NeuroCOPE: A novel intervention to increase professional fulfillment and reduce burnout by connecting Neuro-ICU healthcare workers to their post-recovery patients

Background: Healthcare workers (HCWs) caring for patients with acute neurologic injury in the ICU rarely receive detailed information on the recovery of their patients. The missing connection between the period of acute neurologic injury and long-term outcomes is a psychological burden that contributes to moral fatigue and burnout. We hypothesize that attending an Interprofessional conference series through which patients describe their acute brain injury and recovery to Neuro-ICU HCWs may ease moral fatigue, increasing professional fulfillment and reducing burnout.https://knowledgeconnection.mainehealth.org/lambrew-retreat-2023/1014/thumbnail.jp

Owen Jones: Travel and Vision of the Orient / ﺃﻭﻳﻦ ﺟﻮﻧﺰ: ﺍﻟﺮﺣﻠﺔ ﻭﺭﺅﻳﺔ ﺍﻟﺸﺮﻕ

[The British architect Owen Jones (1809-1874) was a major influence on British design and decoration in the mid-nineteenth century. Many of his ideas, particularly concerning color and pattern, were derived from a visit he paid to Egypt in 1832-1833, taking him up the Nile as far as the second cataract, and to southern Spain in 1833-1834 and 1837 where he was profoundly affected by the Alhambra. Jones was working in a period of great interest in the science as in the aesthetics of color. However, there were often loud protests at the strong colors he insisted on using and it is interesting to compare them with similar protests today when \u27Victorian\u27 color schemes (often Jones-inspired) are restored. ﻛﺎﻥ ﻟﻠﻤﻌﻤﺎﺭﻱ ﺍﻟﺒﺮﻳﻄﺎﻧﻲ ﺃﻭﻳﻦ ﺟﻮﻧﺰ(١٨٠٩-١٨٧٤) ﺗﺄﺛﻴﺮ ﻛﺒﻴﺮﻋﻠﻰ ﺍﻟﺘﺼﻤﻴﻢ ﻭﺍﻟﺰﺧﺮﻓﺔ ﻓﻲ ﻣﻨﺘﺼﻒ ﺍﻟﻘﺮﻥ ﺍﻟﺘﺎﺳﻊ ﻋﺸﺮ٠ ﻭﻗﺪ ﺍﺳﺘﻤﺪ ﺍﻟﻌﺪﻳﺪ ﻣﻦ ﺃﻓﻜﺎﺭﻩ٬ ﺧﺎﺻﺔ ﻓﻴﻤﺎ ﻳﺘﻌﻠﻖ ﺑﺎﻟﻠﻮﻥ ﻭﺍﻟﺮﺳﻮﻣﺎﺕ٬ ﻣﻦ ﺭﺣﻠﺔ ﺯﺍﺭ ﻓﻴﻬﺎ ﻣﺼﺮ ﻣﺎ ﺑﻴﻦ ﻋﺎﻣﻲ ١٨٣٢ ﻭ١٨٣٣؛ ﻭﺃﺧﺮﻯ ﺯﺍﺭ ﻓﻴﻬﺎ ﺟﻨﻮﺏ ﺇﺳﺒﺎﻧﻴﺎ ﻣﺎ ﺑﻴﻦ ﻋﺎﻣﻲ ١٨٣٣ ﻭ٬١٨٣٤ ﺛﻢ ﻣﺮﺓ ﺃﺧﺮﺓ ﻓﻲ ﻋﺎﻡ ٠١٨٣٧ ﻭﻛﺎﻥ ﺟﻮﻧﺰ ﻳﻌﻤﻞ ﻓﻲ ﻓﺘﺮﺓ ﺗﻤﻴﺰﺕ ﺑﺎﻻﻫﺘﻤﺎﻡ ﺑﺎﻟﻌﻠﻮﻡ ﻭﺟﻤﺎﻟﻴﺎﺕ ﺍﻟﻠﻮﻥ٠ ﻭﻗﺪ ﻗﻮﺑﻠﺖ ﺃﻋﻤﺎﻟﻪ ﺑﺎﻟﻜﺜﻴﺮ ﻣﻦ ﺍﻻﻋﺘﺮﺍﺿﺎﺕ ﻋﺎﻟﻴﺔ ﺍﻟﻨﺒﺮﺓ ﻓﻴﻤﺎ ﻳﺘﻌﻠﻖ ﺑﺈﺻﺮﺍﺭﻩ ﻋﻠﻰ ﺍﺳﺘﺨﺪﺍﻡ ﺍﻷﻟﻮﺍﻥ ﺍﻟﻔﺎﻗﻌﺔ٬ ﻭﻫﻲ ﻧﻔﺲ ﺍﻻﻋﺘﺮﺍﺿﺎﺕ ﺍﻟﺘﻲ ﻧﺴﻤﻌﻬﺎ ﺍﻟﻴﻮﻡ ﺑﺼﺪﺩ ﺍﻷﻟﻮﺍﻥ ﺍﻟﻤﺴﺘﺨﺪﻣﺔ ﻓﻲ ﺗﺮﻣﻴﻢ ﺃﻋﻤﺎﻝ ﺍﻟﻌﺼﺮ ﺍﻟﭭﻴﻜﺘﻮﺭﻱ (ﺍﻟﻤﺴﺘﻮﺣﺎﺓ ﻓﻲ ﻛﺜﻴﺮ ﻣﻦ ﺍﻷﺣﻴﺎﻥ ﻣﻦ ﺟﻮﻧﺰ ﺫﺍﺗﻪ)٠

Ceftriaxone to PRevent pneumOnia and inflammaTion aftEr Cardiac arresT (PROTECT): study protocol for a randomized, placebo-controlled trial

BACKGROUND: Pneumonia is the most common infection after out-of-hospital cardiac arrest (OHCA) occurring in up to 65% of patients who remain comatose after return of spontaneous circulation. Preventing infection after OHCA may (1) reduce exposure to broad-spectrum antibiotics, (2) prevent hemodynamic derangements due to local and systemic inflammation, and (3) prevent infection-associated morbidity and mortality. METHODS: The ceftriaxone to PRevent pneumOnia and inflammaTion aftEr Cardiac arrest (PROTECT) trial is a randomized, placebo-controlled, single-center, quadruple-blind (patient, treatment team, research team, outcome assessors), non-commercial, superiority trial to be conducted at Maine Medical Center in Portland, Maine, USA. Ceftriaxone 2 g intravenously every 12 h for 3 days will be compared with matching placebo. The primary efficacy outcome is incidence of early-onset pneumonia occurring \u3c 4 days after mechanical ventilation initiation. Concurrently, T cell-mediated inflammation bacterial resistomes will be examined. Safety outcomes include incidence of type-one immediate-type hypersensitivity reactions, gallbladder injury, and Clostridioides difficile-associated diarrhea. The trial will enroll 120 subjects over approximately 3 to 4 years. DISCUSSION: The PROTECT trial is novel in its (1) inclusion of OHCA survivors regardless of initial heart rhythm, (2) use of a low-risk antibiotic available in the USA that has not previously been tested after OHCA, (3) inclusion of anti-inflammatory effects of ceftriaxone as a novel mechanism for improved clinical outcomes, and (4) complete metagenomic assessment of bacterial resistomes pre- and post-ceftriaxone prophylaxis. The long-term goal is to develop a definitive phase III trial powered for mortality or functional outcome. TRIAL REGISTRATION: ClinicalTrials.gov NCT04999592 . Registered on August 10, 2021