Articles: pandemics.
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Med Health Care Philos · Feb 2011
Anti-theory in action? Planning for pandemics, triage and ICU or: how not to bite a bullet.
Anti-theory is a multi-faceted critique of moral theory which, it appears, is undergoing something of reassessment. In a recent paper Hämäläinen discusses the relevance of an anti-theoretical perspective for the activity of applied ethics. This paper explores her view of anti-theory. ⋯ Following Hämäläinen in contrasting reflective equilibrium with her anti-theory inspired suggestion of an instrumental approach to moral theory in practice I demonstrate how this understanding complements the diversity of our intuitive moral judgements. Consequentially I suggest that this anti-theoretical instrumental approach is in greater accord with the conditions under which such policy planning and decision making is, or will be, made. Furthermore, on the grounds of keeping open the ethical dimensions of medical practice in conditions of uncertainty, i.e. during a pandemic, I suggest that the anti-theoretical instrumental perspective is, ethically, the preferable approach to producing such policies and guidelines.
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Intensive care medicine · Feb 2011
Multicenter StudyUse of early corticosteroid therapy on ICU admission in patients affected by severe pandemic (H1N1)v influenza A infection.
Early use of corticosteroids in patients affected by pandemic (H1N1)v influenza A infection, although relatively common, remains controversial. ⋯ Early use of corticosteroids in patients affected by pandemic (H1N1)v influenza A infection did not result in better outcomes and was associated with increased risk of superinfections.
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During the influenza A-H1N1 pandemic, only about 16% of pregnant women were vaccinated against the virus, despite their higher expected mortality risk. According to the official data, five pregnant women died. ⋯ The author discusses the causes that deterred pregnant women from being vaccinated. The main problem seems to be that some physicians were under-informed and were reluctant to take responsibility.
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We describe hospital preparedness, including costs, and clinical characteristics of the 2009 influenza A (H1N1) pandemic in adult patients in a Belgian tertiary care centre. A task force coordinated the overall management, including triage and hospitalisation. Between 1 June and 30 November 2009, 521 patients with influenza-like illness were admitted to the emergency ward. ⋯ The financial impact of the epidemic was estimated at €75,691, and approximately half of these costs were related to the enhanced infection control practices. The Belgian 2009 influenza A (H1N1) pandemic, as described in a cohort of 43 hospitalised patients, was associated with a relatively high ICU admission rate of 26% and a fairly typical mortality rate of 3%. This retrospective study may help us refine the management of future epidemics.