Search

BACKGROUND: Our objective was to the describe indications, management, complications and outcomes of renal replacement therapy (RRT) in COVID-19 critically ill patients. To contextualise these findings, comparisons were made against 36 non-COVID-19 consecutive patients requiring RRT on ICU. METHODS: We conducted a retrospective single centre observational cohort study of patients requiring acute RRT between 1st March and 30th June 2020. Comparison was made against those receiving RRT in the pre-COVID-19 period from January 2019 to February 2020. RESULTS: Of 154 COVID-19 patients, 47 (30.5%) received continuous venovenous haemofiltration (CVVHF), all of whom required mechanical ventilation and vasopressor support. The requirement for RRT was related to fluid balance rather than azotaemia. Compared to 36 non-COVID-19 patients, those with COVID-19 were younger (p=0.016) with a lower serum creatinine on hospital admission (p=0.049), and lesser degrees of metabolic acidosis (p

Severe hypertension in pregnancy is a medical emergency. Although expeditious treatment within 30 to 60 minutes is recommended to reduce the risk of maternal death or severe morbidity, treatment is often delayed by more than 1 hour. In this statement, we propose a quality metric that facilities can use to track their rates of timely treatment of severe hypertension. We encourage facilities to adopt this metric so that future reports from different facilities will be based on a uniform definition of timely treatment.

This report examines the relationship between mental and physical health and gambling. The report focuses on adults aged 16 years and older in England and Scotland. The report also examined links between smoking and alcohol use and gambling. Samples were gathered from the 2012, 2015, and 2016 Gambling in England and Scotland Combined Data from the Health Survey for England and the Scottish Health Survey datasets. The report found that people with mental health conditions were more likely to experience problem gambling if they gambled. As well, smoking was linked to risks of problem gambling.

Background: To compare differences in indications, management, complications and outcomes of renal replacement therapy (RRT) in COVID-19 patients compared to non-COVID critically ill patients.Methods: We conducted a retrospective observational single centre cohort study in UK. Patients with COVID-19 requiring RRT, compared to consecutive, non-COVID-19 ICU patients requiring RRTResults: Of 154 COVID-19 patients, 47 (30.5%) received continuous venovenous haemofiltration (CVVHF), all of whom required mechanical ventilation and vasopressor support. The requirement for RRT was related to fluid balance rather than azotaemia. Compared to 36 non-COVID-19 patients, those with COVID-19 were younger with a lower serum creatinine on hospital admission, and lesser degrees of metabolic acidosis and lactataemia before initiation of RRT. In addition, the rate of haemofilter circuit clotting was higher and duration of RRT requirement was longer. However, despite lower CVVHF exchange rates with higher serum creatinine levels following RRT initiation in the COVID-19 patients, metabolic abnormalities were corrected. Hospital mortality was 60% among COVID-19 patients requiring RRT, compared to 67% in non-COVID patients (p=0.508), and renal recovery among survivors was similar.Conclusion: The metabolic phenotype in COVID-19 patients requiring RRT differs from non-COVID-19 patients, although outcomes (mortality and renal recovery) are similar.

Background Ankle fractures are one of the most common fractures in adults aged 20–65 years. The British Orthopaedic Association (BOA) and British Orthopaedic Foot and Ankle Society (BOFAS) jointly produced Standards for Trauma (BOAST) BOAST 12, with the aim of reducing morbidity by standardising care of these injuries. The primary aim of the AUGMENT study was to determine the extent and clinical effect of variation from BOAST 12. Methods AUGMENT was a multi-centre prospective trainee led audit of consecutive patients presenting with an ankle fracture within a four-week period. Data were collected on patient demographics, comorbidities, management and 12-week outcome. The BOAST 12 standards were divided into four subgroups; documentation, imaging, management and follow-up. Percentage compliance with each subgroup was analysed. A multivariate logistic regression analysis was used to determine impact of overall compliance on likelihood of discharge in follow-up period. Findings 971 patients were included across 52 sites. The overall rate of BOAST 12 compliance was 41.7%. Variations in practice were observed in clinical documentation, especially of neurovascular status, (40.7%) and VTE assessment (61.5%). Patient management compliance with all 16 of the BOAST 12 standards was associated with a higher rate of discharge during the 12-week follow-up period (p = 0.005). Conclusion AUGMENT has demonstrated that the management of ankle fractures is variable across the UK. Over half of patients had aspects of their care that were not BOAST 12 compliant. When compliance was observed, it was associated with earlier discharge from orthopaedic care.

Introduction: In this study we aimed to determine surgical outcomes of pediatric patients undergoing surgery with perioperative severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) diagnosis. Methods: We examined all patients 18 years old and younger who underwent surgery at a children's hospital and tested positive for SARS-CoV-2 within 1 week before or after their procedure. Age-matched control patients who underwent similar procedures over the past ten years were included in a 3:1 ratio. The primary outcome of our study was 7- and 30-day mortality rates. Secondary outcomes in our study were postoperative pulmonary complications, specifically unexpected ventilation, pneumonia, or acute respiratory distress syndrome. Other outcomes included postoperative hospital stay, ICU admission, and readmission for surgical complications. Results: Our study included 43 procedures performed on 39 patients who tested positive for SARS-CoV-2 and underwent surgery from March 1, 2020 to December 31, 2020. No 7- or 30-day mortality events were observed in any patients. Pulmonary complications were observed in 3 out of 43 (7%) surgeries performed on patients with perioperative SARS-CoV-2 diagnosis, and no pulmonary complications were observed in 124 surgeries performed on patients without SARS-CoV-2 diagnosis (p=.003). SARS-CoV-2 diagnosis did not affect length or occurrence of postoperative hospital stay, ICU admission, and readmission for surgical complications. Abnormal preoperative chest x-ray and preoperative blood pressure were also associated with pulmonary complications in additional analyses (p=.02 and.01, respectively). Conclusion: Our results indicate that pediatric patients undergoing surgery with perioperative SARS-CoV-2 diagnosis may be at increased risk for pulmonary complications.

© 2019 Wiley Periodicals, Inc. While the efficacy of peer-led support groups such as Alcoholics Anonymous (AA) are well established for people recovering from addiction, the “active ingredients” which underpin their efficacy are less understood. Drawing on social identity perspectives, in particular the Social Identity Model of Cessation Maintenance, the current study aimed to explore the relative effects of two possible processes: social identification and involvement with the group's activities. A sample (n = 44) of AA members completed measures pertaining to their social identification with AA, their involvement in the group's activities and their quit efficacy. The findings suggest that AA involvement was significantly related to identity. Mediation analysis revealed a relationship between involvement and efficacy meditated by identity. However, in contrast, the identity-efficacy link was not mediated by involvement. The findings suggest that social identification with AA is as important as, or more important than, simple involvement in the group's activities. This suggests that group planners and facilitators should therefore encourage opportunities to generate a sense of belonging alongside the activities the group revolve around.

Mild traumatic brain injuries (mTBI) are the most common of traumatic brain injuries and patients often experience a wide range of symptoms such as headache, fatigue, dizziness, sleep problems and subjective cognitive deficits. While most symptomatic patients recover quickly, a sub-group of ~ 10-20% of patients experience prolonged symptoms. There is currently a lack of evidence-based treatment for these patients.The objective of the present paper was to conduct a systematic review of the literature on psychotherapeutic interventions specifically for patients with prolonged symptoms (3 months after injury) after mTBI.With a more precise definition of psychotherapy than previous reviews, an extensive literature search was conducted that yielded 2332 hits, of which five were considered to meet the criteria. Only two of the studies were randomized controlled trials.Results revealed several methodological limitations in the included studies, leading to the conclusion that it is premature to make any strong recommendations on psychotherapeutic treatment of prolonged symptoms after mTBI. With in-depth methodological analyses of the included studies and comprehensive recommendations for future research, the present review aims to inform clinicians and to encourage scientists to engage in collaborative effort towards increasing the number of methodologically sound clinical trials in the field.

The development of German archival appraisal theory since 1990 has been little discussed in the English-speaking world. This article provides an introductory overview of the Federfuhrungsmodell developed by the Bundesarchiv (Federal Archives), the horizontal and vertical appraisal approach of the Landesarchiv (State Archives) of Baden-Wurttemberg, and the documentation plans typical of municipal and university archives. It also examines the new focus on records management and calls for collaboration in appraisal between different archives, levels of government and heritage institutions.

800x600 Normal 0 21 false false false NO-BOK X-NONE X-NONE MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Vanlig tabell"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman","serif";} This paper presents an overview of how the university library at the Norwegian University of Science and Technology (NTNU) participates in the education and support of Ph.D. candidates. NTNU has a broad academic scope, the range of subjects are from engineering and technology to humanities, psychology, medicine and fine arts. The courses given by the NTNU university library reflects the different cultures, traditions, contents and developments. This paper also discusses various aspects in connection with the need for information literacy at doctoral level, integration of the courses as well as the need for further development in this field which is both connected to technological developments (such as Google) as well as implementation of the Norwegian Qualification Framework.

Phd-kurs ved NTNU-bibliotekene – en utviklingshistorieVi vil se nærmere på ide/opplegg, organisering, gjennomføring og erfaringer fra forskjellige kurs for phd-kandidater ved NTNU-biblioteket: Kurs for humanister og samfunnsvitere, kurs for medisinere og kurs for kandidater innen teknologi og naturvitenskap (mest sivilingeniører), avholdt på forskjellige campuser og av forskjellige undervisere. Å mestre avansert søking og databehandling blir bare mer og mer sentralt for forskning, selv om det varierer fra disiplin til disiplin. Vi vil gjennomgå egen erfaring, fagmiljøenes behov og hva forskning viser om behovet for informasjonskompetanse-undervisning av PhD-kandidater, med fokus på forskjellige vitenskapers informasjonskompetanse. Krav om at forskning skal være original, bygge på tidligere forskning og de muligheter som vi har fått til å behandle mye større mengder data enn før (e-science) innebærer at kursholderne må være svært oppdatert og ha spisskompetanse i de enkelte baser og verktøy. Dessuten er plagiering og kildevurdering viktige og aktuelle tema. Kursene krever høy kompetanse hos kursholderne og det beste er å utnytte de forskjellige kompetansene som finnes i biblioteket slik at kursene blir et resultat av team-arbeid. I tillegg trekkes andre fagfolk inn (forskningsetikk, akademisk skriving m.m). De organisatoriske utfordringene og markedsføring av kursene blir også viktige når vi arrangerer slike kurs. Undervisningstilbudet blir evaluert fortløpende, og vi ønsker å sette fokus på erfaringsutveksling og praktisk gjennomføring i tillegg til å se på innholdet i våre kurs.

A VERY extensive literature has grown up during the past half century, on the subject of the chemistry of normal human milk. So vast has this literature become, that the task of absorbing and correlating its conclusions into a coherent understanding of the subject as a whole has become one of extreme difficulty and laboriousness. On the other hand, some attempt to do so must form the basis of any new work. From a review of the main communications in the literature, a list of which is appended, certain facts stand out and can, we suggest, be made the basis of an attempt to explore the matter in greater detail. 1. We have reliable and accurate knowledge of the general nature of the main constituents of human milk, and adequate methods for their estimation. 2. We have on record a very large number of observations of milk at all stages of lactation, and are aware of the changes most usually found. If, however, we review the aggregate of facts presented by points 1 and 2, an admirable consideration of which appeared in a communication last year [Gardner and Fox, 1925], the main feature of the picture is the exceedingly wide range of values shown in normal milk by each constituent. These variations complicate our understanding of the composition of normal milk, and put a serious bar to any study of the conditions of abnormal milk. Furthermore, the great bulk of the work done hitherto on normal milk has not only been done abroad, but has also been achieved through the study of wet nurses-that is, of women accustomed to a specialised routine for the production and extraction of milk. As their conditions differ radically from those of ordinary nursing mothers, it cannot safely be assumed that the lactation results will necessarily be the same. The present paper is the report of an attempt on the basis of work already known to deal with both these positions, to investigate in ordinary normal mothers the factors determining the variations in the chemical composition of their milk.