Abstract The paper focuses on analysing, discussing, and reviewing literature on the impact of communication breakdowns on the satisfaction of patients. 10 articles are chosen, analyzed in accordance with their eligibility, and used to present the impact and significance of communication in nursing, as well as the possible ways to...
The Social Change Recognizing a lack of awareness about effective methods of addressing the global pandemic in a skilled nursing facility is vital. More consistent levels of consciousness will positively contribute to the emergence of change on multiple societal levels. COVID-19 directly impacts all health care consumers due to the...
Background Information A 48-year-old man with a history of alcohol abuse had just undergone surgery, and I provided him with postoperative care, including pain management. However, the patient refused medications because of his religious beliefs. He stated that he was a sinner, and he believed that God wanted him to...
Introduction Leadership is a vital component of any organization as it helps in providing the management function which directs the available fiscal, physical, and human resources towards achieving strategic goals with the utmost efficiency. Leaders are individuals who have the ability to inspire, motivate, guide, and direct people in an...
Nurses experience various cases during their practice that may be detrimental to their emotional well-being. In my practice, it was difficult to handle with a great amount of work and do extra hours. Stress driven by working hours made me and my peers experience burn out. By such constant stressful...
Summary Modern health systems are known to be highly interwoven systems and are often characterized as messy. The quality and safety of health care provided to patients can be improved by implementing evidence-based practice techniques by the nurse leaders to improve the population health within the community they serve. Nurses...
Obtaining an MSN degree, or a Master of Science in Nursing, is a relevant prospect, and given career goals and skills honing, this step is an essential component of professional development. According to Massimi et al. (2017), while taking into account the specifics of preparation of MSN students, this level...
Patient loyalty may be defined as a patient’s willingness to use the services of a particular medical facility repeatedly. As medical services develop and transform, patient satisfaction and loyalty become essential aspects that require consideration. In many cases, healthcare facilities shift to more business-related approaches, and the financial element becomes...
Summary In the healthcare system, there is increasing competition for fund use amongst services offered. Therefore, nursing leaders must formulate proper budgeting criteria to enable effective and efficient operations. Developing a systematic budget will allow the administrator to have deep insight into the income and necessary expenditures hence can strategize...
The video by Robert Wood Johnson Foundation (2009) shows a good example of implementations to improve the performance of nursing staff. In the video, we can see different strategies used to organize the healthcare process. The status board with three color indicators is used to highlight the workload status of...
Introduction Clinical supervision occurs when a senior practitioner oversees and monitors a junior member’s practice in order to increase his/her quality of service. The counseling profession has its ethical standards and particular tools to ensure compliance among practitioners when they face decision-making issues (Francis & Turner, 2020). The most critical...
Numerous patients need information about medical care. Healthcare workers should evaluate their patients to pinpoint the ideal approach to instruct them about their wellbeing and decide the amount they think about their ailment. Given the undeniable degrees of obesity in the populace, quantities of individuals in out-of-home consideration, and information...
Introduction Rural areas often face disparities in healthcare across the United States. Some of the healthcare gaps are related to fewer resources and higher poverty rates. To be able to support access to health care and resources would help to contribute to improved health outcomes in addition to a better...
Purpose of the Study The goal of this study was to see how effective structured treatments were in reducing the frequency of AVF self-care behaviors in ESRD patients enrolled in traditional HD programs (Souza et al., 2020). Type of Research & the Design This was quasi-experimental research involving HD patients...
Nursing Notes and other documentation procedures in healthcare are essential in care provision. Documentation facilitates maintaining the record of all services received by the patient and is critical for handing over duties within healthcare facilities (Kollerup et al., 2018). In the care delivery process, patients undergo several procedures, all of...
Introduction Professional associations in nursing are important for their members’ professional and personal growth. In particular, they provide resources, certification, education, and networking opportunities, as well as career assistance in various specialty areas. As a result, nurses can enhance their practice and competence, providing safe and high-quality care for patients....
WebMD is a health website that caters to the all-around health needs of the population. It is a friendly website with clear images that illustrate the various points discussed. It has five primary tabs under which information is classified: health A-Z, drugs & supplements, living healthy, family & pregnancy, and...
Analyzing health records and statistics is vital for understanding the current trends in public health issues and the development of new concerns, as well as the assessment of the implemented interventions and the promotion of target audiences’ education. The available data sources indicate that the state of public health in...
An evidence-based approach toward addressing health-related issues in the clinical and nursing settings has become an inseparable part of contemporary healthcare. However, the role and weight of evidence-based decision-making for healthcare workers could use further explanation due to the misunderstandings and misconceptions surrounding the issue of EB in some healthcare...
Nursing is a profession that involves diagnosis, counseling, implementation of medical regimes, and evaluation of a patient’s medical progress. The roles of a nurse are not limited to nurses only but extend to colleagues. Notably, the nursing process helps address staff members’ shortcomings by identifying their strengths and weaknesses (Dahlin...
My philosophy of nursing is based on the idea that nurses should support patients in their strive to achieve good physical and mental health. This means that I want to use my knowledge and expertise in combination with the patient’s input on how they want to manage their health and...
The theoretical basis in the nursing profession allows a large amount of information to be gathered and structured. The principles of nursing care are based on the formation of algorithms that contribute to a speedy recovery. Theoretical courses in psychology, basics of nursing, disease-specific and age-specific course information are reinforced...
Abstract The work aims to emphasize a problem related to nursing burnout. The issue is important to address since it affects patient care quality and patient safety. Nurses’ professional burnout could be partially solved by the three actions suggested in the paper: creating a positive spiritual climate at the workplace,...
Summary Healthcare facilities should eliminate clinical variations to ensure their patients receive the highest quality and safest health services. Reducing clinical variations also helps to reduce the cost of care on a national and organizational level. Unfortunately, clinical variations permeate various healthcare facilities. Clinical variations refer to the excessive use,...
Nowadays, obesity has become one of the most relevant and prominent issues in the United States, given its epidemiological character and higher risk of developing other diseases. Besides traditional causes of obesity, the academic community has revealed other factors contributing to the respective issue; notably, it concerns the ethnic or...
Health Belief Model The Health Belief Model (HBM) was developed in the 1950s by behavioral scientists from the US Public Health Service (Green et al., 2020). Since its development the HBM has been used frequently in the health behavior research around the globe; over the decades the model has been...
Introduction Contemporary global society has developed an extensive domain of emergency response measures based on prior experiences, scientific knowledge, and technological development. The amount of tools capable of managing an emergency is expected to help humanity cope with challenges and contingencies. However, as the recently emerged COVID-19 pandemic illustrated, health...
Research article Ethnographic study of incidence and severity of intravenous drug errors by Taxis and Barber (2003b) uses observation for qualitative data collection. Wards and hospitals were selected for observation through a purposive sampling strategy, followed by a pilot test to determine 10 wards (Taxis & Barber, 2003b, p. 1)....
The article entitled “Physical activity-dependent regulation of parathyroid hormone and calcium-phosphorous metabolism” looks upon how exercise may contribute to alterations of parathyroid function through changing the levels of mediators and hormones. Lombardi et al. (2020) investigate how physical training impacts calcium and phosphate levels through energy consumption and look into...
Barough introduces great reasons and tips for a walk and proves this is one of the best ways to get in exercise with little effort. Exercise has for quite some time been demonstrated to assist with mental and actual wellness. Whether you disdain working out, walking is an extraordinary way...
Introduction Acne is a protracted inflammatory skin infection and is the most common skin ailment. It is normal for teenagers to contract acne, which is caused by hormones that cause pores to become clogged and infected with some bacteria (Chen et al., 2018). Therefore, the condition is peculiar in the...
According to the Preliminary Care Coordination Plan, acute respiratory failure is a significant issue affecting the population. Since the document presented a general overview of the problem, it is necessary to research the literature to identify evidence-based practices. Such an approach is required to ensure that the given plan offers...
The provided paper focuses on analyzing a particular experience using Johns’ model of structured reflection. This activity is vital for nursing as it helps to outline possible areas of improvement and plan actions to become a better specialist. For this reason, the paper explains the importance of reflection, describes the...
Summary Care coordination enables health workers to meet patients’ needs and hasten their recovery. The care coordinators yearn for good relationships between the sick and the healthcare employees (Hannigan et al., 2018). They plan and employ techniques that ensure efficient service delivery to those suffering from different illnesses. For instance,...
Implementing strategies that will benefit the quality of care is an essential task for health care organizations. To introduce novel changes properly and secure the necessary improvements, it is required to utilize specific approaches that allowed to yield the desired prospects, avoiding potential complications. Although there are several choices regarding...
Digestion is the process where larger food particles are broken down into smaller particles that can easily be absorbed by blood plasma. Digested food particles after the absorption of nutrients help produce energy, growth, and repair cells. The paper will emphasize the process of digestion from the ingestion of food...
The research question is: How has radiology changed medicine? “Advances in imaging and information technology have increased the importance of the radiologist not only by increasing utilization of diagnostic imaging, but also by moving the radiologist into a more central role in integrated patient care” (Knechtges & Carlos, 2007, p....
Introduction When investigating the development of methods to prevent hyperphosphatemia and chronic kidney disease, a researcher is particularly concerned about the following ethical principles of study participants’ sampling, recruitment, and data collection and reporting. Through ethical research, one can ensure that the study’s findings are aligned with ethics and provide...
Introduction Nursing is primarily concerned with medicine and patient care. However, every area of human life is closely intertwined with each other. It follows that a responsible and outstanding nurse can go into politics to control and influence health care with a plan that is relevant to patients. Many politicians...
A computerized assisted coding system (CACS) is called upon to facilitate ICD-10 implementation, compensating for financial losses and a gap in staff competencies. Since ICD-10 codes have a complex nature, they might represent an obstacle to the efficient work of doctors and nurses (Allen, 2020). Thus, the need for comprehensive...
Healthcare organizations, such as American Organization for Nursing Leadership, always try to enhance their performance. For years, this aspiration was reflected in the Triple Aim, combining the population health improvement, better conditions for patients, and lower healthcare costs. Recently a fourth element of improving the experience of providing care was...
Patient-focused care mediations are reliant on many factors. Regardless of far-reaching preparations and tedious work, some interventions do not lead to predetermined outcomes. Elements out of reach and outside the limits of our awareness alter the expected consequences. Wagner (2018, p. 93) states, “this is typical of events in complex...
While every occupation should be driven by the fact that there is always room for improvement, this idea is significantly more relevant to the field of health care. When thinking of Continuous Quality Improvement (CQI), many people perceive this phenomenon as something that solely describes innovative approaches to physical patient...
I agree that the essential characteristic of effective communication is the positive involvement of the targeted audience. However, the techniques chosen for establishing the communication process are different, and it is often challenging to determine the most efficient one in each particular case. For instance, Shonhe (2017) states that communication...
The profession of nursing is similar to puzzles, a multi-layered culture of healthcare that changes with all interactions. It is not ideal to detach from what is known and integrate to flourish in this present atmosphere of globalization. In order to retain its ideals, nursing practices are not and should...
Introduction Nursing has been developing ever since the nineteenth century. Being an evidence-based area of practice, nursing requires a proper research process. Every implied technique or obtained skill must be justified by the evidence. Since the treatment delivered by nurses can be qualified as a holistic health care approach, the...
Introduction It is important to note that the Los Angeles area has a number of viable options in regard to chronic pain assistance measures. The three identified ones are TMJ Expert Dr. Eddie Siman, Pain & Healing Institute, and Dr. Carr Integrative Physical Therapy. The given assessment will focus on...
Nursing specialists are professionals who must rely on the principles of moral conduct and social responsibility when doing their job. The Nursing Code of Ethics developed by the American Nurses Association is a document that guides nurses’ practice and assists them in understanding their professional obligations. Nevertheless, on certain occasions,...
Introduction As a target policy, the SUPPORT for Patients and Communities Act will be analyzed. This policy is an important aspect of the national health program to combat substance use and disorder prevention (“H.R.6,” 2018). Involving junior medical personnel in evaluating the effectiveness of this policy is a meaningful decision...
Coordination Care Programs A quality healthcare system is organized, patient-centered, and has a good communication system. Health care coordination activities involve getting a patient the right care when it is needed through communicating their needs to the involved care providers. For instance, when a patient visits a hospital, they should...
The process of reaching a consensus in terms of a specific setting has now become one of the most crucial notions in the context of management and enterprise development. Previously, the decision-making was the responsibility of the top management, creating a rather authoritative approach to the concept. Thus, it was...
Overview of Pharmacists and Medical terminology Pharmacists are specialists in medicine who help people in the provision, usage, preservation and storage of medicine. Pharmacists help people live a healthy life by providing solutions through medication to cure diseases and illnesses. In the pharmacy or medical world there exist terminologies that...
Popular Media Critique The article’s headline is based on the assumption that psychedelic drug users tend to have better overall physical health than non-users. Based on the article, I anticipate a quantitative study approach. The anticipated variables include the psychedelic drugs being studied and potential health outcomes. In summary, the...
Implicit biases include associations outside of conscious awareness that leads to a person’s negative assessment based on irrelevant characteristics such as race, gender or age. Health care providers display the same level of implicit bias as the general population. The interaction between the patient’s multiple characteristics and the healthcare professional...
Introduction Today, much attention is paid to the quality of sleep and its impact on various disorders and health problems. This presentation discusses the relationship between three issues: metabolism, sleep, and obesity. Sleep is connected to hormonal and metabolic changes, provoking imbalance and disruption of functions. As soon as metabolism...
Villa Health Remote Collaboration Scenario In the media scenario, various stakeholders are looking for a solution concerning Caitlynn, a two-year-old patient who has pneumonia. Caitlynn has been admitted for the second time in six months at Valley City Regional Hospital. With the intervention of Dr. Erica Copeland and Virginia Anderson,...
Math skills are a basic requirement for nurses to offer perfect clinical service to their clients. In nursing, the ability to solve problems encountered while on duty is imparted by competency in arithmetic computations while addressing the patients’ needs (Wendel 19). Safety in the process of giving medical treatments against...
Standards of Care Standards of care in Florida are defined in the following way. “Level of care, skill, and treatment which, in light of all relevant surrounding circumstances, is recognized as acceptable and appropriate by reasonably prudent similar health care providers” (Medical Malpractice and Related Matters, 2020, para. 1). Scope...
The Sick Role Theory developed by Talcott Parsons in 1951 has remained a substantial trace in modern sociology. The researcher claimed that a sick role is a form of deviant conduct allowing humans to diverge from obligatory social tasks from time to time. The four characteristics of the sick role...
While social distancing and other lockdown and preventative measures have worked to reduce the occurrence of Covid-19 cases, they have had a negative effect on the mental wellbeing of a lot of individuals. Mental healthcare barriers, job loss, loss of childcare, and the loss of family and loved ones have...
Introduction There is a negative relationship between professional burnout and patient safety. According to the conducted reaches, once a nurse gets burnout, her patients’ safety level decreases (Garcia et al., 2019). Thus, there is a correlation between these two variables. Therefore, to increase patient safety, nurses’ burnout should be prevented....
Nurses are recommended to forestall infections by performing, observing, and guaranteeing consistence with aseptic work works on; fill in as the essential asset to educate all residents. According to Ragusa et al. (2018), appropriate washing of medical devices and providing a clean environment are a vital mediation in interfering with...
Considering lack of motivation as a primary reason for inefficient prophylaxis of urinary tract infection in the elderly is a relevant idea that focuses on the cause itself as the driving force of this medical error. Motivating nurses by implementing new initiatives will lead to more positive outcomes for patients...
In the work environment, nurses often face barriers to the patients ’safety and the services’ quality that are truly hard to overcome. Farokhzadian et al. (2018) performed the study that helped them to uncover the most widespread challenges nurses face that impede the creation of a safe patient environment, and...
Introduction Incivility represents a significant problem in modern society as it may every aspect of life. In the majority of cases, incivility occurs in the industries that provide services and products, which require direct interaction between employees, customers, and stakeholders. In some cases, a conflict of interests may lead to...
It is important to note that the proposed solution for the identified problem of burnout among nursing professionals is to provide the specialists with a flexible and individualized educational program based on a resilience-based approach. It should be noted that the subject is not a local one since nurses all...
The vocation of a nursing leader, besides managerial and organizational tasks, encompasses the importance of being a role model and public supporter of one’s followers. Thus, when interacting with nurses, one of the primary leader’s responsibilities is to accumulate data on the staff’s concerns and expectations from the job. These...
A common health problem worldwide is a shortage of professional nurses, including staff turnover associated with occupational burnout. There is compelling evidence that resilience in nursing staff reduces nursing burnout and significantly influences the quality of patient care and support provided. The article “REST: Break through to resilience” aims at...
Medical services associations are continually changing due to innovative headways, maturing populaces, changing illness designs, new disclosures for the therapy of sicknesses, and political changes and strategy drives. Offering care and counsels through telemedicine is one of the major late changes in nursing practice and a significant new obligation (Bashir...
Nurses can be more assertive by training to speak and listen in a way that helps them express their views and by paying attention to what their patients and colleagues are saying. According to Yoshinaga et al. (2017), assertiveness is typically defined as the ability to express one’s opinion freely...
Introduction Nursing as a whole may be defined as a profession, which involves caring for patients and helping them with various needs and problems in order to create an appropriate healthcare environment. However, caring is not the only function of nursing, and hence there is a number of diverse dimensions...
The current critique focuses on the article “Can the Detection Dog Alert on COVID-19 Positive Persons by Sniffing Axillary Sweat Samples? A Proof-of-Concept Study” by Grandjean et al. The article under review is an experiment to determine whether trained dogs can identify COVID-19 positive individuals by their sweat samples. A...
As a healthcare professional, there are a lot of considerations one must take into account. The well-being and safety of patients are a consideration that requires constant attention and focus. Different patient demographics, however, have differing needs, depending on their lived experiences or background. Persons from marginalized groups often require...
Feedback about any experience is crucial for its provider, and healthcare is the sector where the client’s opinion and outcomes determine the course of development. Nash et al. (2019) claim that “in multiple analyses of the independent drivers of patients’ global ratings of care, the measures that have consistently emerged...
In this chapter, we learned the basic rules and variations of stretching exercises and warming up and calming down before and after a workout. Stretching promotes optimal blood flow throughout the body and prevents varicose veins, obesity, heart disease, and arthritis. Stretching is a powerful weapon against the ruinous sedentary...
Type 2 diabetes mellitus (T2DM) remains a severe healthcare issue for patients both worldwide and in the US alone. Despite the variety of approaches to the treatment of T2DM, there is no explicit clinical evidence on the superiority of any of them. The motivation behind the scholarly inquiries presented by...
Role of the Day Charge Nurse in Assisting Ms. Clark Delegation in nursing practice denotes the practice of sharing responsibilities with other caregivers to maintain a certain level of service and ensure favorable working conditions for caregivers (Marthaler, 2018). The day charge nurse is obligated to assign some tasks to...
The purpose of the website “Streptococcal Infections (invasive group A strep, GAS)” is to provide comprehensive information on the bacteria Group A streptococci, how it is spread, the diseases caused by the bacteria, signs and symptoms of these diseases, the diseases’ prevalence, risk groups for the diseases caused by the...
The barriers LGBTQIA folk face when accessing reproductive health care Stigma and healthcare providers’ lack of awareness of the unique needs of LGBTQIA are the main barriers hindering this group from accessing quality reproductive healthcare. Some healthcare workers change their attitudes and become uncomfortable once they realize that their patient...
Introduction Catholic social teaching (CST) is one of the central doctrines that claim human dignity and the common good as its main values. They spread across all the spheres of life, including medical services. CST sees all humans’ well-being as a result of collaboration between medical science and the Church...
Introduction Throughout history, every country has elaborated its healthcare system with distinctive features formed based on particular philosophies, local traditions, and views. In this regard, despite many economic and political commonalities of the United States with the most developed countries, its healthcare system is strikingly different and unique, especially in...
Introduction There are a lot of occupational safety risks that are involved in medical administration. These are brought about by risk factors that diminish the quality of the baccalaureate nurse and their efforts in providing quality health services. These factors are sometimes general to all patients and can sometimes be...
Self-Assessment During difficult times, faith gives me strength, and I always believe that every hard thing will eventually change for the best. Secondly, life purpose is the aspect of spirituality that has been very helpful to me. In simple terms, it can be explained as a spiritual pillar that anchors...
The American Association of Colleges of Nursing (AACN) has specific documents called Essentials that address different educational levels in nursing. These Essentials describe core competencies necessary for various nursing programs associated with a specific educational level. This paper aims to analyze the Essentials of Master’s Education in Nursing to see...
Quality Improvement The quality of services provided by nurses is key to secure patient outcomes and overall healthcare development. Hence, there are various factors that tend to affect the nurses’ productivity in the workplace, including interprofessional collaboration, qualifications, motivation, and communication skills. However, arguably the most important factor that contributes...
Nursing burnout is a considerable problem as it affects patient safety. Therefore, maintaining nurses’ mental health is essential in adverse events prevention. The possible intervention measures will involve workshops conducted by volunteers with online yoga and meditation classes held via Instagram Live. Recent studies prove that depression issues are common...
Knowledge and outcomes of practicum projects can be shared using various methods. They include communicating in front of the audience (e.g., podiums, panels, and round table formats) and using poster presentations and journal publications (Milner, 2016). Other ways of disseminating knowledge often consist of conducting clinical rounds, brief discussions, and...
A nursing intervention of any scope requires having adequate resources to improve the chances of success as well as provide the basis upon which further quality improvement changes will occur. In the effort to educate CHF patients about precautions they should take when traveling to prevent adverse events, the first...
Abstract Background Healthcare systems globally are experiencing a shortage of nursing personnel. The nurses comprise a critical portion of the healthcare workforce. It can be argued that within the healthcare industry, nursing is the largest profession whose roles in achieving patient wellbeing are critical. In any industry, an imbalance between...
Core Clinical Objectives Plan Resources Core Clinical Objective #1- Create a safe and effective care environment for clients and health care personnel Providing and being able to direct care to patients. While implementing proper PPE attire for nurses and other health care personnel. Discussing techniques on how to have proper...
The reform of regulations governing long-term care (LTC) in the United States by the Centers for Medicare & Medicaid Services (CMS) aimed at enhancing services provided for the elderly. According to Wilensky & Teitelbaum (2019), “ the United States spends more on healthcare than most of the other developed countries,...
The combination of external and internal evidence-based practice (EBP) dissemination strategies seems to be a useful solution. The primary goal of dissemination is to make relevant information available to the members of interdisciplinary teams, while it is especially valuable for nurses, who are the main person responsible for direct care....
Introduction There are several numerous things that should be done before applying for a job. Select (2019), one of the leading HR companies, recommends cleaning the social media, doing research on the potential employer, thinking about what is expected from the job, and considering the strategy. Additionally, it is crucial...
The worldwide prevalence of social media platforms, as well as the extent to which people interact through social media on a daily basis, has inevitably led to the process of health professionals embracing various platforms in order to connect with the medical community and the general public. However, sometimes, when...
Introduction The challenging workplace conditions of nurses inevitably affect their decision to leave work or change the employer for the sake of a better working environment. Nurse turnover, which stands for the process of nurses either leaving their workplace or transferring to a different position within a unit, is a...
Low breast milk production is one of the most common complaints among mothers with newborn babies. A general recommendation is to abstain from smoking during pregnancy and breastfeeding, as this behavior can lead to various problems in children: from breathing problems to sudden infant death syndrome1. That is why this...
Postpartum hemorrhage is a serious condition that threatens new mothers’ lives everywhere in the world. Nurses have a very important role in preventing and managing the issues of birth-related bleedings. The three reviewed articles examine the potential the educational intervention has at helping nurses prevent postpartum hemorrhage and reduce maternal...
Introduction The onset of the COVID-19 pandemic has severely affected the welfare of numerous populations, resulting in multiple negative consequences. The professionals involved in the medical sphere were reported to have been most adversely impacted by the effects of the virus, manifesting both psychological and physical exhaustion due to the...
There is a clear distinction between evidence-based practice and research as far as project research in nursing is concerned. Research deals with testing hypotheses to create new knowledge, while evidence-based practices appraise research-based evidence and try to implement it (Thomas, 2017). Therefore, this leads to the conclusion that research generates...
Nursing is a critical part of healthcare systems that can be overlooked and ignored by the leadership. However, after the fatal COVID-19 affected dozens of countries, it became clear how nursing is one of the most vital aspects of healthcare institutions. When the first COVID-19 pandemic case was reported in...
A common practice on telemetry floor health assessment starts from a bedside overview. Later, tell monitor observation is done to ensure they are in rhythm. Then follows a comprehensive assessment of the patient through an evaluation of medical history, a general survey, and an examination of the patient. The comprehensive...
In her TED talk, Dr. Carol E. Gunn discusses medical errors and their impact on healthcare. Gunn shares the story of her sister Anna who for a long time complained of chest pain. However, the lack of sufficient physician’s attention to her symptoms resulted in a heart attack that Anna...