Why practice philosophy as a way of life?

This essay explains why there are good reasons to practice philosophy as a way of life. The argument begins with the assumption that we should live well but that our understanding of how to live well can be mistaken. Philosophical reason and reflection can help correct these mistakes. Nonetheless, the evidence suggests that philosophical reasoning often fails to change our dispositions and behavior. Drawing on the work of Pierre Hadot, the essay claims that spiritual exercises and communal engagement mitigate the factors that prevent us from living in accord- ance with our conceptions of the good life. So, many of us have reasons to engage in philosophical reasoning along with behavioral, cognitive, and social strategies to alter our behavior and attitudes so that they’re in line with our philosophical commitments. In these respects, many of us should practice philosophy as a way of life

Optimal Nutrition Care for all, from Policy to Action – A National Nutrition Program in Israel

Abstract \ Background \ Malnutrition is a significant public health problem which includes both ends of the nutrition spectrum, with obesity and overweight at one end and under nutrition at the other. Israel is one of 14 countries in Europe which has joined the European Nutrition for Health Alliance (ENHA) whose common goals are ‘Optimal Nutrition Care for All\u27(ONCA). Israel is unique in that the four health maintenance organizations, which provide coverage for all, are fully computerized, with big accessible data. \ Objective \ Creating national awareness for better nutrition for all the population. \ Methods \ Four subcommittees were formed to develop policy: interventions in hospitals; within the community; communication and patient opinion; continuity of care with the aid of computerized and big data tools. \ Results \ All stakeholders signed a charter which included: Implementation of weighing in all health-care settings; screening for malnutrition; creating health quality indicators; improving the nutritional quality of food served to patients in hospital settings; continuity of treatment-care sequence; promoting a healthy lifestyle for the entire population and establishing a national malnutrition registry. \ Conclusion \ Multidisciplinary teams must work together at a national level towards reaching the goal of ‘Optimal Nutrition Care for All\u27 against malnutrition.

Weaning from Mechanical Ventilation

Weaning off mechanical ventilation (MV) is a process that ultimately ends with a patient’s liberation from the ventilator. As extubation failure worsens prognosis, every effort should be made to safely extubate the patient when the clinical condition allows it. There are several methods and techniques to assess whether a patient is ready for weaning. The clinician should choose the proper method for each patient to minimalize the risk of extubation failure. When liberation from MV is not possible, tracheostomy and transferring the patient to a long-term rehabilitation ward may be required. If this is not feasible, palliative care should be considered

Antibiotics induced commensal flora disruption favours escherichia coli AIEC colonization and mesenteric translocation in NOD2 knock-out mice

International audienc

Rapid iron loading in a pregnant woman with transfusion-dependent thalassemia after brief cessation of iron chelation therapy

In general, in women with transfusion-dependent thalassemia, during pregnancy, iron chelation therapy is ceased. We report a splenectomized patient, who was an excellent complier with chelation therapy, who before embarking on a pregnancy showed no evidence of iron overload, with normal cardiac, thyroid function and glucose metabolism. Laboratory findings showed ferritin 67 μg/L, myocardial T2* of 34 ms and liver magnetic resonance imaging (MRI) liver iron concentration of 1 mg/g dry weight. She became pregnant by in vitro fertilization in October 2006, delivery occurred in June 2007. She breast fed for 2 months. After 12 months without iron chelation, ferritin was 1583 μg/L. Quantitative MRI showed myocardial T2* of 27 ms, that the liver iron concentration had increased to 11.3 mg/g dry weight, indicative of moderate to heavy iron load. This case demonstrates that iron overload can develop rapidly and that physicians caring for patients with transfusion-dependent thalassemia should be particularly alert to any discontinuation of chelation therapy over time

To eat or not to eat? Indicators for reduced food intake in 91,245 patients hospitalized on nutritionDays 2006-2014 in 56 countries worldwide: A descriptive analysis

Background: Inadequate nutrition during hospitalization is strongly associated with poor patient outcome, but ensuring adequate food intake is not a priority in clinical routine worldwide. This lack of priority results in inadequate and unbalanced food intake in patients and huge amounts of wasted food. Objectives: We evaluate the main factors that are associated with reduced meal intake in hospitalized patients and the differences between geographical regions. Design: We conducted a descriptive analysis of data from 9 consecutive, annual, and cross-sectional nutritionDay samples (2006-2014) in a total of 91,245 adult patients in 6668 wards in 2584 hospitals in 56 countries. A general estimation equation methodology was used to develop a model for meal intake, and P-value thresholding was used for model selection. Results: The proportion of patients who ate a full meal varied widely (24.7-61.5%) across world regions. The factors that were most strongly associated with reduced food intake on nutritionDay were reduced intake during the previous week (OR: 0.20; 95% CI: 0.17, 0.22), confinement to bed (OR: 0.49; 95% CI: 0.44, 0.55), female sex (OR: 0.53; 95% CI: 0.5, 0.56), younger age (OR: 0.74; 95% CI: 0.64, 0.85) and older age (OR: 0.80; 95% CI: 0.74; 0.88), and low body mass index (OR: 0.84; 95% CI: 0.79, 0.90). The pattern of associated factors was homogenous across world regions. Conclusions: A set of factors that are associated with full meal intake was identified and is applicable to patients hospitalized in any region of the world. Thus, the likelihood for reduced food intake is easily estimated through access to patient characteristics, independent of world regions, and enables the easy personalization of food provision

Zooming-in on the SU(2) fundamental domain

For SU(2) gauge theories on the three-sphere we analyse the Gribov horizon and the boundary of the fundamental domain in the 18 dimensional subspace that contains the tunnelling path and the sphaleron and on which the energy functional is degenerate to second order in the fields. We prove that parts of this boundary coincide with the Gribov horizon with the help of bounds on the fundamental modular domain.Comment: 19p., 6 figs. appended in PostScript (uuencoded), preprint INLO-PUB-12/93. Revision: ONLY change is a much more economic PostScript code for figures 1-4 (with apologies

Dangers of hyperoxia

Oxygen (O-2) toxicity remains a concern, particularly to the lung. This is mainly related to excessive production of reactive oxygen species (ROS). Supplemental O-2, i.e. inspiratory O-2 concentrations (FIO2) > 0.21 may cause hyperoxaemia (i.e. arterial (a) PO2 > 100 mmHg) and, subsequently, hyperoxia (increased tissue O-2 concentration), thereby enhancing ROS formation. Here, we review the pathophysiology of O-2 toxicity and the potential harms of supplemental O-2 in various ICU conditions. The current evidence base suggests that PaO2 > 300 mmHg (40 kPa) should be avoided, but it remains uncertain whether there is an "optimal level" which may vary for given clinical conditions. Since even moderately supra-physiological PaO2 may be associated with deleterious side effects, it seems advisable at present to titrate O-2 to maintain PaO2 within the normal range, avoiding both hypoxaemia and excess hyperoxaemia.Peer reviewe