scholarly journals Recent Advances in Preventing and Managing Postoperative Delirium

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 607 ◽  
Author(s):  
Phillip Vlisides ◽  
Michael Avidan
Keyword(s):  
Postoperative Delirium ◽  
Management Strategies ◽  
Surgical Patients ◽  
Substantial Portion ◽  
Effective Prevention ◽  
Current State ◽  
Prevention Trials ◽  
Severity Of Dementia ◽  
Hospital Elder Life Program ◽  
Quality Evidence

Postoperative delirium is a common and harrowing complication in older surgical patients. Those with cognitive impairment or dementia are at especially high risk for developing postoperative delirium; ominously, it is hypothesized that delirium can accelerate cognitive decline and the onset of dementia, or worsen the severity of dementia. Awareness of delirium has grown in recent years as various medical societies have launched initiatives to prevent postoperative delirium and alleviate its impact. Unfortunately, delirium pathophysiology is not well understood and this likely contributes to the current state of low-quality evidence that informs perioperative guidelines. Along these lines, recent prevention trials involving ketamine and dexmedetomidine have demonstrated inconsistent findings. Non-pharmacologic multicomponent initiatives, such as the Hospital Elder Life Program, have consistently reduced delirium incidence and burden across various hospital settings. However, a substantial portion of delirium occurrences are still not prevented, and effective prevention and management strategies are needed to complement such multicomponent non-pharmacologic therapies. In this narrative review, we examine the current understanding of delirium neurobiology and summarize the present state of prevention and management efforts.

A polysomnography study examining the association between sleep and postoperative delirium in older hospitalized cardiac surgical patients

2021 ◽  
Author(s):  
Reine Ibala ◽  
Jennifer Mekonnen ◽  
Jacob Gitlin ◽  
Eunice Y. Hahm ◽  
Breanna R. Ethridge ◽  
...  
Keyword(s):  
Postoperative Delirium ◽  
Surgical Patients

scholarly journals Air quality trends in Europe over the past decade: a first multi-model assessment

2011 ◽  
Vol 11 (7) ◽  
pp. 19029-19087 ◽  
Author(s):  
A. Colette ◽  
C. Granier ◽  
Ø. Hodnebrog ◽  
H. Jakobs ◽  
A. Maurizi ◽  
...  
Keyword(s):  
Air Quality ◽  
Management Strategies ◽  
Anthropogenic Emissions ◽  
Model Assessment ◽  
Transport Models ◽  
The Past ◽  
Current State ◽  
Primary Compounds ◽  
Long Term Trend

Abstract. We discuss the capability of current state-of-the-art chemistry and transport models to reproduce air quality trends and inter annual variability. Documenting these strengths and weaknesses on the basis of historical simulations is essential before the models are used to investigate future air quality projections. To achieve this, a coordinated modelling exercise was performed in the framework of the CityZEN European Project. It involved six regional and global chemistry-transport models (Bolchem, Chimere, Emep, Eurad, OsloCTM2 and Mozart) simulating air quality over the past decade in the Western European anthropogenic emissions hotspots. Comparisons between models and observations allow assessing the skills of the models to capture the trends in basic atmospheric constituents (NO2, O3, and PM10). We find that the trends of primary constituents are well reproduced (except in some countries – owing to their sensitivity to the emission inventory) although capturing the more moderate trends of secondary species such as O3 is more challenging. Apart from the long term trend, the modelled monthly variability is consistent with the observations but the year-to-year variability is generally underestimated. A comparison of simulations where anthropogenic emissions are kept constant is also investigated. We find that the magnitude of the emission-driven trend exceeds the natural variability for primary compounds. We can thus conclude that emission management strategies have had a significant impact over the past 10 yr, hence supporting further emission reductions strategies.

scholarly journals Review of existing energy management standards and possibilities for its introduction in Serbia

2010 ◽  
Vol 14 (3) ◽  
pp. 613-623 ◽  
Author(s):  
Dubravka Jelic ◽  
Dusan Gordic ◽  
Milun Babic ◽  
Davor Koncalovic ◽  
Vanja Sustersic
Keyword(s):  
Best Practices ◽  
Energy Management ◽  
Energy Efficient ◽  
Management Practices ◽  
Energy Savings ◽  
Management Strategies ◽  
Current Status ◽  
Positive Effects ◽  
Management Standards ◽  
Current State

Until recent times, energy management practices primarily consisted in replacing inefficient equipment and then using any number of methods to estimate obtained savings. Experience shows that positive effects of energy efficient improvements were decreased over time. There have been significant efforts over the last decade to define appropriate standards and best practices and implement the consistent energy management system to increase and maintain the energy savings. The knowledge gained from thousands of energy efficient projects is driving a transition from traditional tactical practice (one-time "build and forget" projects) to energy management strategies proposed and endorsed by a number of international organizations. The current status of internationally developed energy management standards, including an analysis of their shared features and differences is presented in this paper. The purpose of the analysis is to describe the current state of ?best practices? for this emerging area of energy efficiency policymaking in order to study the possibility of implementation of energy management standards in Serbia and to estimate the effects and the potential for energy saving that would be made by its implementation.

scholarly journals Case Scenario: Postoperative Delirium in Elderly Surgical Patients

2010 ◽  
Vol 112 (1) ◽  
pp. 189-195 ◽  
Author(s):  
Jean Mantz ◽  
Hugh C. Hemmings ◽  
Jacques Boddaert
Keyword(s):  
Postoperative Delirium ◽  
Surgical Patients ◽  
Case Scenario

scholarly journals What’s in a Bantu verb? Actionality in Bantu languages

2019 ◽  
Vol 23 (2) ◽  
pp. 303-345 ◽  
Author(s):  
Thera Marie Crane ◽  
Bastian Persohn
Keyword(s):  
Real World ◽  
Future Research ◽  
State Change ◽  
Bantu Languages ◽  
Fine Grained ◽  
Current State ◽  
Quality Evidence

Abstract The lexical and phrasal dimensions of aspect and their interactions with morphosyntactic aspectual operators have proved difficult to model in Bantu languages. Bantu actional types do not map neatly onto commonly accepted categorizations of actionality, although these are frequently assumed to be universal and based on real-world event typologies. In this paper, we describe important characteristics and major actional distinctions attested across Bantu languages. These, we argue, include complex lexicalizations consisting of a coming-to-be phase, the ensuing state change, and the resultant state; sub-distinctions of coming-to-be phases, and other issues of phasal quality. Despite these fine-grained distinctions in phasal structure and quality, evidence for a principled distinction between activity- and accomplishment-like predicates is mixed. We review the current state of evidence for these characteristics of Bantu actionality and sketch methodological directions for future research.

Acute Respiratory Distress Syndrome: Etiology, Pathogenesis, and Summary on Management

2019 ◽  
Vol 35 (8) ◽  
pp. 723-737 ◽  
Author(s):  
Shawn Kaku ◽  
Christopher D. Nguyen ◽  
Natalie N. Htet ◽  
Dominic Tutera ◽  
Juliana Barr ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Management Strategies ◽  
Treatment Strategies ◽  
Acute Lung Inflammation ◽  
Hypoxemic Respiratory Failure ◽  
Pulmonary Vascular Permeability ◽  
Current State

The acute respiratory distress syndrome (ARDS) has multiple causes and is characterized by acute lung inflammation and increased pulmonary vascular permeability, leading to hypoxemic respiratory failure and bilateral pulmonary radiographic opacities. The acute respiratory distress syndrome is associated with substantial morbidity and mortality, and effective treatment strategies are limited. This review presents the current state of the literature regarding the etiology, pathogenesis, and management strategies for ARDS.

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