376 research outputs found
sj-jpg-2-inc-10.1177_17511437231202898 – Supplemental material for Dynamic dosing for continuous renal replacement therapy: Service evaluation of the safety and effectiveness of titrating dose to biochemistry
No full textSupplemental material, sj-jpg-2-inc-10.1177_17511437231202898 for Dynamic dosing for continuous renal replacement therapy: Service evaluation of the safety and effectiveness of titrating dose to biochemistry by Jack C Eldridge, Aroon Bhardwaj Shah, Susana Lucena-Amaro, Christopher J Kirwan, John R Prowle and Yize I Wan in Journal of the Intensive Care Society</p
sj-jpg-3-inc-10.1177_17511437231202898 – Supplemental material for Dynamic dosing for continuous renal replacement therapy: Service evaluation of the safety and effectiveness of titrating dose to biochemistry
No full textSupplemental material, sj-jpg-3-inc-10.1177_17511437231202898 for Dynamic dosing for continuous renal replacement therapy: Service evaluation of the safety and effectiveness of titrating dose to biochemistry by Jack C Eldridge, Aroon Bhardwaj Shah, Susana Lucena-Amaro, Christopher J Kirwan, John R Prowle and Yize I Wan in Journal of the Intensive Care Society</p
sj-docx-1-inc-10.1177_17511437231202898 – Supplemental material for Dynamic dosing for continuous renal replacement therapy: Service evaluation of the safety and effectiveness of titrating dose to biochemistry
No full textSupplemental material, sj-docx-1-inc-10.1177_17511437231202898 for Dynamic dosing for continuous renal replacement therapy: Service evaluation of the safety and effectiveness of titrating dose to biochemistry by Jack C Eldridge, Aroon Bhardwaj Shah, Susana Lucena-Amaro, Christopher J Kirwan, John R Prowle and Yize I Wan in Journal of the Intensive Care Society</p
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Managing escalating demand for public services in a time of financial austerity: a case study of family interventions
No full textThe UK (along with many other countries) is facing the challenges of financial austerity with little or no growth in public funding for the foreseeable future. This creates particular challenges for public services as economic downturns often increase the demand for public services at a time when resources are constrained. A particular service of this type is the provision of support to ‘troubled’ families through what are termed family interventions, in one local authority area, and the impact of financial austerity on those services. It considers the strategic options available for dealing with the dilemma of increasing demand and declining resources, and assesses the implications of implementing these options. It also considers the key factors which inhibit the development and implementation of such approaches, in order to provide a starting point for developing a practical strategy for dealing with the challenges ahead. Finally, it considers how the findings related to family interventions can be applied to other services in a similar situation of increasing demand and decreasing resources
Standardizing end points in perioperative trials: Towards a core and extended outcome set
No full textCOMPAC-StEP Group members include: J. Bartoszko, W. S. Beattie, R. Bellomo, D. Buggy, L. Cabrini, J. Canet, T. Cook, D. J. Cooper, T. Corcoran, P. J. Devereaux, R. Eckenhoff, L. Evered, T. J. Gan, T. Gin, H. Grocott, G. Haller, S. Howell, M. Jayarajah, C. Kalkman, K. Karkouti, B. Kavanagh, A. Klein, G. Landoni, K. Leslie, D. R. McIlroy, D. Mazer, A. Moller, M. Mythen, M. Neuman, M. Neuman, R. Pearse, P. Peyton, J. Prowle, T. Richards, D. A. Scott, D. Sessler, A. Shaw, T. Short, M. Shulman, B. Silbert, M. Singer, J. R. Sneyd, D. Story, D. van Dijk, and W. van Klei
Recent Trials in Critical Care Nephrology
No full textSeveral large observational studies or randomized controlled trials in the field of critical care nephrology have been completed and reported, or recently completed or have recently begun recruitment. These studies provide important information to guide our appreciation of current practice and consider new potentially effective intervention for the prevention or attenuation of acute kidney injury or suggest new avenues for the use of renal replacement therapy (RRT) in the treatment of sepsis. In particular, two studies, the ATN study and the RENAL study (both multicenter randomized controlled trials of >1,000 patients) provide, for the first time, level I evidence to guide the practice of RRT in critically ill patients and to better define the optimal intensity of such RAT in this setting. Clinicians practicing in the field of critical care nephrology need to be aware of these trials, their details, their findings or design or current recruitment rate and likely time of completion to continue to offer their patients the highest level of evidence-based medical care. Copyright (C) 2010 S. Karger AG, Base
Evaluation of the Social Services and Well-being (Wales) Act 2014: Literature Review
No full textEvaluation of the Social Services and Well-being (Wales) Act 2014: Literature Review
Edited by:
Llewellyn, M., Verity, F. and Wallace, S.
Chapter authors:
Chapter 1: Evaluation Overview and Literature Methodology
Verity, F., Wallace, S., Llewellyn, M., Anderson, P. and Lyttleton-Smith, J.
Chapter 2: Well-being literature review
Anderson, P., Lyttleton-Smith, J., Kosnes, L., Read, S., Blackmore, H. and Williams, Z.
Chapter 3: Prevention and early intervention literature review
Verity, F., Read, S. and Richards, J.
Chapter 4: Co-production literature review
Andrews, N., Calder, G., Blanluet, N., Tetlow, S. and Wallace, S.
Chapter 5: Multi-agency literature review
Wallace, C., Orrell, A., Garthwaite, T., Tetlow, S. and Wallace, S.
Chapter 6: Voice and control literature review
Llewellyn, M., Saltus, R., Blackmore, H., Tetlow, S., Williams, Z. and Wallace, S.
Chapter 7: Financial and economic literature review
Phillips, C., Prowle, M., Tetlow S. and Williams Z.Mae’r ddogfen yma hefyd ar gael yn Gymraeg. This document is also available in Welsh. OGL © Crown Copyright Digital ISBN 978-1-80038-948-9.This document is a summary of the extensive review of the literature to inform the evaluation of the Social Services and Well-being (Wales) Act 2014 (hereafter referred to as ‘the Act’).Welsh Governmen
In-hospital clinical outcomes after upper gastrointestinal surgery: Data from an international observational study
No full textAIMS:
Previous research suggests that patients undergoing upper gastrointestinal surgery are at high risk of poor postoperative outcomes. The aim of our study was to describe patient outcomes after elective upper gastrointestinal surgery at a global level.
METHODS:
Prospective analysis of data collected during an international seven-day cohort study of 474 hospitals in 27 countries. Patients undergoing elective upper gastrointestinal surgery were recruited. Outcome measures were in-hospital complications and mortality at 30-days. Results are presented as n(%) and odds ratios with 95% confidence intervals.
RESULTS:
2139 patients were included, of whom 498 (23.2%) developed one or more postoperative complications, with 30 deaths (1.4%). Patients with complications had longer median hospital stay 11 (6-18) days vs. 5 (2-10) days. Infectious complications were most frequent, affecting 368 (17.2%) patients. 328 (15.3%) patients were admitted to critical care postoperatively, of whom 161 (49.1%) developed a complication with 14 deaths (4.3%). In a multivariable logistic regression model we identified age (OR 1.02 [1.01-1.03]), American Society of Anesthesiologists physical status III (OR 2.12 [1.44-3.16]) and IV (OR 3.23 [1.72-6.09]), surgery for cancer (OR 1.63 [1.27-2.11]), open procedure (OR 1.40 [1.10-1.78]), intermediate surgery (OR 1.75 [1.12-2.81]) and major surgery (OR 2.65 [1.72-4.23]) as independent risk factors for postoperative complications. Patients undergoing major surgery for upper gastrointestinal cancer experienced twice the rate of complications compared to those undergoing other procedures (224/578 patients [38.8%] versus 274/1561 patients [17.6%]).
CONCLUSIONS:
Complications and death are common after upper gastrointestinal surgery. Patients undergoing major surgery for cancer are at greatest risk
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The importance of strategic financial leadership in the UK public sector in a time of financial austerity
No full textGiven the severity of financial pressures on public authorities, this report is concerned with how finance managers in public services are coping with the demands placed on them and how they can demonstrate improved value by providing more effective strategic financial leadership. It considers how they are applying managerial approaches and solutions to the challenges of austerity and the role that the public sector finance function can play in this process
Association between multimorbidity and quality of life after hip replacement surgery: analysis of routinely collected patient-reported outcomes.
No full textBACKGROUND: Total hip replacement surgery is performed to improve quality of life (QoL). We explored the association between multimorbidity and change in QoL after total hip replacement. METHODS: Analysis of patients included in the NHS England hip replacement Patient Reported Outcome Measures (PROMs) database with complete preoperative from 3 to 6 months postoperative EQ-5D QoL data from April 2013 to March 2018. Multimorbidity was defined as two or more chronic diseases excluding arthritis. The primary outcome measure was change in QoL using the Pareto Classification of Health Change. We compared QoL change for patients with and without multimorbidity and those with no multimorbidity using multivariable modelling. Data are presented as odds ratio (OR) with 95% confidence interval or n (%). RESULTS: Of 216,191 patients, we included 178,129 (82.4%) patients with complete data. Most patients 63,327 (35.6%) were 70-79 yr of age, and 98,513 (55.3%) were women. Multimorbidity was present in 38,384 patients (21.6%). QoL improved after surgery for 149,774 (84.1%) patients, remained unchanged for 10,219 (5.7%) patients, and became worse after surgery for 7289 (4.1%) patients. QoL changes were mixed (at least one QoL domain improved and at least one deteriorated) for 10,847 (6.1%) patients. Poor QoL outcomes (unchanged/mixed/worse) were more likely for patients with multimorbidity (OR 1.53 [1.49-1.58]). CONCLUSIONS: Hip replacement surgery improves QoL. However, patients with multimorbidity are less likely to experience these benefits. Poor QoL outcomes became more frequent as the number of comorbid diseases increased. These data should inform shared decision-making conversations around joint replacement surgery
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