Trending Articles
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Meta Analysis Comparative Study
Balanced crystalloids versus normal saline for fluid resuscitation in critically ill patients: A systematic review and meta-analysis with trial sequential analysis.
Intravenous resuscitation with balanced crystalloid fluids does not reduce mortality or kidney injury compared with normal saline in critically ill patients.
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An exploration of the ethics, challenges and practical reality of treating family members. Hutchison & McConnell deploy models of virtue, utilitarianism, deontology and principlism in an accessible and applied way.
- Virtue ethics – behaving in the way we think is right; embodying courage.
- Utilitarianism – behaving so as to maximise the best outcomes for the greater number of people.
- Deontology – obeying the rules; following a duty to moral law.
- Principlism – balances beneficence, nonmaleficence, autonomy and justice.
They cautiously challenge the blanket prohibitions of many professional bodies against treating family members.
Well worth reading.
summary“Only by constantly questioning whether they are the correct person to deliver care can they hope to do right by both their relative and themselves.”
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J Pain Symptom Manage · May 2020
Heart Failure: A review of disease, therapies and medications with a focus on symptoms, function, and quality of life.
Despite significant advances in heart failure (HF) treatment, HF remains a progressive, extremely symptomatic, and terminal disease with a median survival of 2.1 years after diagnosis. HF often leads to a constellation of symptoms, including dyspnea, fatigue, depression, anxiety, insomnia, pain, and worsened cognitive function. Palliative care is an approach that improves the quality of life of patients and their caregivers facing the problems associated with life-threatening illness and therefore is well suited to support these patients. ⋯ This review describes HF and current targeted therapies and their effects on symptoms, hospital admission rates, exercise performance, HRQL, and survival. Pharmacological interactions with and precautions related to commonly used palliative care medications are reviewed. The goal of this review is to equip palliative care clinicians with information to make evidence-based decisions while managing the balance between optimal disease management and patient quality of life.
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J Exp Psychol Hum Percept Perform · May 2018
Optimal task-sets override attentional capture by rare cues.
Many studies converge on the conclusion that spatially irrelevant precues do not capture attention when cue and target features do not match. However, a recent study reported that rare onset cues captured attention even though observers searched for a nonmatching color target. Hence, attentional capture by rare onsets cues might be cognitively impenetrable (Folk & Remington, 2015). ⋯ Moreover, we examined the previous suggestion that frequency effects are limited to onset cues by presenting rare color cues with nonmatching color targets (Experiment 3). We observed capture by rare color cues, but again, capture could be prevented when a nontarget in the cue color was added to the target display (Experiment 4). Overall, these findings suggest that capture by rare cues can be prevented when the suppressive bias against nontarget features is optimally directed against the cue properties. (PsycINFO Database Record
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Cochrane Db Syst Rev · Apr 2020
Meta AnalysisPersonal protective equipment for preventing highly infectious diseases due to exposure to contaminated body fluids in healthcare staff.
This is the second update to Verbeek et al.'s 2016 Cochrane Review of personal protective equipment (PPE) for preventing infections in healthcare workers (HCW). The prior update was in July 2019.
What's worth knowing?
Overall most studies of PPE efficacy are of low quality and offer a low certainty of conclusions. Caveat emptor...
- Powered air-purifying respirator (PAPR) with coverall may be more protective than N95 masks and gown (RR 0.27), but create unique donning challenges.
- Long-gowns may be better than a coverall, but are also more difficult to doff. Gowns are better than aprons. Better sealing, fitting, and one-piece removal at gown-glove interfaces and closer fit around the neck may reduce exposure.
- Double-gloving may reduce exposure.
- Better training, computer simulation, video lectures, following CDC protocols, and spoken instruction may improve donning and doffing compliance.