Maternal stress as a potential risk factor for having an offspring Research Proposal

Maternal stress as a potential risk factor for having an offspring with a ventricular septal defect - Research Proposal Example ency, misalignment or failure of fusion of the components of the interventricular septum, viz., endocardial cushions, aorticopulmonary septum and the muscular part of the septum, is the primary cause of the ventricular septal defects (Shinebourne et al, 2006). A hole or complete absence of the septum allows the blood to mix in the ventricles, which is supplied to the lungs as well as the rest of the body giving rise to symptoms like ‘blue babies’. Soto et al (1980) gave an objective classification of the ventricular septal defects (VSD). On the basis of angiograms of 220 children with VSD, they observed that the defects in the septum could present with the following morphologies - perimembranous defects; muscular defects and subarterial infundibular defects. Perimembranous defects as well as the muscular defects were further divided into three sub-groups each. A stressful life of the mother has been studied as a risk factor for a number of congenital malformation in the offspring, e.g. orofacial cleft (Montenegro et al, 1995), neural tube defects (Carmichael and Shaw, 2000) and conotruncal heart defects (Suarez, 2003). Carmichael et al (2007) have conducted a comprehensive population based case-control study involving 1355 mothers and calculated a ‘stressful life event score’ based on exposure to 18 possible stress-events and its association with congenital birth defects. Their results showed that a 3-point increase in the stress score increases the odds-ratio of a birth defect to 1.45 ( C.I. 1.03-2.06) and the risk is further aggravated to O.R. of 2.35 (CI = 1.47 – 3.77), if the mother is not taking vitamin (folic acid) supplement during early pregnancy. Hansen et al (2000), in a rare 12 year prospective study with a 16 months retrospective component, reported an increased incidence of cranial-neural-crest malformatio ns as well as other congenital malformations in children born to mothers exposed to severe life events like death, hospitalization for

Leadership and mangement Essay Example | Topics and Well Written Essays - 1000 words

Leadership and mangement - Essay Example Since the concept of patient-centered care is increasingly emphasized in today’s healthcare environment, responding to patient feedback, grievances, and complaints are very important. Under this patient care model, patients have the right to file complaints and grievances if they are not satisfied with the health services received (Kaplan, 2014). Healthcare organizations are legally obliged to comply with federal regulations and Joint Commission standards while dealing with patient grievances and complaints (Dearmon, n.d.). This is inevitable for nurses to promote patient safety and to reduce their liability risk. Generally, patient grievances may be about unmet care expectations, offensive staff behavior, immediate discharges, compromising of confidentiality, treatment without informed consent, or any other unethical healthcare practice (ECRI Institute, 2010). According to Duxbury and Wittington (2005), addressing grievances involves difficult tasks as patients’ grieva nces can be different. An inexperienced nurse cannot easily handle the situation as there may not be a particular procedure for dealing with each type of patient grievances. As Devers, Pham and Liu point out (2004), even experienced nursing staff are not completely informed of the regulations and standards set by Centers for Medicare and Medicaid Services, the Joint Commission, and other government entities. Hence they become confused when they are required to handle situations of patient grievances. Generally patients may not be familiar with the grievance process, and therefore it is the duty of the nursing staff to assist clients to file their grievances. According to O’Daniel and Rosenstein (2008), good communication is the key to the effective execution of the grievance process because proper communication will avoid misunderstanding, and hence will