Long-term physical impairments in survivors of COVID-19-associated ARDS compared with classic ARDS: A two-center study

Purpose: This work aimed to compare physical impairment in survivors of classic ARDS compared with COVID-19-associated ARDS (CARDS) survivors. Material and methods: This is a prospective observational cohort study on 248 patients with CARDS and compared them with a historical cohort of 48 patients with classic ARDS. Physical performance was evaluated at 6 and 12 months after ICU discharge, using the Medical Research Council Scale (MRCss), 6-min walk test (6MWT), handgrip dynamometry (HGD), and fatigue severity score (FSS). We also assessed activities of daily living (ADLs) using the Barthel index. Results: At 6 months, patients with classic ARDS had lower HGD (estimated difference [ED]: 11.71 kg, p < 0.001; ED 31.9% of predicted value, p < 0.001), 6MWT distance (ED: 89.11 m, p < 0.001; ED 12.96% of predicted value, p = 0.032), and more frequent significant fatigue (OR 0.35, p = 0.046). At 12 months, patients with classic ARDS had lower HGD (ED: 9.08 kg, p = 0.0014; ED 25.9% of predicted value, p < 0.001) and no difference in terms of 6MWT and fatigue. At 12 months, patients with classic ARDS improved their MRCss (ED 2.50, p = 0.006) and HGD (ED: 4.13 kg, p = 0.002; ED 9.45% of predicted value, p = 0.005), while those with CARDS did not. Most patients in both groups regained independence in ADLs at 6 months. COVID-19 diagnosis was a significant independent predictor of better HGD (p < 0.0001) and 6MWT performance (p = 0.001), and lower prevalence of fatigue (p = 0.018). Conclusions: Both classic ARDS and CARDS survivors experienced long-term impairments in physical functioning, confirming that post-intensive care syndrome remains a major legacy of critical illness. Surprisingly, however, persisting disability was more common in survivors of classic ARDS than in CARDS survivors. In fact, muscle strength measured with HGD was reduced in survivors of classic ARDS compared to CARDS patients at both 6 and 12 months. The 6MWT was reduced and fatigue was more common in classic ARDS compared to CARDS at 6 months but differences were no longer significant at 12 months. Most patients in both groups regained independent function in ADLs at 6 months

The relationship between Europeanisation and policy styles: a study of agricultural and public health policymaking in three EU Member States

© 2020 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDer-ivatives License (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distri-bution, and reproduction in any medium, provided the original work is properly cited, and is not altered, transformed, or built upon in any way.The role of policy styles in policymaking has attracted renewed scholarly interestin recent years. One of the central debates in this literature revolves around thequestion of how to reconcile archetype national policy styles with considerabledifferences in modus operandi across policy sectors. A sector-specific featurethat is considered a key determinant of the manifestation of archetypenational policy styles in the European Union is the degree of Europeanisationof policy sectors. This paper picks up this suggestion by addressing thequestion of whether and how Europeanisation affects the degree to whichfeatures of an archetype national policy style are manifest within a sector. Weaddress this question by exploring sectoral policy styles in agricultural andfood-related public health policymaking across three EU Member States: TheNetherlands, the United Kingdom (England), and France. Our findings suggestthat the degree of Europeanisation of a policy sector does prove an importantcondition that helps to understand the relationship between national andsectoral policy styles. More specifically, Europeanisation has the strongesteffect when sectors face a higher adaptation pressure, i.e., when there is alarger misfit between sectoral regimes and EU-induced institutional demands.We suggest various promising avenues of future research on this relationship.Peer reviewe

Speech Perception Changes in the Acoustically Aided, Nonimplanted Ear after Cochlear Implantation: A Multicenter Study

In recent years there has been an increasing percentage of cochlear implant (CI) users who have usable residual hearing in the contralateral, nonimplanted ear, typically aided by acoustic amplification. This raises the issue of the extent to which the signal presented through the cochlear implant may influence how listeners process information in the acoustically stimulated ear. This multicenter retrospective study examined pre- to postoperative changes in speech perception in the nonimplanted ear, the implanted ear, and both together. Results in the latter two conditions showed the expected increases, but speech perception in the nonimplanted ear showed a modest yet meaningful decrease that could not be completely explained by changes in unaided thresholds, hearing aid malfunction, or several other demographic variables. Decreases in speech perception in the nonimplanted ear were more likely in individuals who had better levels of speech perception in the implanted ear, and in those who had better speech perception in the implanted than in the nonimplanted ear. This raises the possibility that, in some cases, bimodal listeners may rely on the higher quality signal provided by the implant and may disregard or even neglect the input provided by the nonimplanted ear

Nurses' perceptions of aids and obstacles to the provision of optimal end of life care in ICU

Contains fulltext : 172380.pdf (publisher's version ) (Open Access

LABORATORIO ITALIA ROMA 2006. L[es] Etranger[es] 1995/2005 esperienze progettuali di architetti stranieri in Italia (Museo Diocesano, Brescia, 18 febbraio 2006-11 marzo 2006).

Riallestimento congiunto delle mostre LABORATORIO ITALIA L[es] Etranger[es] 1995/2005 esperienze progettuali di architetti stranieri in Italia, Museo Diocesano, Brescia, 18 febbraio 2006-11 marzo 2006 e LABORATORIO ITALIA Esposizione d’Architettura 2005, Parma, secondo Festival dell’Architettura di Parma, chiesa di S. Lodovico, Parma 19-25 settembre 2005), Roma, Ex Casa di Correzione del San Michele, Sala Clementina, 6 maggio – 4 giugno 2006. Promossa da Aid’A – Agenzia Italiana d’Architettura – Federico Motta Editore e In/Arch - Istituto Nazionale di Architettura, d’intesa con DARC – Direzione generale per l’architettura e l’arte contemporanee - e con la Soprintendenza per i Beni Architettonici e per il Paesaggio di Roma