Sequential decoupling of negative-energy states in Douglas-Kroll-Hess theory

Here, we review the historical development, current status, and prospects of Douglas--Kroll--Hess theory as a quantum chemical relativistic electrons-only theory.Comment: 15 page

Exact decoupling of the relativistic Fock operator

ISSN:1432-881XISSN:1432-223

Where should patients with or at risk of delirium be treated in an acute care system? Comparing the rates of delirium in patients receiving usual care versus alternative care : a systematic review and meta‐analysis

Background: Delirium is an acute condition that occurs in hospitalised patients and leads to poor patient outcomes that can last long term. Therefore, the importance of prevention is undeniable and adopting new models of care for at risk patients should be prioritised. Objectives: This systematic review and meta‐analysis will assess the effectiveness of different interventions designed to prevent or manage delirium in acutely unwell hospitalised patients. Methods: MEDLINE, EMBASE, PsychINFO, OpenGrey, Web of Science and reference lists of journals were searched. Eligible studies reported on incidence or duration of delirium, used a validated delirium diagnostic tool, and compared an intervention to either a control or another intervention group. Meta‐analyses were conducted, and GRADE pro software was used to assess the certainty of evidence. This review is registered on PROSPERO. Results: A total of 59 studies were included and 33 were eligible for meta‐analysis. Delirium incidence was most significantly reduced by non‐pharmacological multicomponent interventions compared to usual care, with pooled risk ratios of 0.57 (95% CI: 0.44 to 0.73, ten randomised controlled trials) and 0.47 (95% CI: 0.35 to 0.64, six observational studies). Single component interventions did not significantly reduce delirium incidence compared to usual care in seven randomised trials (risk ratio= 0.92, 95% CI: 0.81 to 1.04). The most effective single component intervention in reducing delirium incidence, was a hospital‐at‐home intervention (risk ratio = 0.29, 95% CI: 0.09 to 0.87). Conclusions: Non‐pharmacological multicomponent interventions are effective in preventing delirium, however the same cannot be said for other interventions due to uncertain results. There is some evidence that providing multicomponent interventions in patients’ homes is more effective than a hospital setting. Therefore, researching the benefits of hospital‐at‐home interventions in delirium prevention is recommended