Livres sur le sujet « Censored failure time outcome »

Clinical outcome comparisons for research and quality assurance require risk adjustment measures validated in the population of interest. There are many scoring systems using intensive care unit (ICU)-specific or administrative data sets, or both. Risk-adjusted ICU and hospital mortality outcome measures may be not granular enough or may be censored before the absolute risk of the studied outcome reaches that of the population at large. Data linkage methods may be used to examine longer-term outcomes. Organ failure scores provide a method for assessing the intra-episode time course of illness and scores using treatment variables may be useful for assessing care requirements. Each adjustment system has specific merits and limitations, which must be understood for appropriate use. Graphical representations of the comparisons facilitate understanding and time-appropriate response to variations in outcome. There are, as yet, no universally-accepted measures for severity of illness and risk adjustment in deteriorating patients outside the ICU.

Acute liver failure produces widespread physiologic derangements including encephalopathy, coagulopathy, peripheral vasodilation, a systemic inflammatory response, and multiorgan failure. Morbidity is significant, and mortality is 50%. The classification of liver failure and the various etiologies, including viral hepatitis, drug-induced, toxins, and autoimmunity are reviewed here. The multisystem effects of acute liver failure influence all aspects of perioperative care and adequate supportive care during this time is crucial to providing the best possible outcome for the patient. Specific treatment objectives and recommendations are discussed, and the anesthetic management with regard to drug choices, hemodynamic goals, and intraoperative monitoring is reviewed.

Sepsis is the main cause of multiple organ failure and remains a concern because of the associated high morbidity and mortality. In recent years, important advances have been made in the understanding of the pathophysiology of sepsis. Sepsis and septic shock are the end result of complex interactions between infecting organisms and various elements of the host response. A key feature of the common sequence of organ failure is dysfunction of the cardiovascular system, including microcirculatory elements. Outcome improvement in sepsis is based on recognizing the process early and instituting effective therapies. The time window for intervention is relatively short, and treatment must promptly control the source of infection, restore haemodynamic homoeostasis, and support failing organ systems.

Sepsis is the main cause of multiple organ failure and remains a concern because of the associated high morbidity and mortality. In recent years, important advances have been made in the understanding of the pathophysiology of sepsis. Sepsis and septic shock are the end result of complex interactions between infecting organisms and various elements of the host response. A key feature of the common sequence of organ failure is dysfunction of the cardiovascular system, including microcirculatory elements. Outcome improvement in sepsis is based on recognizing the process early and instituting effective therapies. The time window for intervention is relatively short, and treatment must promptly control the source of infection, restore haemodynamic homoeostasis, and support failing organ systems.

Sepsis is the main cause of multiple organ failure and remains a concern because of the associated high morbidity and mortality. In recent years, important advances have been made in the understanding of the pathophysiology of sepsis. Sepsis and septic shock are the end result of complex interactions between infecting organisms and various elements of the host response. A key feature of the common sequence of organ failure is dysfunction of the cardiovascular system, including microcirculatory elements. Outcome improvement in sepsis is based on recognizing the process early and instituting effective therapies. The time window for intervention is relatively short, and treatment must promptly control the source of infection, restore haemodynamic homoeostasis, and support failing organ systems.

Sepsis is the main cause of multiple organ failure and remains a concern because of the associated high morbidity and mortality. In recent years, important advances have been made in the understanding of the pathophysiology of sepsis. Sepsis and septic shock are the end result of complex interactions between infecting organisms and various elements of the host response. A key feature of the common sequence of organ failure is dysfunction of the cardiovascular system, including microcirculatory elements. Outcome improvement in sepsis is based on recognizing the process early and instituting effective therapies. The time window for intervention is relatively short, and treatment must promptly control the source of infection, restore haemodynamic homoeostasis, and support failing organ systems.

This chapter argues that in order to become (and remain) a ‘healthy’ person, I need the others to recognize me in my being-so, that is, in my otherness with respect to them, and at the same time I need their acknowledgement of the value of the otherness that I am. Also, I need to be able to recognize the otherness of the Other. What kind of reaction can generate in me my awareness of non-recognition, be it a kind of emotional dis-attunement, or misunderstanding; or, in general, what could be the outcome of my failed dialogue with the Other? The various shelters or defensive housings in which each of us seeks refuge with respect to our failure in dealing with the aporias of recognition include scepticism, cynicism, mysticism, agnosticism, and contemplation.

What explains war? The so-called bargaining approach has evolved quickly in the past two decades, opening up important new possibilities and raising fundamental challenges to previous conventional thinking about the origins of political violence. Bargaining is intended to explain the causes of conflict on many levels, from interpersonal to international. War is not the product of any of a number of variables creating opportunity or willingness, but instead is caused by whatever factors prevent competitors from negotiating the settlements that result from fighting. Conflict is thus a bargaining failure, a socially inferior outcome, but also a determined choice.Embraced by a growing number of scholars, the bargaining perspective rapidly created a new consensus in some circles. Bargaining theory is radical in relocating at least some of the causes of conflict away from material, cultural, political, or psychological factors and replacing them with states of knowledge about these same material or ideational factors. Approaching conflict as a bargaining failure—produced by uncertainty and incentives to misrepresent, credible commitment problems, or issue indivisibility—is the “state of the art” in the study of conflict.At the same time, bargaining theories remain largely untested in any systematic sense: theory has moved far ahead of empirics. The bargaining perspective has been favored largely because of compelling logic rather than empirical validity. Despite the bargaining analogy’s wide-ranging influence (or perhaps because of this influence), scholars have largely failed to subject the key causal mechanisms of bargaining theory to systematic empirical investigation. Further progress for bargaining theory, both among adherents and in the larger research community, depends on empirical tests of both core claims and new theoretical implications of the bargaining approach.The limited amount of systematic empirical research on bargaining theories of conflict is by no means entirely accident or the product of lethargy on the part of the scholarly community. Tests of theories that involve intangible factors like states of belief or perception are difficult to pursue. How does one measure uncertainty? What does learning look like in the midst of a war? When is indivisibility or commitment a problem, and when can it be resolved through other measures, such as ancillary bargains? The challenge before researchers, however, is to surmount these obstacles. To the degree that progress in science is empirical, bargaining theory needs testing.As should be clear, the dearth of empirical tests of bargaining approaches to the study of conflict leaves important questions unanswered. Is it true, for example, as bargaining theory suggests, that uncertainty leads to the possibility of war? If so, how much uncertainty is required and in what contexts? Which types of uncertainty are most pernicious (and which are perhaps relatively benign)? Under what circumstances are the effects of uncertainty greatest and where are they least critical? Empirical investigation of the bargaining model can provide essential guidance to theoretical work on conflict by identifying insights that can offer intellectual purchase and by highlighting areas of inquiry that are likely to be empirical dead ends. More broadly, the impact of bargaining theory on the study and practice of international relations rests to a substantial degree on the success of efforts to substantiate the perspective empirically.