Screening and Psychological Debriefing of Adolescent Survivors of Life-Threatening Events

1993 ◽  
Vol 163 (5) ◽  
pp. 660-665 ◽  
Author(s):  
Paul Stallard ◽  
Fergus Law
Keyword(s):  
Cruise Ship ◽  
Group Of Seven ◽  
Perceived Need ◽  
Psychological Debriefing ◽  
Screening Battery ◽  
Life Threatening ◽  
Young Survivors ◽  
To Receive

There is a perceived need for schools and casualty departments to receive appropriate information and guidelines in order to minimise the effect of PTSD. A recommended screening battery for PTSD was administered at the start of a two-session debriefing group and again three months later to a group of seven young survivors of a minibus accident. No studies using this screen other than those of shipping disasters have been reported to date. Screen scores were compared with those of survivors of the cruise ship Jupiter. No significant differences were found between minibus survivors when assessed at six months (before intervention), and Jupiter survivors, who when assessed at five months had already undergone debriefing. Post-debriefing assessment of minibus survivors demonstrated significant reductions on all measures.

scholarly journals Effect of a hospital-wide campaign on COVID-19 vaccination uptake among healthcare workers in the context of raised concerns for life-threatening side effects

PLoS ONE ◽  
2021 ◽  
Vol 16 (10) ◽  
pp. e0258236
Author(s):  
Min Hyung Kim ◽  
Nak-Hoon Son ◽  
Yoon Soo Park ◽  
Ju Hyun Lee ◽  
Da Ae Kim ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Online Survey ◽  
Vaccine Coverage ◽  
Intervention Strategy ◽  
National Policy ◽  
Vaccine Dose ◽  
Vaccination Uptake ◽  
Severance Hospital ◽  
Life Threatening ◽  
To Receive

Background All healthcare workers (HCWs) in Yongin Severance Hospital were allocated to receive the ChAdOx1 nCov-19 vaccine according to national policy. A report of thrombosis and thrombocytopenia syndrome (TTS) associated with ChAdOx1 nCoV-19 led to hesitancy about receiving the second dose among HCWs who had received the first dose. Methods From 7 to 14 May, 2021, we performed a survey to identify the factors associated with hesitancy about receiving the second vaccine dose among HCWs at the hospital who had received the first dose of the vaccine. Based on survey results, a hospital-wide campaign was implemented on 18 May 2021 to improve vaccine coverage. HCWs who completed the second dose completed a self-administered questionnaire to evaluate the effect of the campaign. Findings Of 1,171 HCWs who had received the first dose of the vaccine, 71.5% completed the online survey, of whom 3.7% refused to take the second dose and 22.3% showed hesitancy. Hesitancy to receive a second dose was significantly associated with age under 30 years and concerns about TTS, and was less common among those who trusted effectiveness and safety of the vaccine. Among HCWs who received the first dose, 96.2% completed vaccination with the second dose between 27 May and 4 June, 2021. Of those who answered the questionnaire asked about the timing of their decision to receive the second dose, 57.1% reported that they were motivated by the hospital-wide campaign. Conclusion A tailored intervention strategy based on a survey can improve COVID-19 vaccination uptake among HCWs.

scholarly journals A Retrospective Study on Using a Novel Single Needle Cone Puncture Approach for the Iodine-125 Seed Brachytherapy in Treating Patients With Thoracic Malignancy

2021 ◽  
Vol 11 ◽  
Author(s):  
Fenge Li ◽  
Liping Wang ◽  
Yixiang Zhang ◽  
Weihong Feng ◽  
Tao Ju ◽  
...  
Keyword(s):  
Hospice Care ◽  
Tumor Regression ◽  
Remission Rate ◽  
Progression Free Survival ◽  
Local Tumor ◽  
Thoracic Malignancy ◽  
Life Threatening ◽  
Iodine 125 ◽  
To Receive

BackgroundPatients with progressive thoracic malignancy characterized by large irregular tumors with necrosis and life-threatening symptoms lack effective treatments. We set out to develop a single needle cone puncture method for the Iodine-125 seed (SNCP-125I) brachytherapy, and aim to report the initial results.Methods294 patients with advanced thoracic malignancy were treated with local SNCP-125I brachytherapy between March 2009 and July 2020, followed by thorough evaluation of clinical outcome, overall survival (OS), progression-free survival (PFS) and procedure-related complications after treatment.ResultsThe overall response rate (ORR) among the treated patients was 81.0% (238/294). Life-threatening symptoms due to tumor oppression, hemoptysis and large irregular tumor with necrosis were successfully alleviated after the SNCP-125I treatment with a remission rate at 91% to 94%. The median OS and PFS were 13.6 months and 5.8 months, respectively. Procedure-related side effects including pneumothorax (32/294), blood-stained sputum (8/294), subcutaneous emphysema (10/294), puncture site bleeding (16/294) and chest pain (6/294) were observed. Patients who were able to follow with chemotherapy or immunotherapy experienced extended OS and PFS, as compared with patients who opted to receive hospice care (16.5 months Vs. 11.2 months). Further pathological and immunological analysis showed that SNCP-125I induced tumor lymphocytes infiltration and long-term tumor necrosis.ConclusionSNCP-125I brachytherapy effectively eliminates life-threatening symptoms due to local tumor oppression, hemoptysis and large irregular and necrotic tumors in patients with unresectable chest malignancy and significantly induces local tumor regression. SNCP-125I brachytherapy combines with chemotherapy significantly prolong OS and PFS compare with SNCP-125I brachytherapy alone.

Emergency-Only Hemodialysis Policies

2020 ◽  
Vol 48 (3) ◽  
pp. 527-534 ◽  
Author(s):  
Richa Lavingia ◽  
Rajeev Raghavan ◽  
Stephanie R. Morain
Keyword(s):  
Undocumented Immigrants ◽  
Moral Distress ◽  
State Level ◽  
The United States ◽  
Policy Reforms ◽  
Life Threatening ◽  
Stage Renal Disease ◽  
End Stage ◽  
Ethical Critique ◽  
To Receive

An estimated 6,500 undocumented immigrants in the United States have been diagnosed with end-stage renal disease (ESRD). These individuals are ineligible for the federal insurance program that covers dialysis and/or transplantation for citizens, and consequently are subject to local or state policies regarding the provision of healthcare. In 76% of states, undocumented immigrants are ineligible to receive scheduled outpatient dialysis treatments, and typically receive dialysis only when presenting to the emergency center with severe life-threatening symptoms. ‘Emergency-only hemodialysis’ (EOHD) is associated with higher healthcare costs, higher mortality, and longer hospitalizations. In this paper, we present an ethical critique of existing federal policy. We argue that EOHD represents a failure of fiduciary and professional obligations, contributes to moral distress, and undermines physician obligations to be good stewards of medical resources. We then explore potential avenues for reform based upon policies introduced at the state level. We argue that, while reform at the federal level would ultimately be a more sustainable longterm solution, state-based policy reforms can help mitigate the ethical shortcomings of EOHD.

Sirolimus plus prednisolone vs sirolimus monotherapy for kaposiform hemangioendothelioma: a randomized clinical trial

Blood ◽  
2022 ◽  
Author(s):  
Yi Ji ◽  
Siyuan Chen ◽  
Jiangyuan Zhou ◽  
Kaiying Yang ◽  
Xuepeng Zhang ◽  
...  
Keyword(s):  
Adverse Events ◽  
Primary Outcome ◽  
Treatment Strategies ◽  
Platelet Response ◽  
Kaposiform Hemangioendothelioma ◽  
Total Incidence ◽  
Short Course ◽  
Life Threatening ◽  
Grade 3 ◽  
To Receive

The Kasabach-Merritt phenomenon (KMP) in kaposiform hemangioendothelioma (KHE) is characterized by life-threatening thrombocytopenia and consumptive coagulopathy. This study compared the efficacy and safety of sirolimus plus prednisolone versus sirolimus monotherapy as treatment strategies for KHE with KMP in the largest cohort to date. Participants were randomized to receive either sirolimus in combination with a short course of prednisolone or sirolimus monotherapy for at least 12 months. The primary outcome was defined as achievement of a durable platelet response (platelet count >100×109/L) at week 4. Participants completed efficacy assessments 2 years after the initial treatment. At week 4, a durable platelet response was achieved by 35 of 37 patients given sirolimus and prednisolone compared with 24 of 36 patients given sirolimus monotherapy (difference 27.9%; 95% CI, 10.0% to 44.7%). Compared with the sirolimus monotherapy group, the combination treatment group showed improvements in terms of measures of durable platelet responses at all points during the initial 3-week treatment period, median platelet counts during weeks 1 to 4, increased numbers of patients achieving fibrinogen stabilization at week 4, and objective lesion responses at month 12. Patients receiving combination therapy had fewer blood transfusions and a lower total incidence of disease sequelae than patients receiving sirolimus alone. The frequencies of total adverse events and grade 3-4 adverse events during treatment were similar in both groups. The responses seen in patients with KHE with KMP were profound and encouraging, suggesting that sirolimus plus prednisolone should be considered a valid treatment for KHE with KMP. ClinicalTrial.gov, number NCT03188068

Sacraments and the Pandemic

2020 ◽  
Vol 45 (5) ◽  
pp. 3-5
Author(s):  
Marie Hilliard ◽  
Keyword(s):  
Public Health ◽  
Canon Law ◽  
Communicable Diseases ◽  
Health Authorities ◽  
Life Threatening Illness ◽  
Public Health Authorities ◽  
Life Threatening ◽  
New Challenges ◽  
The Right ◽  
To Receive

It is the right of the Catholic faithful to receive the sacraments when appropriate. The COVID-19 pandemic has presented new challenges in dispensing the sacraments, particularly to the sick who often need them most. Canon law dictates who can dispense the sacraments as well as where this can happen. Many dioceses have sought to find creative ways to reach those in need of the sacraments while keeping to the guidelines laid out by Canon law and public health authorities. Anointing of the Sick presents particular challenges while also being vitally important to Catholics who suffer from a life-threatening illness. Special precautions must be taken to ensure that communicable diseases are not spread during the administering of this sacrament, but it is essential that it be administered at the appropriate time.

Overcoming Barriers to Palliative Care Consultation

2015 ◽  
Vol 35 (5) ◽  
pp. 44-52 ◽  
Author(s):  
Kathleen Ouimet Perrin ◽  
Mary Kazanowski
Keyword(s):  
Health Care ◽  
Palliative Care ◽  
Critical Care ◽  
Health Care Team ◽  
Critical Care Units ◽  
Palliative Care Consultation ◽  
Life Threatening ◽  
Care Consultation ◽  
To Receive

Palliative care consultations for patients with life-threatening illnesses provide benefits for the patients and their families as well as for the health care team. Patients have better quality of life and live longer but cost the health care system less. Still, many patients are not offered the opportunity to receive a palliative care consultation. Barriers to palliative care consultation for patients in critical care units include misunderstandings about palliative care and not having agreed upon criteria for referral. Critical care nurses can assist in overcoming these barriers.

scholarly journals A Case Report of Infective Endocarditic Aortic Valve Abscess with Perforation in Infant

2020 ◽  
Author(s):  
Yanfeng Yang ◽  
Feifei Si ◽  
Mei Jin ◽  
Sheng Yang
Keyword(s):  
Infective Endocarditis ◽  
Aortic Valve ◽  
Structural Damage ◽  
Autologous Pericardial Patch ◽  
Life Threatening ◽  
One Year ◽  
Surgery Department ◽  
Short Time ◽  
To Receive

Abstract Background: Infective endocarditis (IE) is an uncommon but a potentially life-threatening infectious disease in children. The epidemiology of IE has changed in the past three to four decades and its incidence has been increasing recently. This case with atypical present including culture-negative and no-cardiovascular diseases got cardiovascular structural damage that deteriorate in short time. Case presentation: This case was an infant less than one year old without basic cardiovascular disease,and this case was admitted with Kawasaki disease early. His diagnosis was infective endocarditic aortic valve abscess with perforation. The patient received intravenous injection of cefotaxime for two days and piperacillin sulbactam and cefazolin for six days. On 9 th day, piperacillin sulbactam combining with vancomycin were used. On 10 th day, the patient was sent to cardiac surgery department to receive aortic valve repair. The operation is successful.The abscess cavity of the inferior aortic valve and the vegetations on the aortic valve were completely removed, the left coronary valve was removed, and the left coronary valve was locally widened by autologous pericardial patch. Conclusions: Infective Endocarditis in children may be difficult to diagnosis and manage.and the treatment are becoming a new challenge for conventional antibiotic therapy. Some IE require serial follow-up to determine potential need for subsequent cardiovascular surgery (CVS) intervention despite microbiologic cure with antimicrobial therapy.

Violation of Dignity in Care-Related Situations

2004 ◽  
Vol 18 (4) ◽  
pp. 371-385 ◽  
Author(s):  
Joakim Öhlén
Keyword(s):  
Palliative Care ◽  
Mass Media ◽  
Family Members ◽  
The State ◽  
Focal Points ◽  
Finding Meaning ◽  
Life Threatening Illness ◽  
Welfare Systems ◽  
Life Threatening ◽  
To Receive

This study seeks to explore narratives of care-related violations for patients with life-threatening illness receiving palliative care. Narratives told in dialogues with the researcher were processed phenomenologically hermeneutically. Four structures of meanings are described: focal points in recalling the experiences, experienced consequences of being violated, relationships causing violation, and personal struggling. The phenomenon of care-related violations means a complex experience of suffering as being abandoned, confronted with hopelessness, and further wounded. This experience may be directed toward readiness to share, introspectiveness, willingness to comprehend the incomprehensible, the riskiness of facing others, and attentiveness to acts of caring. It can be experienced in various relationships to professionals, family members and friends, to the mass media, and to welfare systems. Care-related violating episodes reveal the vulnerability of the person who is already suffering and makes him or her still more wounded, when actually comfort is expected. To receive affirmation in the state of fragility with increased suffering provoked by care-related violations can contribute to a transformation from human degradation into dignity, finding meaning, or reaching reconciliation in suffering.

Water and Sign Magic in al-Jabin, Yemen

2008 ◽  
Vol 25 (3) ◽  
pp. 82-96 ◽  
Author(s):  
Ingrid Hehmeyer
Keyword(s):  
Water Supply ◽  
Group Of Seven ◽  
Run Off ◽  
Life Threatening ◽  
Magical Power ◽  
The Town

The preserved heritage of al-Jabin, a town located in Yemen’s western highlands, offers a unique opportunity to document traditional water engineering principles. There are no springs in the immediate vicinity, because the town is perched at the edge of the mountain escarpment. Even today, water is provided by open cisterns that collect surface run-off following a rain. But as the rains needed to feed the system are highly unpredictable, the water supply is never secure. The perimeter wall of one of the cisterns bears a group of seven signs, a detailed description of which is given in Kitab Shams al-Ma`arif wa-Lata’if al-`Awarif, a work attributed to Ahmad ibn `Ali al-Buni (d. 1225), a well-known prolific writer on magic. Al-Buni explains that the signs symbolize God’s supreme name and thus display great magical power of a protective and well-wishing nature. Generally speaking, magical practices attempt to influence the course of natural events by calling upon a superhuman force. In the case of the cistern, God’s supreme name was inscribed in the hopes that this would lead to a guaranteed water supply. While it is easy to dismiss al-Buni’s text and the observed practice in al-Jabin as superstitious frailty, one needs to bear in mind that under life-threatening circumstances, even people in the modern West easily resort to magical procedures.

A Jewish Perspective on Access to Healthcare

1998 ◽  
Vol 7 (3) ◽  
pp. 260-265 ◽  
Author(s):  
NOAM J. ZOHAR
Keyword(s):  
Social Justice ◽  
Medical Care ◽  
Universal Access ◽  
Access To Healthcare ◽  
Jewish Tradition ◽  
Life Threatening ◽  
Traditional Institutions ◽  
To Receive

Can anyone doubt that the Jewish tradition mandates universal access to healthcare? In a comprehensive and illuminating discussion, A.L. Mackler seems to have already said all that needs to be said. After aptly analyzing the principles of the traditional institutions and norms relating to tzedakah (social justice, or welfare), Mackler proceeded to apply these traditions to the context of healthcare, concluding thatSociety has the responsibility to ensure that needed medical care is provided to those who would otherwise be unable to receive it... Medical care for potentially life-threatening conditions justifies extraordinary expenditures, and represents an urgent obligation of society. (p. 150)

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