Results of at-home ASCT with prophylactic administration of ceftriaxone and domiciliary treatment of febrile neutropenia with piperacillin and tazobactam are highly satisfactory and significantly cheaper compared with those obtained with conventional in-hospital ASCT.
When people think about what might have been, they undo an outcome by changing events in regular ways. Suppose two contestants could win £1,000 if they picked the same color card; the first picks black, the second red, and they lose. The temporality effect refers to the tendency to think they would have won if the second player had picked black. Individuals also think that the second player will experience more guilt and be blamed more by the first, We report the results of five experiments that examine the nature of this effect. The first three experiments examine the temporality effect in scenarios in which the game is stopped after the first contestant's card selection because of a technical hitch, and then is restarted. When the first player picks a different card, the temporality effect is eliminated, for scenarios based on implicit and explicit negation and for good outcomes. When the first player picks the same card, the temporality effect occurs in each of these situations. The second two experiments show that it depends on the order of events in the world, not their descriptive order: It occurs for scenarios without preconceptions about normal descriptive order; it occurs whether the second event is mentioned in second place or first, The results are consistent with the idea that the temporality effect arises because the first event is presupposed and so it is immutable; and the elimination of the temporality effect arises because the availability of a counterfactual alternative to the first event creates an opposing tendency to mutate it. Wesketch a putative account ofthese effects based on characteristics of the mental models people construct when they think counterfactually.Many everyday thoughts rely on imaginative skills, especially when people think about how the past could have been different. These counterfactual suppositions can be close to the actual situation, for example, If! had taken the side road, I would have avoided the traffic jam. (I)
Background: The purpose of this paper is to describe how end-of-life care is managed when life-support limitation is decided in a Pediatric Intensive Care Unit and to analyze the influence of the further development of the Palliative Care Unit. Methods: A 15-year retrospective study of children who died after life-support limitation was initiated in a pediatric intensive care unit. Patients were divided into two groups, pre-and post-palliative care unit development. Epidemiological and clinical data, the decision-making process, and the approach were analyzed. Data was obtained from patient medical records. Results: One hundred seventy-five patients were included. The main reason for admission was respiratory failure (86/175). A previous pathology was present in 152 patients (61/152 were neurological issues). The medical team and family participated together in the decision-making in 145 cases (82.8%). The family made the request in 10 cases (9 vs. 1, p = 0.019). Withdrawal was the main life-support limitation (113/175), followed by withholding lifesustaining treatments (37/175). Withdrawal was more frequent in the post-palliative group (57.4% vs. 74.3%, p = 0.031). In absolute numbers, respiratory support was the main type of support withdrawn. Conclusions: The main cause of life-support limitation was the unfavourable evolution of the underlying pathology. Families were involved in the decision-making process in a high percentage of the cases. The development of the Palliative Care Unit changed life-support limitation in our unit, with differences detected in the type of patient and in the strategy used. Increased confidence among intensivists when providing end-of-life care, and the availability of a Palliative Care Unit may contribute to improvements in the quality of end-of-life care.
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