scholarly journals Redefining the Relationship: Palliative Care in Critical Perinatal and Neonatal Cardiac Patients

Children ◽  
2021 ◽  
Vol 8 (7) ◽  
pp. 548
Author(s):  
Natasha S. Afonso ◽  
Margaret R. Ninemire ◽  
Sharada H. Gowda ◽  
Jaime L. Jump ◽  
Regina L. Lantin-Hermoso ◽  
...  
Keyword(s):  
Palliative Care ◽  
Depression And Anxiety ◽  
Medical Providers ◽  
Term Survival ◽  
Medical Interventions ◽  
Patient Groups ◽  
Neonatal Patient ◽  
And Coping ◽  
The Relationship

Patients with perinatal and neonatal congenital heart disease (CHD) represent a unique population with higher morbidity and mortality compared to other neonatal patient groups. Despite an overall improvement in long-term survival, they often require chronic care of complex medical illnesses after hospital discharge, placing a high burden of responsibility on their families. Emerging literature reflects high levels of depression and anxiety which plague parents, starting as early as the time of prenatal diagnosis. In the current era of the global COVID-19 pandemic, the additive nature of significant stressors for both medical providers and families can have catastrophic consequences on communication and coping. Due to the high prognostic uncertainty of CHD, data suggests that early pediatric palliative care (PC) consultation may improve shared decision-making, communication, and coping, while minimizing unnecessary medical interventions. However, barriers to pediatric PC persist largely due to the perception that PC consultation is indicative of “giving up.” This review serves to highlight the evolving landscape of perinatal and neonatal CHD and the need for earlier and longitudinal integration of pediatric PC in order to provide high-quality, interdisciplinary care to patients and families.

No Longer Disabled: The Legal Impact of the New Social Construction of HIV

1997 ◽  
Vol 23 (1) ◽  
pp. 7-43
Author(s):  
Wendy E. Parmet ◽  
Daniel J. Jackson
Keyword(s):  
Chronic Disease ◽  
Social Construction ◽  
Social Problem ◽  
Positive Development ◽  
Hiv Disease ◽  
Term Survival ◽  
Medical Interventions ◽  
Terminal Disease ◽  
Hiv Epidemic

The second social construction of HIV disease has begun. In the first fifteen years of the HIV epidemic, many viewed the disease “as the modern plague.” Now, as the epidemic matures and new “miracle treatments" are heralded, the disease is beginning to conjure a very different set of images. Where once AIDS was dreaded as the inexplicable cataclysm of the end of the millennium, now, as the virus appears amenable to treatment, we are beginning to see the disease as something both preventable and controllable, no longer beyond human direction. And, where the disease was once synonymous with death, disability, and decline, we now witness stories of miracle recoveries and long-term survival. In the minds of many, the terminal disease has become the chronic disease; the dreaded plague has become but another social problem.In most respects, the new social construction of HIV, emerging from the advent of potentially effective medical interventions, is a positive development.

scholarly journals The relationship of the prolonged PR interval with the long-term survival in patients with heart failure undergoing cardiac resynchronization therapy

2020 ◽  
Vol 25 (1) ◽  
pp. 33-38
Author(s):  
A. M. Soldatova ◽  
V. A. Kuznetsov ◽  
T. P. Gizatulina ◽  
L. M. Malishevsky ◽  
S. M. Dyachkov
Keyword(s):  
Cardiac Resynchronization ◽  
Rank Test ◽  
Term Survival ◽  
Log Rank Test ◽  
Group I ◽  
Pr Interval ◽  
Qrs Duration ◽  
Group Ii ◽  
The Relationship

Aim. To assess the relationship between the prolonged PR interval (≥200 ms) and the long-term survival of patients undergoing cardiac resynchronization therapy (CRT).Material and methods. A total of 85 patients (mean age — 55,1Ѓ}9,9 years; men — 81,2%) with NYHA class II-IV heart failure (HF) were examined. The mean follow-up was 34,0Ѓ}21,2 months. Patients with PR<200 ms (n=52) made up group I, with PR≥200 ms (n=33) — group II. Then the patients were divided into subgroups depending on the QRS duration: ≥150 ms (n=33 in group I and n=14 in group II, respectively) <150 ms (n=19 in group I and n=19 in group II, respectively).Results. In patients of group II, a history of myocardial infarction (MI) was more often registered (p=0,005), left ventricular ejection fraction (LVEF) was lower (p=0,032). In a multivariate analysis, MI (OR 3,217; CI 95% 1,188-8,712; p=0,022) and LVEF value (OR 0,869; CI 95% 0,780-0,968; p=0,011) had a significant relationship with the PR interval prolongation (≥200 ms). The survival of patients of group I was 59,6%, group II — 18,2% (Log-rank test p<0,001). According to Cox regression model, the initial left ventricle end-systolic volume (OR 1,012; 95% CI 1,006-1,017; p<0,001), inferior wall MI (OR 1,690; 95% CI 1,131-2,527; p=0,011) and PR interval ≥200 ms (OR 2,179; 95% CI 1,213–3,915; p=0,009) were associated with long-term mortality. In patients with PR≥200 ms, survival rate was low, regardless of the QRS duration (21,4% in patients with QRS≥150 ms, 15,8% in patients with QRS<150 ms; Log-rank test p=0,698) In patients with PR<200 ms, the survival rate of patients with QRS≥150 ms was 72,7%, and for patients with QRS<150 ms — 36,8% (Log-rank test p=0,031).Conclusion. In HF patients, PR interval prolongation (≥200 ms) is associated with long-term mortality increase. The highest survival rates were observed in patients with PR<200 ms and QRS≥150 ms. In patients with QRS≥150 ms, the presence of PR≥200 ms should be considered as an additional criterion for CRT.

Connecting the Dots

2017 ◽  
pp. 26-41
Author(s):  
Olajumoke Ogunsanya
Keyword(s):  
Creative Thinking ◽  
Business Practices ◽  
Business Organizations ◽  
Sustainable Business ◽  
Term Survival ◽  
Collective Creativity ◽  
Connecting The Dots ◽  
Creativity And Innovation ◽  
The Relationship

Calls for businesses to act with concern for the environment and society create new operating scenarios in which sustainability concerns must be taken into consideration along with the primary objectives of profitability and competitiveness. These additional obligations contribute to dynamism of the marketplace and make it important for businesses to draw on creativity and innovation to find connections between the unrelated in order to establish new efficiencies that can create competitive advantage and differentiation in the environment they find themselves. The central theme of this chapter is how bisociation informs collective creativity and innovation, and influences sustainability for business organizations competing in an environment that is in a permanent state of flux. This chapter trails a series of concepts to find the relationship between the concept of bisociation, collective creativity and sustainable business practices. The aim is to show how consistent creative thinking and exploration of information in different spaces of thought can proffer innovative solutions organizations require for their long term survival and prosperity.

scholarly journals Effects of Serum Albumin Levels on Antithrombin Supplementation Outcomes Among Patients With Sepsis-Associated Coagulopathy: A Retrospective Study

2019 ◽  
Vol 12 ◽  
pp. 1179545X1985836
Author(s):  
Masatomo Ebina ◽  
Kazunori Fujino ◽  
Akira Inoue ◽  
Koichi Ariyoshi ◽  
Yutaka Eguchi
Keyword(s):  
Retrospective Study ◽  
Serum Albumin ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Term Survival ◽  
Hazards Model ◽  
The Relationship

Background:Severe sepsis is commonly associated with mortality among critically ill patients and is known to cause coagulopathy. While antithrombin is an anticoagulant used in this setting, serum albumin levels are known to influence serum antithrombin levels. Therefore, this study aimed to evaluate the outcomes of antithrombin supplementation in patients with sepsis-associated coagulopathy, as well as the relationship between serum albumin levels and the effects of antithrombin supplementation.Methods:This retrospective study evaluated patients who were >18 years of age and had been admitted to either of two intensive care units for sepsis-associated coagulopathy. The groups that did and did not receive antithrombin supplementation were compared for outcomes up to 1 year after admission. Subgroup analyses were performed for patients with serum albumin levels of <2.5 g/dL or ⩾2.5 g/dL.Results:Fifty-one patients received antithrombin supplementation and 163 patients did not. The Cox proportional hazards model revealed that antithrombin supplementation was independently associated with 28-day survival (hazard ratio [HR]: 0.374, P = 0.025) but not with 1 year survival (HR: 0.915, P = 0.752). In addition, among patients with serum albumin levels of <2.5 g/dL, antithrombin supplementation was associated with a significantly lower 28-day mortality rate (9.4% vs 36.8%, P = .009).Conclusion:Antithrombin supplementation may improve short-term survival, but not long-term survival, among patients with sepsis-associated coagulopathy.

The role of surgery in the management of supratentorial intermediate and high-grade astrocytomas in adults

1990 ◽  
Vol 73 (3) ◽  
pp. 331-344 ◽  
Author(s):  
Jules M. Nazzaro ◽  
Edward A. Neuwelt
Keyword(s):  
Surgical Management ◽  
Survival Data ◽  
Postoperative Radiotherapy ◽  
High Grade ◽  
Survival Times ◽  
Term Survival ◽  
Content Type ◽  
The Relationship

✓ In this analysis, the authors review studies over the last 50 years addressing the association between long-term survival and type of surgical management in adults with supratentorial intermediate or high-grade astrocytomas. Earlier reports are included because they are repeatedly referenced in current works and clearly are an important basis upon which present attitudes are predicated. Because recent work has definitively demonstrated the significance of prognostic variables on outcome, the handling of such factors in studies that investigated survival data according to degree of surgery is emphasized. Study design, experimental methods used, and methods of data analysis are also examined. This analysis shows that there is little justification for dogmatic statements concerning the relationship between increasing patient survival times and aggressive surgical management in adults with supratentorial intermediate or high-grade astrocytomas, if patients receive postoperative radiotherapy.

Impact of intraoperative staging of gastric cancer on long-term survival.

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 302-302
Author(s):  
Keisuke Koumori ◽  
Kazuki Kano ◽  
Hayato Watanabe ◽  
Yota Shimoda ◽  
Hirohito Fujikawa ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Negative Impact ◽  
Tnm Classification ◽  
Clinical Stage ◽  
Term Survival ◽  
Long Term Survival ◽  
Preoperative Stage ◽  
The Impact ◽  
The Relationship

302 Background: The preoperative stage and intraoperative stage of gastric cancer were unified as the clinical stage in the 8th edition of the TNM classification (UICC). Although there are some reports about the relationship between preoperative stage and prognosis, the relationship between intraoperative stage and prognosis remains unclear. The aim of this study was to clarify the impact of intraoperative diagnosis and staging on long-term survival. Methods: Overall survivals were examined in 915 patients who underwent curative resection for gastric adenocarcinoma between April 2011 and March 2019 in our hospital. Results: The median age of the patients was 69 years (27-90 years), including 585 male and 330 female. The median follow-up period was 33.6 months (0.1-86.7 months). The number of the patients according to intraoperative stage were 641(70.1 %) in stageI, 15(1.6%) in stageIIA, 135(14.8%) in stageIIB, 111(12.1%) in stageIII, 12(1.3%) in stageIVA and 1(0.1%) in stageIVB. The hazard ratios of intraoperative stage for overall survival were as follows (ref: StageI); StageIIA, 6.990 (95% CI: 2.473-19.760, p < 0.001), StageIIB, 2.234 (95% CI: 1.220-4.092, p = 0.009), StageIII, 4.091 (95% CI: 2.416-6.928, p < 0.001), StageIVA, 6.061 (95% CI: 2.150-17.080, p < 0.001), StageIVB, 14.92 (95% CI: 2.035-109.3, p = 0.008). Conclusions: The survival of intraoperative StageIIA was poorer than StageIIB/III. Intraoperative positive lymph node metastasis could be negative impact of survival, even if tumor invasion was T1 or T2.

scholarly journals Relationtionship of Authentic Leadership and Organisational Culture with Organisational Innovation in Pharmaceutical Industry

2019 ◽  
Vol 8 (2S4) ◽  
pp. 637-641
Keyword(s):  
Organizational Culture ◽  
Global Economy ◽  
Authentic Leadership ◽  
Organizational Innovation ◽  
Leadership Skills ◽  
Team Leaders ◽  
Term Survival ◽  
The Relationship ◽  
Practical Implications

Purpose – The purpose of this paper is to investigate the relationship between authentic leadership and organizational culture which organizational innovation under VUCA business environment.Organizations must foster organizational innovation in the organizations for their sustainability(Chen, Zheng, Yang, & Bai, 2016). Organizational Innovation is important for the continuity of organizations and organizations that do not innovate run a large risk to perish (Verlag, 2016).Organizational innovation is crucial for the survival of the organizations in the conditions and situations of volatility, uncertainty, complexity and ambiguity prevalent in the current global economy. Business is facing more challenges in this VUCA environment, especially in the pharma sector. This environment demands to work on innovative ways to strengthen the competitive advantage and to sustain the businesses. Due to this environment, there is a need for continuous and sustainable innovation for long-term survival of the organizations. This study intends to give insights into the organizational culture and authentic leadership which have an influence on the organizational innovation. Design/methodology/approach – This study used positivist deductive approach. A deductive approach starts with well-defined theories and identified variables. A Survey was conducted with a structured questionnaire. The questionnaire was administered to the employees working in R&D project teams in the pharma sector. Multiple regression was used to test the hypothesized relationships. Findings – Authentic leadership and Organizational culture showed significant relationship with the organizational innovation Practical implications – Organizations should focus on creating the authentic leadership skills among the project team leaders to reap maximal organizational innovation and have an organizational culture topromoting organizational fosters organizational innovation. The study has practical implications for both the top management and individual employee working in theresearch-intensiveprojects in the organizations. Originality/value – The findings contribute to theleadership, organizational culture,and innovation literature first by showing how authentic leadership influences organizational innovation and how the organizational culture play an important role in the organizational innovation in the pharma industry.

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