Peritoneal Dialysis in Austere Environments: An Emergent Approach to Renal Failure Management

Peritoneal dialysis (PD) is a means of renal replacement therapy (RRT) that can be performed in remote settings with limited resources, including regions that lack electrical power. PD is a mainstay of end-stage renal disease (ESRD) therapy worldwide, and the ease of initiation and maintenance has enabled it to flourish in both resource-limited and resource-abundant settings. In natural disaster scenarios, military conflicts, and other austere areas, PD may be the only available life-saving measure for acute kidney injury (AKI) or ESRD. PD in austere environments is not without challenges, including catheter placement, availability of dialysate, and medical complications related to the procedure itself.  However, when hemodialysis is unavailable, PD can be performed using generally available medical supplies including sterile tubing and intravenous fluids. Amidst the ever-increasing global burden of ESRD and AKI, the ability to perform PD is essential for many medical facilities

Roundtable Discussion Transcript: The Legal and Ethical Limits of Technological Warfare Symposium, February 1, 2013, University of Utah, S.J. Quinney College of Law

The Utah Law Review brought in a panel of experts for a symposium on the legal and ethical limits of technological warfare. This roundtable discussion crystalized the issues discussed throughout the symposium. The collective experience and diversity of viewpoints of the panelists produced an unparalleled discussion of the complex and poignant issues involved in drone warfare. The open dialogue in the roundtable discussion created moments of tension where the panelists openly challenged each other’s viewpoints on the ethics and legality of drone warfare. The discussion captured in this transcript uniquely conveys the diversity of perspectives and inherently challenging legal and moral questions associated with drone warfare

Content validation of two SF-36 subscales for use in type 2 diabetes and non-dialysis chronic kidney disease-related anemia

PURPOSE: This study aimed to evaluate the relevance and importance of two SF-36 subscales, Vitality (VT) and Physical Function (PF), to assess concepts of energy and physical function in patients with type 2 diabetes mellitus (DM) and non-dialysis CKD-related anemia. METHODS: Patients with clinical history of DM and non-dialysis CKD-related anemia (n = 68) were identified as follows: 40 participated in concept elicitation (CE) interviews; 20 in cognitive interviews (CI), and 8 in pilot interviews. Relevance and importance ratings for SF-36 VT and PF items were obtained. Interviews were recorded, transcribed, and patient expressions of concepts coded. Inter-rater agreement was used to evaluate coding consistency. Concepts elicited were mapped to SF-36 VT and PF items. RESULTS: Patients (n = 64) were 65.6% women, 42.2% Caucasian, with mean age of 66.1 +/- 11.6 years. Of 830 coded concepts, 388 (47%) were Energy expressions and 287 (35%) were PF limitations expressions. Low energy was reported by 85% patients and rated as an important limitation by 88%. Limitations in PF were reported by 56-82% patients and rated important by 44-96%. CE and CI quotes correspond well to SF-36 VT and PF items. CONCLUSION: SF-36 VT and PF contents were suitable for assessing energy and physical function limitations, respectively, in this patient population