The Influence of Socioeconomic Status on Maternal Health Amongst African American Women in an Urban Setting

This paper explores the effect of socioeconomic status on maternal health in an urban setting. Maternal health is an ongoing challenge within the United States. Unfortunately, the maternal mortality rate in the U.S has been identified as one of the worst amongst other industrialized countries. Studies have shown that proper prenatal, delivery, and post-partum care are essential for the well-being of mother and child. Without proper care, the likelihood of pregnancy complications or death occurring becomes higher. According to the Centers for Disease Control and Prevention (2019), African American women are three to four times more likely to die from pregnancy-related causes than White women (CDC 2019). This is consistent with the fact that individuals within the African American community have been historically denied opportunities for quality healthcare. The lack of adequate care is particularly detrimental for pregnant African American women. Underlying health issues such as heart disease, hypertension, and thrombotic pulmonary embolism may contribute to the increased rate of pregnancy-related deaths (CDC 2019). However, other factors such as race, geographic location, socioeconomic status, and inadequate care throughout pregnancy are also significant factors (Fogel et al., 2017). One would argue that the racial disparities among women in lower socioeconomic classes seems to be consistent with the lack of access and poor quality of healthcare. A review of relevant literature from peer-reviewed publications was completed using scientific databases such as PubMed. This review\u27s expectation is to better understand this public health dilemma and address any possible strategies that could be implemented to improve women\u27s health within the African American community

Monitoring the effectiveness of traumatic brain injury treatment

Traumatic brain injury is a condition of major public health importance due to the increasing incidence of traumatic brain injury all over the world (both in developed and developing countries). In developed countries, the major causes of TBI are falls (mostly in the elderly) while the major causes of TBI in developing countries are due to accidents (mainly traffic accidents and mostly in young and active population). Although, few countries have a standard epidemiological monitoring system on TBI, the mortality of TBI is still on the rise worldwide. Even with the hi-tech gadget available in the most hospitals today, the effectiveness of most TBI treatments have not been proven scientifically (i.e. a general consensus has not been reached by scientists) and most treatments are employed empirically. The disease burden of severe intracranial trauma is seriously high in Hungary especially among middle aged men being leading cause of death in the young, active population. Because of the limited knowledge on pathomechanisms elicited by head injury, the potential of personalized therapy is still restricted. The adherence to guidelines relying on well characterized effectiveness of certain clinical interventions is the most effective approach to diminish this increasing mortality. The fatal outcome is unacceptably high and has not been improved in Hungary in the last decade, and the insufficiency of rehabilitation is more pronounced among older patients. The adaption of guidelines did not improve the prognosis most probably due to the low adherence of its application. The Hungarian experiences demonstrated that the guideline potential cannot be exploited without proper auditing.MSc/MAnépegészségügyiangolnappal

LEGAL AND INSTITUTIONAL FRAMEWORK FOR MONETARY UNION IN ANGLOPHONE WEST-AFRICA: THE NIGERIAN PERSPECTIVE

PhDEconomic and monetary integration efforts in West Africa over the past several decades have been highly problematic. However, with the recent commitment of the international community and key international institutions to assist Africa bring about economic advancement, such integration can be achieved. It is within this context of renewed optimism for Africa that this thesis aims to address the role of law and institutions in facilitating closer economic integration and eventual monetary union among the Anglophone states of West Africa This thesis proposes that legal infrastructure and institutions will help achieve and sustain the WAMZ monetary union. It argues for the development of appropriate infrastructural "pillars" for such a union, which would be brought about by comprehensive regional treaty provisions and structures in conjunction with complementary domestic legal and institutional reforms. It focuses specifically on the existence of adequate legal and institutional framework for the integration of the banking markets, central bank independence, and fiscal management in Member States. In assessing these issues, a comparative analysis is provided between the Monetary Union proposed by the Anglophone West African states (WAMZ) and those of the Francophone West African states (WAMU) and the European Union. Nigeria is used as a case study in assessing the state of preparedness of the Member States of this proposed Union, since it has the largest economy in the sub-region and is the main political driving force behind the project of integration. This thesis is divided into two parts comprising six chapters. Part one, consisting of three chapters, considers the legal and institutional requirements for economic integration. Chapter One presents the preliminary background by considering the relevant theories of economic integration and by assessing the benefits and possible drawbacks of such integration within the context of West Africa. Chapter Two provides a historical analysis of economic regional efforts in Anglophone West Africa. This assessment shows that failures of these efforts are attributed, in part, to inadequate legal and institutional arrangements at the regional level. Chapter Three considers the domestic legal and institutional requirements for effective participation in an economic integration arrangement and provides a case study on Nigeria. Chapters Four to Six constitute part two of the work and assess the legal and institutional framework for the proposed monetary union. This second part considers, specifically, whether Member States possess the legal and institutional requirements for the integration of their banking markets, for the preservation of central bank independence and for the effective conduct of fiscal management. By using international standards of best practices, these Chapters assess the adequacy of relevant institutions in Nigeria, which are necessary preconditions for supporting the proposed monetary union

Legal and institutional framework for monetary union in Anglophone West Africa : the Nigerian perspective

EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Postoperative pain management after craniotomy: Literature review and evaluation of evidence

Background: The effective management of postoperative pain have the tendency to reduce morbidity and mortality. Currently it is becoming clear that appropriate and adequate analgesia is a significant component of post craniotomy care. The goal of this review is to analyse and appraise evidence for postoperative analgesia following craniotomy. Methods: Literature search conducted using EMBASE, Medline and Cochrane database for systematic reviews. Key words applied were" postoperative analgesia", "neurosurgery", "neurosurgical procedures". Resultant yield limited to 10 years, English language journal, intracranial (craniotomy) surgeries. Studies were limited to English and those involving humans. Studies limited from 1995 to 2015. Relevant studies were isolated for further critique. About 30 trials were identified but some could not be retrieved. Results: Total of 140 citations were identified, after thorough screening non relevant studies and non-randomised clinical trials were exempted. One systematic review and three randomised controlled study, Studies were limited to English and those involving humans. Conclusion: The data available showed improved analgesia with use of codeine sulphate against the backdrop of the popular tramadol which is a weak opioid fraught with significant post-operative nausea and vomiting. Also some evidences support use of regional scalp block for post craniotomy analgesia. The non-narcotics paracetamol and NSAIDs such Ketoprofen are useful analgesia compliment

Role of Corticosteroids in the Management of Acute Traumatic Brain Injury: Literature Review and Critical Appraisal of Evidence

Background Traumatic brain injury is a prominent and leading cause of premature mortality and disability. Corticosteroids were widely used in the clinical management of traumatic brain injury but their benefit has been challenged in so many studies and their efficacy but their use in TBI still remains unclear. The aim of this review is to evaluate the effectiveness and efficacy of corticosteroids in reducing mortality or morbidity in people with acute traumatic brain injury. Methods A systematic literature searches as enabled a thorough and robust process of rigorous critical appraisal in order to make an informed, balanced and evidenced based judgement on the use of corticosteroids in the management of acute traumatic brain injury to quantify effectiveness of corticosteroids in reducing mortality and morbidity in reducing traumatic brain injury. Results Systematic literature search relevant to corticosteroid use in acute traumatic brain injury. The search strategy involving data base including Embase, MEDLINE, Cochrane Database of Systematic Review Seven studies have been critically appraised to determine the effectiveness and efficacy of corticosteroid use in acute traumatic brain injury. Conclusion It can be safely concluded that there is no significant benefit or efficacy of the use of corticosteroid in the management of acute traumatic brain injury. There is no reduction in mortality with the use of corticosteroid however progesterone use caused no discernible harm and showed possible sign of benefit but in a very small and single institution study. Overall the efficacy of amino-steroids in patients with moderate and severe head injury could not be demonstrated