63 research outputs found
Adult advanced life support: Section 3 of the European Resuscitation Council Guidelines for Resuscitation 2015
Erweiterte lebensrettende MaĂnahmen fĂŒr Erwachsene (âadvanced life supportâ, ALS) kommen zum Einsatz, nachdem BasismaĂnahmen zur Wiederbelebung (âbasic life supportâ, BLS) begonnen und, wenn sinnvoll, ein automatisierter externer Defibrillator (AED) verwendet wurde. Die BasismaĂnahmen zur Wiederbelebung eines Erwachsenen und der Einsatz von AEDs wird in Kap. 2 ausgefĂŒhrt. Basis- und erweiterte MaĂnahmen sollen nahtlos ineinander ĂŒbergehen, da erstere fortgefĂŒhrt werden und sich mit den erweiterten ĂŒberschneiden. Dieses Kapitel ĂŒber die erweiterten MaĂnahmen beinhaltet die Vermeidung des Kreislaufstillstands, spezielle Aspekte des auĂerklinischen ALS, den Start der innerklinischen Reanimation, den ALS-Algorithmus, die manuelle Defibrillation, das Atemwegsmanagement wĂ€hrend der Reanimaton, Medikamente und ihre Anwendung wĂ€hrend der Reanimation sowie die Behandlung von Periarrest-Arrhythmien. Es gibt zwei Ănderungen in der Ă€uĂeren Form dieser Leitlinien des EuropĂ€ischen Rats fĂŒr Wiederbelebung seit den Leitlinien von 2010: [1] Das Kapitel âElektrotherapieâ [2] ist nicht mehr eigenstĂ€ndig, sondern Teil dieses Kapitels; und die Leitlinien zur Behandlung nach Reanimation sind in ein neues Kapitel ausgegliedert, welches die Bedeutung dieses letzten Glieds der Ăberlebenskette unterstreicht [3].
Diese Leitlinien basieren auf den International Liaison Committee on Resuscitation (ILCOR) Consensus on Science and Treatment Recommendations (CoSTR) fĂŒr ALS von 2015 [4]. Die ĂberprĂŒfung der ILCOR-Empfehlungen von 2015 konzentrierte sich auf 42 Themen, entsprechend der zeitlichen Abfolge der erweiterten MaĂnahmen: Defibrillation, Atemwege, Oxygenierung und Ventilation, KreislaufunterstĂŒtzung und Ăberwachung und Einsatz von Medikamenten wĂ€hrend der Reanimation. FĂŒr diese Leitlinien wurden die ILCOR-Empfehlungen durch ein gezieltes Literatur-Review ergĂ€nzt, welches von der ERC-ALS-Leitlinien Autorengruppe zu den Themen die nicht in den ILCOR-CoSTR-Empfehlungen von 2015 ĂŒberarbeitet wurden erstellt wurde. Die Leitlinien wurden ausgearbeitet, von den ALS-Verfassern geprĂŒft und abschlieĂend von der ERC-Vollversammlung und dem ERC-Vorstand abgesegnet
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The subjective experiences of people who regularly receive depot neuroleptic medication in the community
Little has been written on the subjective experiences of people who receive depot injections in the community. The authors of this paper have identified distinct gaps in the literature in terms of the views of service users regarding this particular intervention. Existing studies tend to focus upon the side effects of depot neuroleptic medication and the attitudes of Community Mental Health Nurses (CMHNs) towards administering depot medication and issues of compliance and non-compliance. Mental health nurses are frequently perceived as adhering solely to a biomedical approach to patient care in their practice and the therapeutic aspects of their role is frequently unacknowledged. This paper explores how, within the process of giving a depot injection, CMHNs are able to carry out an assessment of their client's needs as well as being someone who is consistent, reliable and supportive. This means that the process of giving a depot injection may be considered as a therapeutic intervention. Qualitative data were obtained through the administration of a semi-structured interview schedule that was constructed and consisted of a range of questions that elicited service users views and opinions related to their experiences of receiving depot neuroleptic medication in the community. The relationship between patient and nurse, as this study reveals, was one that was not only therapeutic, but also provided a forum where psychosocial and clinical issues could be discussed and explored. Crucially, the service users felt they did have a role and an influence in the delivery of their care
TRY plant trait database â enhanced coverage and open access
Plant traitsâthe morphological, anatomical, physiological, biochemical and phenological characteristics of plantsâdetermine how plants respond to environmental factors, affect other trophic levels, and influence ecosystem properties and their benefits and detriments to people. Plant trait data thus represent the basis for a vast area of research spanning from evolutionary biology, community and functional ecology, to biodiversity conservation, ecosystem and landscape management, restoration, biogeography and earth system modelling. Since its foundation in 2007, the TRY database of plant traits has grown continuously. It now provides unprecedented data coverage under an open access data policy and is the main plant trait database used by the research community worldwide. Increasingly, the TRY database also supports new frontiers of traitâbased plant research, including the identification of data gaps and the subsequent mobilization or measurement of new data. To support this development, in this article we evaluate the extent of the trait data compiled in TRY and analyse emerging patterns of data coverage and representativeness. Best species coverage is achieved for categorical traitsâalmost complete coverage for âplant growth formâ. However, most traits relevant for ecology and vegetation modelling are characterized by continuous intraspecific variation and traitâenvironmental relationships. These traits have to be measured on individual plants in their respective environment. Despite unprecedented data coverage, we observe a humbling lack of completeness and representativeness of these continuous traits in many aspects. We, therefore, conclude that reducing data gaps and biases in the TRY database remains a key challenge and requires a coordinated approach to data mobilization and trait measurements. This can only be achieved in collaboration with other initiatives
Non-AIDS defining cancers in the D:A:D Study-time trends and predictors of survival : a cohort study
BACKGROUND:Non-AIDS defining cancers (NADC) are an important cause of morbidity and mortality in HIV-positive individuals. Using data from a large international cohort of HIV-positive individuals, we described the incidence of NADC from 2004-2010, and described subsequent mortality and predictors of these.METHODS:Individuals were followed from 1st January 2004/enrolment in study, until the earliest of a new NADC, 1st February 2010, death or six months after the patient's last visit. Incidence rates were estimated for each year of follow-up, overall and stratified by gender, age and mode of HIV acquisition. Cumulative risk of mortality following NADC diagnosis was summarised using Kaplan-Meier methods, with follow-up for these analyses from the date of NADC diagnosis until the patient's death, 1st February 2010 or 6 months after the patient's last visit. Factors associated with mortality following NADC diagnosis were identified using multivariable Cox proportional hazards regression.RESULTS:Over 176,775 person-years (PY), 880 (2.1%) patients developed a new NADC (incidence: 4.98/1000PY [95% confidence interval 4.65, 5.31]). Over a third of these patients (327, 37.2%) had died by 1st February 2010. Time trends for lung cancer, anal cancer and Hodgkin's lymphoma were broadly consistent. Kaplan-Meier cumulative mortality estimates at 1, 3 and 5 years after NADC diagnosis were 28.2% [95% CI 25.1-31.2], 42.0% [38.2-45.8] and 47.3% [42.4-52.2], respectively. Significant predictors of poorer survival after diagnosis of NADC were lung cancer (compared to other cancer types), male gender, non-white ethnicity, and smoking status. Later year of diagnosis and higher CD4 count at NADC diagnosis were associated with improved survival. The incidence of NADC remained stable over the period 2004-2010 in this large observational cohort.CONCLUSIONS:The prognosis after diagnosis of NADC, in particular lung cancer and disseminated cancer, is poor but has improved somewhat over time. Modifiable risk factors, such as smoking and low CD4 counts, were associated with mortality following a diagnosis of NADC
Feasible mechanisms for achieving monetary stability A comparison of inflation targeting and the ERM
SIGLEAvailable from British Library Document Supply Centre-DSC:9350.8308(BE-WP--52) / BLDSC - British Library Document Supply CentreGBUnited Kingdo
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