the effect of positive end expiratory pressure (peep) on the hepatic elimination of low to moderate extraction ratio drugs has not been clearly defined. we prospectively investigated the effect of peep on the clearance of theophylline in 30 (20 males and 10 females) intubated critically ill adult patients with acute lung injury/acute respiratory distress syndrome (ali/ards). the mean (±sd) age ...

Self-care management is essential for effective chronic disease management. Yet prevailing approaches of healthcare practitioners often undermine the efforts of those who require on-going medical attention for chronic conditions, emphasizing their status as patients, failing to consider their larger life experience as people, and most importantly, failing to consider them as people with the pot...

Health care providers, hospital administrators, and politicians face competing challenges to reduce clinical errors, control expenditure, increase access and throughput, and improve quality of care. The safe management of the acutely ill inpatient presents particular difficulties. In the first of five Lancet articles on this topic we discuss patients' safety in the acute hospital. We also prese...

The concepts are synergistic in that population management capabilities help to identify high-risk patients, whose costliest episodes can be managed through integrated specialty services, including cardiac and orthopedics that makes better use of post-acute and community-based follow-up. Even in a chronically-ill population, what drive high costs are acute episodes. Bajner believes integrating ...

Civil commitment involves abridgment of civil rights of the mentally ill person. The involuntarily hospitalized patient is deprived of many elementary rights" which the average citizen takes for granted, such as visitation, written communication and compensation for work." , Furthermore, the committed patients often have been deprived of various rights dealing with their functioning in the soci...

A pilot of item-of-service payments (85 Pounds per annum per patient) to general practitioners for monitoring long-term mentally ill individuals was successful in recruiting practices and ensuring assessments. It did not, however, demonstrate an improvement in health care.

Many people who are terminally ill would prefer to die at home. Integrated professional working is necessary to enable patients to remain in their homes for end of life care. This article describes how an integrated district nursing team in Lincolnshire provides end of life care to patients in the community. The team uses the Gold Standards Framework and the Liverpool Care Pathway to provide op...

Technological advances and societal changes in recent years have contributed to a shift in traditional care models and in the relationship between patients and their doctors/carers, with (in general) an increase in the patient-carer physical distance and corresponding changes in the modes of access to relevant care information by all groups. The objective of this paper is to showcase the resear...