercise every day. More high school boys (36.6%) than girls (17.7%) self-reported having been physically active at least 60 minutes per day on all seven days.


Healthy Diet

  • Less than 1 percent of U.S. adults meet the American Heart Association’s definition for “Ideal Healthy Diet.” Essentially no children meet the definition. Of the 5 components of a healthy diet, reducing sodium and increasing whole grains are the biggest challenges.
  • Eating patterns have changed dramatically in recent decades. Research from 1971 to 2004 showed that women consumed an average of 22 percent more calories in that span and men consumed and average of 10 percent more. The average woman eats about 1,900 calories a day and the average man has nearly 2,700, according to the government figures.



  • Most Americans older than 20 are overweight or obese. Over 159 million U.S. adults – or about 69 percent – are overweight or obese.
  • About 32 percent children are overweight or obese. About 24 million are overweight and about 13 million – 17 percent – are obese.
  • In 2008, an estimated 1.46 billion adults worldwide were overweight or obese. The prevalence of obesity was estimated at 205 million men and 297 million women.



  • About 43 percent of Americans have total cholesterol higher of 200 mg/dL or higher. The race and gender breakdown is: o 46 percent of Hispanic men o 46 percent of white women o 43 percent of Hispanic women o 41 percent of black women o 40 percent of white men o 37 percent of black men
  • About 13 percent of Americans have total cholesterol over 240 mg/dL.
  • Nearly one of every three Americans has high levels of LDL cholesterol (the “bad” kind).
  • About 20 percent of Americans have low levels of HDL cholesterol (the “good” kind).


High Blood Pressure

  • About 80 million U.S. adults have high blood pressure. That’s about 33 percent. About 77 percent of those are using antihypertensive medication, but only 54 of those have their condition controlled.
  • About 69 percent of people who have a first heart attack, 77 percent of people who have a first stroke and 74 percent who have congestive heart failure have blood pressure higher than 140/90 mm Hg.
  • Nearly half of people with high blood pressure (46 percent) do not have it under control.
  • Hypertension is projected to increase about 8 percent between 2013 and 2030.
  • Rates of high blood pressure among African-Americans is among the highest of any population in the world. Here is the U.S. breakdown by race and gender. o 46 percent of African-American women o 45 percent of African-American men o 33 percent of white men o 30 percent of white women o 30 percent of Hispanic men o 30 percent of Hispanic women
  • In 2000, it was estimated that 972 million adults worldwide had hypertension.


Blood Sugar/Diabetes

  • The prevalence of diabetes for adults worldwide was estimated to be 6.4 percent in 2010 and is projected to be 7.7 percent in 2030. The total number of people with diabetes is projected to rise from 285 million in 2010 to 439 million in 2030.
  • About 21 million Americans have diagnosed diabetes. That’s almost 9 percent of the adult population, but diabetes rates are growing. In fact, about 35 percent of Americans have pre-diabetes.
  • African-Americans, Hispanics/Latinos and other ethnic minorities bear a disproportionate burden of diabetes in the U.S.

With the foregoing, there is a need to be proactively involved in stemming the tide of this seeming pandemic…this is so because the facts are truly scary. If this significant number of people are suffering and dying from these diseases then it requires practical action plan to ensure a mitigation against the crippling effects worldwide. Access to advanced healthcare facilities are available in the U.S. and other Western countries, and may well be the reason why there has not been an explosion in the occurrence of more prognosis.

However, the lack of qualitative medical service in the developing nations brings to fore the disparity in incident of cardiovascular diseases. Inaccessibility to good health care also prevents.



David M. Morens, Gregory K. Folkers, and Anthony S. Fauci. What Is a Pandemic? J Infect Dis. (2009) 200 (7): 1018-1021 DOI: 10.1086/644537

Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ, Cushman M, de Ferranti S, Després J-P, Fullerton HJ, Howard VJ, Huffman MD, Judd SE, Kissela BM, Lackland DT, Lichtman JH, Lisabeth LD, Liu S, Mackey RH, Matchar DB, McGuire DK, Mohler ER 3rd, Moy CS, Muntner P, Mussolino ME, Nasir K, Neumar RW, Nichol G, Palaniappan L, Pandey DK, Reeves MJ, Rodriguez CJ, Sorlie PD, Stein J, Towfighi A, Turan TN, Virani SS, Willey JZ, Woo D, Yeh RW, Turner MB; on behalf of the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics— 2015 update: a report from the American Heart Association [published online ahead of print December 17, 2014]. Circulation. doi: 10.1161/CIR.0000000000000152.

Ethics vs. The Law: Addressing A Growing Medical Dilemma

Medical ethics and principles

What Is Ethics?

One finds it very hard to put a hold on the meaning of ethics. In fact, some years back, a research survey conducted by Sociologist Raymond Baumhart, on asking business people “what does ethics mean to you?” revealed a varying amount of response. While some of the candidates couldn’t quite say much about ethics; the survey reveals that a good number of them tended to equate ethics with their feelings –a certain sense of inner conviction as to what is right or wrong.

However, facts with regards to ethics gives the notion that, even though human feeling goes a long way to form the backgrounds of the concept, being ethical has very little to do with feelings. This article aims to address the growing concerns that many doctors and medical practitioners face in relation to the dilemma that the conflict between ethics and the law poses for the smooth practice of their profession.


medical ethics and principlesIn an article titled “Medical Ethics”, Dr. Roger Henderson refers to ethics in relation to the medical community as involving “…the application of a moral code to the practice of medicine”. This definition per se, hints at a medically revised insinuation of the golden rule: treat the patient as you would wish to be treated yourself. Although, Dr. Henderson candidly states that following such tenets blindly could well lead doctors to finding themselves on the wrong side of the law; it however begs the question as to whether there are hidden clauses to the so-called “Moral Code” that these doctors and medical practitioners are supposed to be applying to their practice. And if so, then of what essence is the Moral Code anyway?

Since the wake of the 21st century, medical and social ethics have advanced and have hitherto being rebranded; more so, to an extent that doctors and other medical practitioners are likely to be faced with controversial issues on a regular basis. Dr. Henderson writes that “every clinician must keep up-to-date on current legislation and ensure that they practice within the law and within the guidelines laid down by their professional body”. This might very well be a good approach to not straying past the confines of the law that governs a medical profession, but it is worth noting that most times, being ethical is not the same as following the law.

According to an article on ethics from the Markkula Center for Applied Ethics, Santa Clara University, California, written and developed by Manuel Velasquez, Claire Andre, Thomas Shanks, S.J., and Michael J. Meyer, it reveals that: laws, like feelings, can deviate from what is ethical; although such laws often incorporates ethical standards to which most citizens subscribe. Two obvious examples come to mind as regards this deviation in all its grotesqueness: the pre-civil war slavery laws of America; and the old apartheid laws of present-day South Africa.

These two examples reveal prolific laws of such times that were anything but ethical. And since ethics and ‘Moral Code” are basically inter-related, it would appear that the true argument lies basically on whether there is a limit to morality in practicing medicine or more succinctly, at what point is say, a doctor supposed to keep morals aside and stick to the confines of the law?

Doctors and medical practitioners are human beings. Hence, faced with certain situations and dilemma they are susceptible to making mistakes or even better making life-saving value based judgements. However, the more one considers the conflict between ethics and the law, the more it becomes clear that in the overall basis of things, one very much champions the other.

The Law

According to Wikipedia, “law is a system of rules that are enforced through social institutions to govern behavior”. And as earlier pointed out, most laws incorporate ethical standards but nevertheless, majority of laws are not so much bounded by such a factor as ethics. Therefore, with respect to the practice of medicine, although some actions and decisions taken by a doctor might appear to be ethically sound; such reasons might hold very little substance in the eyes of the law.

Many might have heard of the Hippocratic Oath, an oath of ethical professional behavior sworn by new physicians. Although the oath is very much a vital part of the statutes that most doctors abide by, it is however not as compulsory as a lot of people may think.

A summary of the ideals and the Hippocratic Oath is given below:

“A solemn promise:

-Of solidarity with teachers and other physicians.

-Of beneficence and non- maleficence towards patients.

-Not to assist suicide or abortion.

-To leave surgery to surgeons.

-Not to harm, especially not to seduce patients.

-To maintain confidentiality and never to gossip”

Let us for argument sake take a better look at the third summarized rule of the Hippocratic Oath. It states: –Not to assist suicide or abortion.

Keeping the issue of suicide apart, abortion still stands as one of the foremost moral dilemmas that rock the hinges of today’s society. So many research findings, expert opinions, debates and basic prejudicial opinions have been thrown around with respect to the moral justifiability or reprehensibility of abortion. While most often, it is the women involved that have to deal with the choice consequences, many doctors often find themselves in the cross-fire, either for their participation or non-participation of the act; be it surgical or prescriptive.

Boldly, the Hippocratic tenets that a host of these doctors stand by, blatantly oppose performing any abortive procedure. In fact till date, abortions are illegal in most African and South American countries. And although, the abortion act 1967 states on what grounds an abortion is allowed to be carried out, very few of these countries have policies upholding such acts. So, you often find in such countries a lot of doctors basically juggling between getting to save a person’s life and risking such a life just to be on the right side of the law that are often with very strict consequences.

Is There A Possible Resolution?

The case of abortion is just one of the most commonly faced dilemmas that bring to light the conflict of medical ethics in relation to the law. The law understandably varies from place to place, no doubt; but often so does ethics. When it comes to the medical world the conflict becomes one that often sets a patient’s life in the balance. Not much has been done to address this growing conflict most especially in the developing world and a deeper insight into the basics behind the two concepts leads to the tumultuous question: what exactly can be done?

A patient’s life is precious; and this is no doubt one of the basic ideals of the average medical practitioner. But at what point does such an ideal take a back seat in comparison to upholding the law? In reality, both concepts cannot do without the other, so certainly finding a balance of compromise might just be the first of steps to take in curbing the conflict where human life is involved.