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Comolli CL, Bolano D, Bernardi L, Voorpostel M. Concentration of critical events over the life course and life satisfaction later in life. Adv Life Course Res 2024; 61:100616. [PMID: 38759484 DOI: 10.1016/j.alcr.2024.100616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 03/28/2024] [Accepted: 05/04/2024] [Indexed: 05/19/2024]
Abstract
Critical events create turning points, disrupt individuals' life courses, and affect wellbeing. Periods of life densely populated with critical events may translate into an acute resource drain, affecting long-term wellbeing more strongly than if the same events were sparsely distributed. We investigate how the co-occurrence of critical events and their concentration in time influence life satisfaction in later life. To do so, we construct a novel indicator, the Concentration Index, based not only on the number but also on the time lag between occurrences. Using retrospective information on critical events in family, work, health, and residential trajectories in Switzerland, we show that the higher the concentration in time of critical events is, the stronger their negative long-term relation to wellbeing, net of sociodemographic characteristics, the total number of events ever experienced, and the time since the last event. Furthermore, relevant gender and social origin differences emerged with a stronger negative association with wellbeing among men and respondents from low socioeconomic backgrounds. Our work clearly shows that simply counting the number of events gives only a partial and potentially inaccurate measure of the complexity of the life course and its relationship with quality of life. Not only how many events experienced matter but also the spacing between them.
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Kennie-Kaulbach N, Crespo K, Janke KK, Davies H, Whelan AM, Bishop A, Price S. A Narrative Inquiry of Critical Events Supporting Professional Identity Formation in Introductory Pharmacy Practice Experiences. Am J Pharm Educ 2024; 88:100614. [PMID: 37914029 DOI: 10.1016/j.ajpe.2023.100614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 10/20/2023] [Accepted: 10/25/2023] [Indexed: 11/03/2023]
Abstract
OBJECTIVE Professional identity formation (PIF) is the process of internalizing a profession's core values and beliefs so that one begins to think, act, and feel like a member of that profession. PIF occurs over an individual's professional socialization in stages, precipitated by critical moments or experiences. The purpose of this study was to answer the following: (1) What are the critical events for pharmacy student PIF in introductory pharmacy practice experiences?; and (2) How do these events support or challenge PIF? METHODS This study used critical event narrative inquiry methodology. A critical event is an experience that creates a change in understanding and affects professional performance. Semistructured interviews were conducted with pharmacy students who completed introductory pharmacy practice experience rotations in community (first year) and hospital (second year) settings. Interviews were coded and analyzed using narrative analysis. RESULTS Twelve first-year and 10 second-year students participated in this study. Narratives revealed that common experiential education experiences resulted in a deeper understanding of core role elements (ie, professional autonomy, responsibility, interprofessional collaboration, and patient-centered care), leading to changes in agency, knowledge, and anticipated future behaviors. While first-year participants' narratives mainly focused on understanding pharmacist roles ("what"), second-year participants focused on understanding the process to fulfill those roles ("how to"). Emotions, assuming responsibility, external validation, and preceptor guidance supported these events. CONCLUSION Critical events in introductory pharmacy practice experiences affect and shape pharmacy students' PIF. These events are relevant to pharmacy education because these experiences can result in changes in knowledge, agency, or future behaviors for students.
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Affiliation(s)
- Natalie Kennie-Kaulbach
- Dalhousie University, Faculty of Health, College of Pharmacy, Practice Experience Program, Halifax, Canada.
| | - Katie Crespo
- Dalhousie University, Faculty of Health, College of Pharmacy, Halifax, Canada
| | - Kristin K Janke
- University of Minnesota College of Pharmacy, Wulling Center for Innovation & Scholarship in Pharmacy Education, Minneapolis, MN, USA; University of Minnesota College of Pharmacy, Pharmaceutical Care & Health Systems, Minneapolis, MN, USA; University of Minnesota College of Pharmacy, Assessment & Quality, Minneapolis, MN, USA
| | - Harriet Davies
- Dalhousie University, Faculty of Health, College of Pharmacy, Clinical Education, Halifax, Canada
| | - Anne Marie Whelan
- Dalhousie University, Faculty of Health, College of Pharmacy, Program Evaluation, Halifax, Canada
| | - Andrea Bishop
- Nova Scotia College of Pharmacists, Research and Engagement, Halifax, Canada
| | - Sheri Price
- Dalhousie University, Faculty of Health, School of Nursing, Halifax, Canada
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Flynn G, Nagle T, Fitzgerald C. Data Evolution in Times of Crisis: an Organisational Mindfulness Perspective. Inf Syst Front 2022:1-16. [PMID: 35506051 PMCID: PMC9051014 DOI: 10.1007/s10796-022-10275-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 03/29/2022] [Indexed: 06/14/2023]
Abstract
The Covid-19 pandemic illustrates that we are never far away from situations that have a scale and impact, which are difficult to predict. Positioned at the intersection of crisis management and resilience, this insider case-study provides the opportunity for a more complete understanding of the organisation-adversity relationship (Williams et al., 2017), by focusing on the third Covid19 wave in Ireland (Dec 2020) and resulting response by an Intensive Care Unit crisis team. The study examines the evolution of seven data supply chains that were developed to support the ICU crisis team through the surge of cases which put the highest level of strain on the Irish health system since the pandemic began. The study focuses on 289 data reviews, which triggered 63 changes each requiring a new iteration of a data supply chain. Incorporating Organisational Mindfulness as the theoretical framework, the study provides an insight into the realities of data management during a crisis but also provides a rich awareness of the complexities of data management that often go unrecognised. In doing so, the study contributes the concept of 'mindful data', which aids managers to understand the key characteristics of resilient data supply chains. The study also provides a rare first-hand insight into how mindful data was constructed, presented, and evolved into an essential element within the critical care environment.
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Affiliation(s)
- Ger Flynn
- Health Service Executive and Cork University Business School, University College Cork, Cork, Ireland
| | - Tadhg Nagle
- Cork University Business School, University College Cork, Cork, Ireland
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Freitas JS, Melo JCFD, Salerno MS, Bagno RB, Brasil VC. An innovative application of event structure analysis (ESA). MethodsX 2021; 8:101256. [PMID: 34434779 PMCID: PMC8374248 DOI: 10.1016/j.mex.2021.101256] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 01/23/2021] [Accepted: 01/28/2021] [Indexed: 11/18/2022] Open
Abstract
This paper presents an innovative application of event structure analysis (ESA). The key improvements incorporated on the method are: (i) a robust system for coding events; (ii) the use of causal process tracing tests for inferring necessary connections; (iii) the combination of ESA with network analyses. Finally, we propose five types of analysis for event network models (i.e., critical elements, critical associations, critical connections, critical specific happenings, and critical antecedents) and exemplify some of them in a causal case study about the process of capability construction for open innovation management in an Industrial Electronic Manufacturer.ESA can be combined with process-tracing tests to ground counterfactual causal inferences. ESA can be combined with network analysis to explore quantitative patterns in event structures. ESA is an outstanding method to conduct process research in management and engineering.
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Affiliation(s)
- Jonathan Simões Freitas
- Federal University of Minas Gerais (UFMG), Presidente Antônio Carlos Avenue, 6627 - Pampulha, Belo Horizonte, MG, Brazil
- Corresponding author.
| | - Julio Cezar Fonseca de Melo
- Production Engineering Department Polytechnic School, University of São Paulo (USP), Av. Professor Luciano Gualberto, 1380 São Paulo, SP, Brazil
| | - Mario Sergio Salerno
- Production Engineering Department Polytechnic School, University of São Paulo (USP), Av. Professor Luciano Gualberto, 1380 São Paulo, SP, Brazil
| | - Raoni Barros Bagno
- Federal University of Minas Gerais (UFMG), Presidente Antônio Carlos Avenue, 6627 - Pampulha, Belo Horizonte, MG, Brazil
| | - Vinicius Chagas Brasil
- Production Engineering Department Polytechnic School, University of São Paulo (USP), Av. Professor Luciano Gualberto, 1380 São Paulo, SP, Brazil
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Leppanen J, Tosunlar L, Blackburn R, Williams S, Tchanturia K, Sedgewick F. Critical incidents in anorexia nervosa: perspectives of those with a lived experience. J Eat Disord 2021; 9:53. [PMID: 33875005 PMCID: PMC8054426 DOI: 10.1186/s40337-021-00409-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 04/07/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Although social-emotional difficulties are believed play a key role in anorexia nervosa (AN), there is uncertainty regarding what these difficulties might look like. Previous research has largely focused on a "disease model" of social-emotional processing in AN with little attention paid to positive emotions and experiences. Therefore, the aim of the present study was to obtain a fuller picture of critical life events as identified by those with lived AN experience. METHODS Thirty-four participants aged 16-48 with current or past AN completed an online survey describing self-defined positive and difficult critical events. Thematic analysis was used to assess patterns in participants narrative responses. RESULTS Two major themes were identified in the descriptions of positive critical events: Moments of celebration and Unexpected positive outcomes. These major themes revealed increased external focus and some corrective experiences that challenged the participants pre-existing expectations leading to new positive outcomes. Difficult events clustered into life events that were identified as Eating disorder (ED) related and Non-ED related and included the dimensions of relational conflict and feeling unsupported. DISCUSSION The findings suggest that although negative emotionality was identified in the accounts of those with lived experience of AN capacity for "big-picture" thinking with and explicit focus on others was also identified. Moreover, an openness to corrective experiences that worked to challenge negative expectations was evident for some participants. Together these findings have scope as targets for further clinical research and treatment interventions.
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Affiliation(s)
- Jenni Leppanen
- Department of Neuroimaging, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, UK.
- Department of Psychological Medicine, Institute of Psychology, Psychiatry and Neuroscience, King's College London, 103 Denmark Hill, London, SE5 8AF, UK.
| | - Lara Tosunlar
- Department of Psychological Medicine, Institute of Psychology, Psychiatry and Neuroscience, King's College London, 103 Denmark Hill, London, SE5 8AF, UK
| | - Rachael Blackburn
- Department of Psychological Medicine, Institute of Psychology, Psychiatry and Neuroscience, King's College London, 103 Denmark Hill, London, SE5 8AF, UK
| | - Steven Williams
- Department of Neuroimaging, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, UK
| | - Kate Tchanturia
- Department of Psychological Medicine, Institute of Psychology, Psychiatry and Neuroscience, King's College London, 103 Denmark Hill, London, SE5 8AF, UK
- South London and Maudsley NHS Foundation Trust National Eating Disorder Service, London, UK
- Psychology Department, Illia State University, Tbilisi, Georgia
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Abstract
Critical events are rare and stressful. These properties make reliance on memory for clinical management highly susceptible to failure. In the past 10 to 20 years, health care has begun to accept the experience of aviation and other high-reliability organizations in addressing failure to rescue from these events through a combination of practice through simulation and the introduction of cognitive aids, known as checklists or emergency manuals. Cognitive aids have a persuasive body of evidence from simulation studies to establish their value in improving clinician performance. However, their introduction to practice is more complex than distribution of the tools.
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Affiliation(s)
- Alexander A Hannenberg
- Ariadne Labs, 401 Park Drive 3-West, Boston, MA 02215, USA; Tufts University School of Medicine, Boston, MA, USA.
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Parveez MQ, Yaddanapudi LN, Saini V, Kajal K, Sharma A. Critical events during intra-hospital transport of critically ill patients to and from intensive care unit. Turk J Emerg Med 2020; 20:135-141. [PMID: 32832732 PMCID: PMC7416857 DOI: 10.4103/2452-2473.290067] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 03/23/2020] [Accepted: 07/06/2020] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Intensive care unit (ICU) patients are at an increased risk of many catastrophic events during intrahospital transport (IHT) for various procedures. This study was planned to determine the incidence and types of adverse events occurring during the transport of critically ill patients in a tertiary care hospital. METHODS This prospective observational study was conducted in the ICU of a tertiary care hospital for 8 months after ethical clearance from the institute ethics committee. All patients transported out of the ICU during the audit period for diagnostic or therapeutic procedures were included in the study. Vitals and several study parameters were recorded before, during, and after shifting patients to and from the ICU. Various critical events were noted during transport and classified into major and minor critical events based on the presence and absence of potential consequences that lead to a change of therapy during transport. RESULTS One hundred and sixty patients were studied for consecutive IHT to and from the ICU. The patients were transported for imaging studies (58.1%), minor surgery (31.8%), major surgery (2.5%), and other procedures (7.5%). A total of 248 critical events were observed in 104 IHTs (65%; 95% confidence interval [95% CI]: 57.4%-72.1%). Hence, an average of 2.38 critical events occurred per IHT. There were 31 major events among the 248 critical events (12.5%; 95% CI: 8.8%-17.1%). CONCLUSIONS Standard guidelines about the accompanying personnel and monitoring need to be followed during IHT. Conduct of minor surgical procedures in the ICU and better bedside diagnostic procedures may be considered for the future.
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Affiliation(s)
- Mohd Qurram Parveez
- Department of Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Lakshmi Narayana Yaddanapudi
- Department of Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Vikas Saini
- Department of Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Kamal Kajal
- Department of Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Ankur Sharma
- Department of Trauma and Emergency (Anaesthesiology), All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
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de Wijn AN, van der Doef MP. Patient-related stressful situations and stress-related outcomes in emergency nurses: A cross-sectional study on the role of work factors and recovery during leisure time. Int J Nurs Stud 2020; 107:103579. [PMID: 32446016 DOI: 10.1016/j.ijnurstu.2020.103579] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 02/21/2020] [Accepted: 03/13/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND Emergency nurses are frequently exposed to patient-related stressful situations, making them susceptible to emotional exhaustion and symptoms of post-traumatic stress disorder. The current study aims to assess differential effects of patient-related stressful situations (emotionally demanding situations, aggression/conflict situations, and critical events) on stress-related outcomes in emergency nurses, and to identify moderating factors based on the Job Demands-Resources model and the Effort-Recovery model (job demands, job resources, and recovery experiences during leisure time). METHOD A cross-sectional study was carried out among nurses working in the emergency departments of 19 hospitals in the Netherlands (N = 692, response rate 73%). Data were collected by means of an online survey. Multiple hierarchical regression analyses were performed, controlling for sociodemographic variables. RESULTS The frequency of exposure to patient-related stressful situations was positively related to stress-related outcomes, with emotionally demanding situations and aggression/conflict situations mainly explaining variance in emotional exhaustion (β = 0.16, p < .01, ∆R² = 0.08, and β = 0.22, p < .01, ∆R² = 0.13), whereas critical events mainly explained variance in post-traumatic stress symptoms (β = 0.29, p < .01, ∆R² = 0.11). Moderating effects were found for within worktime recovery and recovery during leisure time. Work-time demands, autonomy and social support from the supervisor were predictive of stress-related outcomes irrespectively of exposure to patient-related stressful situations. CONCLUSION As patient-related stressful situations are difficult if not impossible to reduce in an emergency department setting, the findings suggest it would be worthwhile to stimulate within worktime recovery as well as recovery experiences during leisure time, to protect emergency nurses from emotional exhaustion and symptoms of post-traumatic stress. Furthermore, this study underscores the importance of reducing work-time demands and enhancing job resources to address stress-related outcomes in emergency nurses. Practical implications, strengths and limitations are discussed.
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Affiliation(s)
- A N de Wijn
- Institute of Psychology, Health, Medical, & Neuropsychology Unit, Leiden University, Wassenaarseweg 52, 2333 AK Leiden, The Netherlands.
| | - M P van der Doef
- Institute of Psychology, Health, Medical, & Neuropsychology Unit, Leiden University, Wassenaarseweg 52, 2333 AK Leiden, The Netherlands
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Chambers S, Healy H, Hoy WE, Kark A, Ratanjee S, Mitchell G, Douglas C, Yates P, Bonner A. Health service utilisation during the last year of life: a prospective, longitudinal study of the pathways of patients with chronic kidney disease stages 3-5. BMC Palliat Care 2018; 17:57. [PMID: 29622009 PMCID: PMC5887240 DOI: 10.1186/s12904-018-0310-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Accepted: 03/21/2018] [Indexed: 12/22/2022] Open
Abstract
Background Chronic kidney disease (CKD) is a growing global problem affecting around 10% of many countries’ populations. Providing appropriate palliative care services (PCS) to those with advanced kidney disease is becoming paramount. Palliative/supportive care alongside usual CKD clinical treatment is gaining acceptance in nephrology services although the collaboration with and use of PCS is not consistent. Methods The goal of this study was to track and quantify the health service utilisation of people with CKD stages 3-5 over the last 12 months of life. Patients were recruited from a kidney health service (Queensland, Australia) for this prospective, longitudinal study. Data were collected for 12 months (or until death, whichever was sooner) during 2015-17 from administrative health sources. Emergency department presentations (EDP) and inpatient admissions (IPA) (collectively referred to as critical events) were reviewed by two Nephrologists to gauge if the events were avoidable. Results Participants (n = 19) with a median age of 78 years (range 42-90), were mostly male (63%), 79% had CKD stage 5, and were heavy users of health services during the study period. Fifteen patients (79%) collectively recorded 44 EDP; 61% occurred after-hours, 91% were triaged as imminently and potentially life-threatening and 73% were admitted. Seventy-four IPA were collectively recorded across 16 patients (84%); 14% occurred on weekends or public holidays. Median length of stay was 3 days (range 1-29). The median number of EDP and IPA per patient was 1 and 2 (range 0-12 and 0-20) respectively. The most common trigger to both EDP (30%) and IPA (15%) was respiratory distress. By study end 37% of patients died, 63% were known to PCS and 11% rejected a referral to a PCS. All critical events were deemed unavoidable. Conclusions Few patients avoided using acute health care services in a 12 month period, highlighting the high service needs of this cohort throughout the long, slow decline of CKD. Proactive end-of-life care earlier in the disease trajectory through integrating renal and palliative care teams may avoid acute presentations to hospital through better symptom management and planned care pathways.
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Affiliation(s)
- Shirley Chambers
- Faculty of Health, Queensland University of Technology, Brisbane, Australia. .,National Health and Medical Research Council, Centre for Research Excellence in End of Life Care, Brisbane, Australia.
| | - Helen Healy
- Kidney Health Service, Metro North Hospital and Health Service, Queensland Health, Brisbane, Australia.,National Health and Medical Research Council, Chronic Kidney Disease Centre for Research Excellence, Brisbane, Australia.,Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Wendy E Hoy
- National Health and Medical Research Council, Chronic Kidney Disease Centre for Research Excellence, Brisbane, Australia.,Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Adrian Kark
- Kidney Health Service, Metro North Hospital and Health Service, Queensland Health, Brisbane, Australia
| | - Sharad Ratanjee
- Kidney Health Service, Metro North Hospital and Health Service, Queensland Health, Brisbane, Australia
| | - Geoffrey Mitchell
- National Health and Medical Research Council, Centre for Research Excellence in End of Life Care, Brisbane, Australia.,National Health and Medical Research Council, Chronic Kidney Disease Centre for Research Excellence, Brisbane, Australia.,Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Carol Douglas
- Palliative Care Service, Royal Brisbane and Women's Hospital, Queensland Health, Brisbane, Australia
| | - Patsy Yates
- Faculty of Health, Queensland University of Technology, Brisbane, Australia.,National Health and Medical Research Council, Centre for Research Excellence in End of Life Care, Brisbane, Australia.,Centre for Palliative Care Research and Education, Queensland Health, Brisbane, Australia
| | - Ann Bonner
- Faculty of Health, Queensland University of Technology, Brisbane, Australia.,National Health and Medical Research Council, Centre for Research Excellence in End of Life Care, Brisbane, Australia.,Kidney Health Service, Metro North Hospital and Health Service, Queensland Health, Brisbane, Australia.,National Health and Medical Research Council, Chronic Kidney Disease Centre for Research Excellence, Brisbane, Australia
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Maher DP, Lee J, Woo P, Zhang X, White PF, Yumul R, Hernandez Conte A. Ritonavir Use in Human Immunodeficiency Virus-Positive Surgical Patients Is Not Associated with an Increase in Postoperative Critical Respiratory Events. J Pain Palliat Care Pharmacother 2016; 30:25-30. [PMID: 26861563 DOI: 10.3109/15360288.2015.1135846] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
This study evaluated whether highly active antiretroviral therapy for human immunodeficiency virus (HIV) including ritonavir is independently associated with increased critical respiratory events after general anesthesia with opioid analgesia. The impact of ritonavir on hepatic microsomal enzymes was considered due to the effect of these enzymes on opioid metabolism. Medical records of over 1900 patients were reviewed, and those of 941 patients met inclusion criteria and were analyzed. Chronic treatment with ritonavir was not associated with critical respiratory events in HIV-positive patients.
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Filippa M, Devouche E, Arioni C, Imberty M, Gratier M. Live maternal speech and singing have beneficial effects on hospitalized preterm infants. Acta Paediatr 2013; 102:1017-20. [PMID: 23848529 DOI: 10.1111/apa.12356] [Citation(s) in RCA: 87] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2013] [Revised: 06/24/2013] [Accepted: 07/10/2013] [Indexed: 11/29/2022]
Abstract
AIM To study the effects of live maternal speaking and singing on physiological parameters of preterm infants in the NICU and to test the hypothesis that vocal stimulation can have differential effects on preterm infants at a behavioural level. METHODS Eighteen mothers spoke and sang to their medically stable preterm infants in their incubators over 6 days, between 1 and 2 pm. Heart rate (HR), oxygen saturation (OxSat), number of critical events (hypoxemia, bradycardia and apnoea) and change in behavioural state were measured. RESULTS Comparisons of periods with and without maternal vocal stimulation revealed significantly greater oxygen saturation level and heart rate and significantly fewer negative critical events (p < 0.0001) when the mother was speaking and singing. Unexpected findings were the comparable effects of maternal talk and singing on infant physiological parameters and the differential ones on infant behavioural state. CONCLUSION A renewed connection to the mother's voice can be an important and significant experience for preterm infants. Exposure to maternal speech and singing shows significant early beneficial effects on physiological state, such as oxygen saturation levels, number of critical events and prevalence of calm alert state. These findings have implications for NICU interventions, encouraging maternal interaction with their medically stable preterm infants.
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Affiliation(s)
- Manuela Filippa
- Université Paris Ouest Nanterre La Défense; Nanterre Cedex; France
| | | | | | - Michel Imberty
- Université Paris Ouest Nanterre La Défense; Nanterre Cedex; France
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Abstract
This prospective study was designed to have an insight into critical events occurring in the 13-bedded multidisciplinary intensive care unit (ICU) of our hospital and to report the critical events to evaluate the avoidable/iatrogenic problems so as to improve patient outcome and keep a self-check in the ICU. The errors reported were due to wrong mechanical or human performance. Repeated performance errors of the same kind pointed to the problem area, to which was paid proper attention in the required manner. Some malfunctioning equipments were abandoned and the need for adequate availability of staff was emphasized. Reporting of critical events was done keeping the patients' and doctor's identities anonymous through a proforma designed to report the event.
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Affiliation(s)
- Mohandeep Kaur
- Department of Anesthesia and Critical Care, Dr. RML Hospital, New Delhi.
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