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Chronic rheumatic heart disease
Chronic rheumatic heart disease
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Acute rheumatic fever (ARF) is defined by Mosby (2010) as a systemic inflammatory disease which is enabled development with inadequate treatment of upper respiratory tract infections of group A beta-hemolytic streptococci. Repeated episodes of ARF can cause autoimmune reactions within the heart which in turn inflicts damage upon the heart muscle and heart valves, a condition termed as rheumatic heart disease (RHD) (Mosby, 2010). Predominately ARF and RDH cases are found to effect people living in developing countries. Steer and Carapetis (2009), have linked this issue with the lowered socioeconomic conditions, household crowding, inadequate health care and poor hygiene. In comparison both ARF and RHD have virtually been eliminated in industrialized countries (Steer & Carapetis, 2009). It is therefore of significant concern that indigenous populations of New Zealand still remain highly effected by ARF and RHD, potentially affecting 1 in 3 Maori and Pacific children with significant morbidity and mortality among young adults (The National Heart Foundation of New Zealand, 2007). In conjunction to this statistic, this essay will examine the pathophysiology and epidemiology of ARF and RHD in New Zealand. Furthermore the role of paramedics and contributions paramedics could make to reduce the burden of ARF and RHD on New Zealand society will be presented in discussion.
Group A streptococcal (GAS) pharyngitis infections have a strong correlation with ARF and RHD. Group A streptococcal (GAS) is a derivative of beta-hemolytic streptococci, based upon the difference in the cell wall polysaccharide build. GAS is again categorised, based on its M type, to which defines the virulence of the particular bacterium. The M protein has been resea...
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Steer, A. C., & Carapetis, J. R. (2009). Acute rheumatic fever and rheumatic heart disease in indigenous populations. The Pediatric Clinics of North America, 56(6), 1401-1419. doi:10.1016/j.pcl.2009.09.011
St John New Zealand. (2013). Clinical Practise Guidelines 2013-2015. Wellington, New Zealand: St John New Zealand.
The National Heart Foundation of New Zealand (Heart Foundation), (2007). A Summary of the New Zealand Guidelines for Rheumatic Fever. Retrieved February 27, 2014, from http://www.heartfoundation.org.nz/
Webb, R., & Wilson, N. (2013). Rheumatic fever in new zealand. Journal of Paediatrics and Child Health, 49(3), 179-184. doi:10.1111/j.1440-1754.2011.02218.x
Wilson, N. (2010). Rheumatic heart disease in indigenous populations--new zealand experience. Heart, Lung & Circulation, 19(5), 282-288. doi:10.1016/j.hlc.2010.02.021
American Indians have had health disparities as result of unmet needs and historical traumatic experiences that have lasted over 500 hundred years.1(p99) Since first contact American Indians have been exposed to infectious disease and death2(p19), more importantly, a legacy of genocide, legislated forcible removal, reservation, termination, allotment, and assimilation3. This catastrophic history had led to generational historical traumas and contributes to the worst health in the United States.2 American Indians and Alaska Natives (AI/AN) represent 0.9 percent of the United States population4(p3) or 1.9 million AI/AN of 566 federally recognized tribes/nations.5 American Indians/Alaska Natives have significantly higher mortality rates of intentional and unintentional injuries, chronic liver disease and cirrhosis, diabetes mellitus, cardiovascular disease and coronary heart disease and chronic lower respiratory disease than other American.6
There are significant health disparities that exist between Indigenous and Non-Indigenous Australians. Being an Indigenous Australian means the person is and identifies as an Indigenous Australian, acknowledges their Indigenous heritage and is accepted as such in the community they live in (Daly, Speedy, & Jackson, 2010). Compared with Non-Indigenous Australians, Aboriginal people die at much younger ages, have more disability and experience a reduced quality of life because of ill health. This difference in health status is why Indigenous Australians health is often described as “Third World health in a First World nation” (Carson, Dunbar, Chenhall, & Bailie, 2007, p.xxi). Aboriginal health care in the present and future should encompass a holistic approach which includes social, emotional, spiritual and cultural wellbeing in order to be culturally suitable to improve Indigenous Health. There are three dimensions of health- physical, social and mental- that all interrelate to determine an individual’s overall health. If one of these dimensions is compromised, it affects how the other two dimensions function, and overall affects an individual’s health status. The social determinants of health are conditions in which people are born, grow, live, work and age which includes education, economics, social gradient, stress, early life, social inclusion, employment, transport, food, and social supports (Gruis, 2014). The social determinants that are specifically negatively impacting on Indigenous Australians health include poverty, social class, racism, education, employment, country/land and housing (Isaacs, 2014). If these social determinants inequalities are remedied, Indigenous Australians will have the same opportunities as Non-Ind...
Hampton, R. & Toombs, M. (2013). Indigenous Australians and health. Oxford University Press, South Melbourne.
Spector, R. E. (2009). Health and illness in the American Indian and Alaska native population. Cultural Diversity in Health and Illness (7th ed.). (pp. 204-228). Upper Saddle River, NJ: Prentice Hall.
Indigenous health is a vital tool in health care today. The case study is about an indigenous lady who is from a remote community. This case study will define culture shock, transcultural theory. Finally it will states the recommendations that can be acquired to improve the current indigenous health care issue as it can be noted that the indigenous health tends has been deteoriating.
Liam is a previously healthy boy who has experienced rhinorrhoea, intermittent cough, and poor feeding for the past four days. His positive result of nasopharyngeal aspirate for Respiratory Syncytial Virus (RSV) indicates that Liam has acute bronchiolitis which is a viral infection (Glasper & Richardson, 2010). “Bronchiolitis is the commonest reason for admission to hospital in the first 6 months of life. It describes a clinical syndrome of cough tachypnoea, feeding difficulties and inspiratory crackles on chest auscultation” (Fitzgerald, 2011, p.160). Bronchiolitis can cause respiratory distress and desaturation (91% in the room air) to Liam due to airway blockage; therefore the infant appears to have nasal flaring, intercostal and subcostal retractions, and tachypnoea (54 breathes/min) during breathing (Glasper & Richardson, 2010). Tachycardia (152 beats/min) could occur due to hypoxemia and compensatory mechanism for low blood pressure (74/46mmHg) (Fitzgerald, 2011; Glasper & Richardson, 2010). Moreover, Liam has fever and conjunctiva injection which could be a result of infection, as evidenced by high temperature (38.6°C) and bilateral tympanic membra...
Therefore, providing culturally appropriate services for people has significant role for health professional; the main reasons of this is culturally appropriate services are linked inextricably with the health of the clients. According to Oda & Rameka (2012), in 1980s, Maori were experience racial discrimination and that is linked to higher rate of illness on Maori, such as mental illness, cardiovascular disease, hypertension, cancer, mortality, and health-risk behaviors such as tobacco and alcohol consumption. This is the results of unfair health service. During to the research (Oda & Rameka, 2012), people are more attempt not to see the doctor when they are experiencing discrimination and it makes their mortality higher than other non- Maori. Another factor could be Maori are not unable to access the health information and there was poor health literacy in that era and they were not able to understand different disease and lack of health education of living with a healthy lifestyle (Oda & Rameka, 2012). A classic example can be seen in the consumption of tobacco and alcohol, at the era, people did not know the repercussion of tobacco and alcohol use, but if they were able to access the information they would understand the
“The health of individuals and populations is influenced and determined by many factors acting in various combinations. Healthiness, disease, disability and, ultimately, death are seen as the result of … human biology, lifestyle and environmental (e.g. social) factors…” (Mary Louise Fleming, 2009) There are many unchangeable contributing factors that play a role in a person’s health condition, this can be anything from the gender and location that they were born into, to genetic impairments and the lifestyle that their parents raised them in or even government policies; but for as many unchangeable factors, there are also changeable factors. In Mr. A’s case he was born from Pacific Islander descent, therefore it can be assumed that he was born into an obese family with little money, and was raised in poorer living conditions than the average Australian. Due to this, his health is expected to be worse that the average Australian because his social determinants make it so. He is now a full-grown man with a family, but still lives in problematic conditions due to his upbringing and culture along with the minimal to no levels of prevention shown. There are many risk factors that have affected Mr. A’s health due to the social determinants that he has been faced with such as obesity, type 2 diabetes, arthritis, etc. There are also upstream and downstream factors affecting his health, “While upstream and midstream determinants influence the type, likelihood, number and severity of diseases that affect a person, downstream inequities come into play when a person becomes ill.” (AMA, 2007). These factors have had a major role in the result of his heart attack. Finally, his level of prevention exhibited is a key aspect on how much of an eff...
Streptococcus pyogenes is thought to live benignly within one in five people, and is thusly one of the most common pathogens among humans. Due to its common
Rochford, T. (2004). Whare Tapa Wha: A Mäori model of a unified theory of health. Journal of Primary Prevention, 25(1), 41-57. doi: 10.1023/B:JOPP.0000039938.39574.9e
“Always remember to be an internist, my dear.” This was an invaluable piece of feedback I received on a rheumatology rotation in my first year of internal medicine residency. Truly, I have never learned so much about medicine as I did during this first rotation in rheumatology. I became fascinated by the subtle presentations and cases that posed a diagnostic challenge to multiple subspecialties. I have been inspired by rheumatology as a field where multisystem disease is encountered on a daily basis and rheumatologists must use both general medicine and subspecialty skillsets to diagnose and treat patients. The academic challenges in rheumatology initially attracted me to the field however my subsequent experiences with patients, mentors, and research have made me passionate about pursuing rheumatology as my specialty.
JAMA: Journal of the American Medical Association. 14 Nov. 2001: 2322. Academic Search Complete. Web.
When caring for patients it is fundamentally important to have a good selection of up to date evidence Based Practice clinical articles to support research strategies, this allows professionals to assemble the most resent and accurate information known which enables them to make decisions tailored to the individual’s plan of care. It is essential to have clinical expertise and have the involvement from the individual patient, they must have full engagement and incorporation in order to have the accurate evaluation.
There is not an ethnic group that is not affected by heart disease. However, “the cardiovascular disease death rate among African Americans is 34 percent higher than for the overall U.S. population”. (“The Facts of Cardiovascular Disease”) African American women ages 50 and up are twice as likely as Caucasian women to be diagnosed with heart disease, and is more likely than Caucasian women to have a heart attack. A heart attack is the most common outcome of heart disease.