OBJECTIVES To explore nurses' perceptions of obstacles to the provision of end of life care (EoLC) in the intensive care unit (ICU) in Saudi Arabia. METHODS A modified version of a questionnaire developed by Beckstrand and Kirchhoff was administered in one setting at Riyadh, Saudi Arabia between March and April 2015. RESULTS A total of 87 questionnaires were returned from 140 potential resp...

322 and family) of good end of life care. Currently the physician may ‘inadvertently fall into the trap of prognostic paralysis’ [1]. The clinical question ‘would I be surprised if this patient died within the next year’ has been advocated as a useful prompt for care planning, discussion with the patient and family, and in decision making [4]. COPD is a chronic incurable disease, and many patie...

In this report, we characterize the design principles of futile cycling in providing rapid adaptation by regulatory proteins that act as environmental sensors. In contrast to the energetically wasteful futile cycles that are avoided in metabolic pathways, here we describe a conditional futile cycle exploited for a regulatory benefit. The FNR (fumarate and nitrate reduction) cycle in Escherichia...

OBJECTIVES This study explores physicians' concepts of futility and use of age as a deciding factor in considering medical futility in clinical interventions. DESIGN Survey. SETTING Five academic hospitals in the United States. PARTICIPANTS Participants were 355 internal medicine physicians, including 162 residents, 98 fellows, and 95 attending physicians. MEASUREMENT Anonymous question...

provides a fascinating window into the complex issue of use of the principle of medical futility in critical care practice. The editors constructed three cases, designed to range from a patient likely to benefit from the therapy we call 'intensive care' to a patient for whom this therapy would provide no benefit and therefore could be considered medically futile. They then identified critical c...

BACKGROUND AND PURPOSE Although recanalization is the goal of thrombolysis, it is well recognized that it fails to improve outcome of acute stroke in a subset of patients. Our aim was to assess the rate of and factors associated with "futile recanalization," defined by absence of clinical benefit from recanalization, following endovascular treatment of acute ischemic stroke. MATERIALS AND MET...

A major debate in medical ethics is the request for futile treatment. The topic of medical futility requires discrete assessment in Iran for at least two reasons. First, the common principles and foundations of medical ethics have taken shape in the context of Western culture and secularism. Accordingly, the implementation of the same guidelines and codes of medical ethics as Western societies ...

PLoS Biology | http://biology.plosjournals.org By next summer, more than 40% of Streptococcus pneumoniae strains in the United States will resist both penicillin and erythromycin, according to a recent prediction from the Harvard School of Public Health. The forecast, based on mathematical modeling, was published in the spring of 2003. It’s too early to tell whether that prediction is precisely...

Lameness is a prominent clinical feature present in animals with musculoskeletal disease and injury. Indeed, resolution of lameness is one of the important hallmarks for documentation of a successful treatment. However, objective evaluation and quantitative grading of gait in clinical practice can be challenging. One of the great, classical studies of animal and human gait was made by Eadweard ...