In many high-income countries, an initial response to the severe impact of Covid-19 on residential care was to shield residents from outside contacts. As the pandemic progressed, these measures have been increasingly questioned, given their detrimental impact on residents' health and well-being and their dubious effectiveness. Many authorities have been hesitant in adapting visiting policies, often leaving nursing homes to act on their own safety and liability considerations. Against this backdrop, this article discusses the appropriateness of viewing the continuation of the practice of shielding as a moral failure. This is affirmed and specified in four dimensions: and (in MacIntyre's sense). is discussed in the context of prudent versus proportionate choices. As to , it will be shown that the continued practice of shielding no longer met the requirements of an (inherently moral) practice, as external goods such as security thinking and structural deficiencies prevented the pursuit of internal goods focusing on residents' interests and welfare, which in many places has led to a loss of trust in these facilities. This specification of moral failure also allows a novel perspective on moral distress, which can be understood as the expression of the psychological impact of moral failure on moral agents. Conclusions are formulated about how pandemic events can be understood as character challenges for healthcare professionals within residential care, aimed at preserving the internal goods of residential care even under difficult circumstances, which is understood as a manifestation of moral resilience. Finally, the importance of moral and civic education of healthcare students is emphasized to facilitate students' early identification as trusted members of a profession and a caring society, in order to reduce experiences of moral failure or improve the way to deal with it effectively.
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http://dx.doi.org/10.1177/09697330231174532 | DOI Listing |
Obstet Med
January 2025
Intensive Care and Obstetric Research Group (GRICIO), Universidad de Cartagena, Cartagena, Colombia.
Objective: This report details the complexities of diagnosing and treating rapid-onset multisystemic hemophagocytic lymphohistiocytosis (HLH) during pregnancy, as evidenced by a fatal case in early pregnancy with severe hematological and obstetric complications.
Case Presentation: A 20-year-old pregnant woman in her second pregnancy presented at 8 weeks of gestation with abdominal pain, fever, and rectal bleeding. Laboratory tests revealed leukopenia, thrombocytopenia, and anemia, leading to immediate transfusion and intensive care unit admission.
Antimicrob Agents Chemother
January 2025
Argentinian Society for Critical Care (SATI), Buenos Aires, Buenos Aires, Argentina.
Unlabelled: Data from low and middle-income countries (LMICs) on multidrug-resistant microorganisms (MDROs) in intensive care units (ICUs) are scarce. Working in several ICUs in Argentina, we sought to estimate the prevalence and characteristics of MDRO infections and carbapenemase-producing Enterobacterales (CPE) colonization. Mortality associated with MDRO infection was also evaluated.
View Article and Find Full Text PDFSevere aortic valve stenosis poses a significant risk for the aging population, often escalating from mild symptoms to life-threatening heart failure and sudden death. Without timely intervention, this condition can lead to disastrous outcomes. The advent of transcatheter aortic valve implantation (TAVI) has gained popularity, emerging as an effective alternative for managing severe aortic stenosis (AS) in high-risk patients experiencing deterioration of previously implanted bioprosthetic surgical aortic valves (SAV), which introduces complex challenges such as device compatibility and anatomical considerations.
View Article and Find Full Text PDFMed Intensiva (Engl Ed)
January 2025
Pulmonology Department, Hospital General Universitario Morales Meseguer, Murcia, Spain.
Objective: The purpose of this study was to analyze the differences in the effectiveness and complications of CPAP versus non-invasive ventilation on bilevel positive airway pressure (BiPAP) in the treatment of COVID-19 associated acute respiratory failure (ARF).
Design: Retrospective observational study.
Setting: ICU.
Diabetes
January 2025
William Harvey Research Institute, Barts Faculty of Medicine and Dentistry, Queen Mary University of London, Charterhouse Square, London, UK.
Diabetes mellitus (DM) leads to a more rapid development of DM cardiomyopathy (dbCM) and progression to heart failure in women than men. Combination of high-fat diet (HFD) and freshly-injected streptozotocin (STZ) has been widely used for DM induction, however emerging data shows that anomer-equilibrated STZ produces an early onset and robust DM model. We designed a novel protocol utilising a combination of multiple doses of anomer-equilibrated STZ injections and HFD to develop a stable murine DM model featuring dbCM analogous to humans.
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