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Search Results: 1 - 10 of 9915 matches for " Anne Burke-Gaffney "
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Plasma thioredoxin levels during post-cardiac arrest syndrome: relationship with severity and outcome
Nicolas Mongardon, Virginie Lemiale, Didier Borderie, Anne Burke-Gaffney, Sébastien Perbet, Nathalie Marin, Julien Charpentier, Frédéric Pène, Jean-Daniel Chiche, Jean-Paul Mira, Alain Cariou
Critical Care , 2013, DOI: 10.1186/cc12492
Abstract: Retrospective study of consecutive patients admitted to a single academic intensive care unit (ICU) for out-of-hospital cardiac arrest (between July 2006 and March 2008). Plasma levels of TRX were measured at admission, day (D) 1, 2 and 3.Of 176 patients included, median TRX values measured in ICU survivors and non-survivors were, respectively: 22 ng/mL (7.8 to 77) vs. 72.4 (21.9 to 117.9) at admission (P < 0.001); 5.9 (3.5 to 25.5) vs. 23.2 (5.8 to 81.4) at D1 (P = 0.003); 10.8 (3.6 to 50.8) vs. 11.7 (4.5 to 66.4) at D2 (P = 0.22); and 16.7 (5.3 to 68.3) vs. 17 (4.3 to 62.9) at D3 (P = 0.96). Patients dying within 24 hours had significantly (P < 0.001) higher TRX levels (118.6 ng/mL (94.8 to 280)) than those who died after 24 hours or survived (50.8 (13.9 to 95.7) and 22 (7.8 to 77)). The area under the ROC curve to predict early death was 0.84 (0.76 to 0.91).TRX levels on admission were significantly correlated with 'low-flow' duration (P = 0.003), sequential organ failure assessment (SOFA) score (P < 0.001), and blood lactate concentration (P < 0.001), but not with 'no-flow' duration or simplified acute physiology score (SAPS) II score. TRX levels and admission arterial pO2 correlated negatively (r = -0.17, P = 0.03). Finally, cardiac arrest with cardiac etiology exhibited lower levels of TRX than in cases of extra-cardiac cause (46 ng/mL (11 to 104) vs. 68 (42 to 137), P = 0.01).Our data show for the first time that TRX levels were elevated early following cardiac arrest, suggestive of oxidative stress and inflammation occurring with this condition. Highest values were found in the most severe patients. TRX could be a useful tool for further exploration and comprehension of post-cardiac arrest syndrome.Shock and intractable multi-organ failure are the main causes of death after successfully resuscitated cardiac arrest (CA) [1]. Whilst cessation and reduction of blood flow are the patent mechanisms of organ dysfunction, the pathophysiology of post-cardiac arrest
Making Things Right: Nurses' Experiences with Workplace Bullying—A Grounded Theory
Donna A. Gaffney,Rosanna F. DeMarco,Anne Hofmeyer,Judith A. Vessey,Wendy C. Budin
Nursing Research and Practice , 2012, DOI: 10.1155/2012/243210
Abstract: While bullying in the healthcare workplace has been recognized internationally, there is still a culture of silence in many institutions in the United States, perpetuating underreporting and insufficient and unproven interventions. The deliberate, repetitive, and aggressive behaviors of bullying can cause psychological and/or physical harm among professionals, disrupt nursing care, and threaten patient safety and quality outcomes. Much of the literature focuses on categories of bullying behaviors and nurse responses. This qualitative study reports on the experiences of nurses confronting workplace bullying. We collected data from the narratives of 99 nurses who completed an open-ended question embedded in an online survey in 2007. A constructivist grounded theory approach was used to analyze the data and shape a theory of how nurses make things right when confronted with bullying. In a four-step process, nurses place bullying in context, assess the situation, take action, and judge the outcomes of their actions. While many nurses do engage in a number of effective yet untested strategies, two additional concerns remain: inadequate support among nursing colleagues and silence and inaction by nurse administrators. Qualitative inquiry has the potential to guide researchers to a greater understanding of the complexities of bullying in the workplace. 1. Introduction The situations are subtle and can range from sarcastic comments to being set up with the wrong patient chart… these sorts of things undermine your work day… erode your sense of comfort and security that you need to do your job in a professional manner (Nurse 41, 2007). The consequences of workplace bullying are as evident today as they were one hundred years ago. In 1909 Leon Harris condemned the treatment of nurses by their managers in an article published in The New York Times. Dr. Harris, citing multiple examples of workplace mistreatment, emphasized how “head nurses abuse their position of power” [1]. A century later the workplace has changed for the better in many parts of the world [2]. Yet, in spite of such advances, nurses still experience bullying in the workplace. As the toll of workplace bullying has become more widely known in all work settings, research has dramatically increased. Many North American studies focus on behavioral categories, causes, and typologies of individual responses [3]. There is limited information on how nurses experience and resolve workplace bullying. While bullying in the healthcare setting has been internationally recognized and researched [4, 5], many
Cough quality in children: a comparison of subjective vs. bronchoscopic findings
Anne Chang, Justin Gaffney, Matthew Eastburn, Joan Faoagali, Nancy C Cox, Ian Masters
Respiratory Research , 2005, DOI: 10.1186/1465-9921-6-3
Abstract: Cough quality of children (without a known underlying respiratory disease) undergoing elective bronchoscopy was independently evaluated by clinicians and parents. A 'blinded' clinician scored the secretions seen at bronchoscopy on pre-determined criteria and graded (1 to 6). Kappa (K) statistics was used for agreement, and inter-rater and intra-rater agreement examined on digitally recorded cough. A receiver operating characteristic (ROC) curve was used to determine if cough quality related to amount of airway secretions present at bronchoscopy.Median age of the 106 children (62 boys, 44 girls) enrolled was 2.6 years (IQR 5.7). Parent's assessment of cough quality (wet/dry) agreed with clinicians' (K = 0.75, 95%CI 0.58–0.93). When compared to bronchoscopy (bronchoscopic secretion grade 4), clinicians' cough assessment had the highest sensitivity (0.75) and specificity (0.79) and were marginally better than parent(s). The area under the ROC curve was 0.85 (95%CI 0.77–0.92). Intra-observer (K = 1.0) and inter-clinician agreement for wet/dry cough (K = 0.88, 95%CI 0.82–0.94) was very good. Weighted K for inter-rater agreement for bronchoscopic secretion grades was 0.95 (95%CI 0.87–1). Sensitivity and specificity for brassy cough (for tracheomalacia) were 0.57 and 0.81 respectively. K for both intra and inter-observer clinician agreement for brassy cough was 0.79 (95%CI 0.73–0.86).Dry and wet cough in children, as determined by clinicians and parents has good clinical validity. Clinicians should however be cognisant that children with dry cough may have minimal to mild airway secretions. Brassy cough determined by respiratory physicians is highly specific for tracheomalacia.Cough is the most common symptom presenting to medical practitioners in Australia, the UK and USA [1-3]. Cough quality, specifically dry versus we t[4] or productive cough, is often used in epidemiological [5-7] and clinical research [8,9]. Clinically, physicians also often differentiate between dry
Contraception for the HIV-Positive Woman: A Review of Interactions between Hormonal Contraception and Antiretroviral Therapy
Jennifer A. Robinson,Roxanne Jamshidi,Anne E. Burke
Infectious Diseases in Obstetrics and Gynecology , 2012, DOI: 10.1155/2012/890160
Abstract: Background. Preventing unintended pregnancy in HIV-positive women can significantly reduce maternal-to-child HIV transmission as well as improve the woman’s overall health. Hormonal contraceptives are safe and effective means to avoid unintended pregnancy, but there is concern that coadministration of antiretroviral drugs may alter contraceptive efficacy. Materials and Methods. We performed a literature search of PubMed and Ovid databases of articles published between January 1980 and February 2012 to identify English-language reports of drug-drug interactions between hormonal contraceptives (HCs) and antiretroviral drugs (ARVs). We also reviewed the FDA prescribing information of contraceptive hormone preparations and antiretrovirals for additional data and recommendations. Results. Twenty peer-reviewed publications and 42 pharmaceutical package labels were reviewed. Several studies of combined oral contraceptive pills (COCs) identified decreased serum estrogen and progestin levels when coadministered with certain ARVs. The contraceptive efficacy of injectable depot medroxyprogesterone acetate (DMPA) and the levonorgestrel intrauterine system (LNG-IUS) were largely unaffected by ARVs, while data on the contraceptive patch, ring, and implant were lacking. Conclusions. HIV-positive women should be offered a full range of hormonal contraceptive options, with conscientious counseling about possible reduced efficacy of COCs and the contraceptive implant when taken with ARVs. DMPA and the LNG-IUS maintain their contraceptive efficacy when taken with ARVs. 1. Introduction The face of the HIV/AIDS epidemic has changed dramatically since its emergence in the 1980s. Far from its origins as an illness of homosexual men, HIV/AIDS is increasingly affecting women around the world: in 2008, women made up nearly half of the global population of those infected with HIV (15.7 million women, 33.4 million total) [1]. While spread of the epidemic has slowed, addressing the health needs of women infected with HIV remains an important priority. Recent efforts have largely focused on expanding access to HIV diagnosis and counseling, as well as treatment with highly-active antiretroviral therapy (HAART). Providing reproductive health services to women living with HIV is crucial to improving their overall health. Preventing unplanned or mistimed pregnancy allows a woman with HIV to optimize her own health and has the potential to decrease maternal-to-child transmission of HIV. The World Health Organization (WHO) reports that approximately 90% of children living with HIV
Why do we yawn?  [PDF]
William Burke
Health (Health) , 2013, DOI: 10.4236/health.2013.510213

The biomedical hypothesis proposed here is that the immediate trigger for a yawn is a restricted collapse of a few alveoli in the lungs. The extent of this alveolar collapse may be too small for it to be detected by current X-ray technology, but this technology is continually improving and may soon be good enough to test the hypothesis. In support of the hypothesis, it is shown that yawning can be inhibited by deep breaths of air, nitrogen or carbogen, thus showing that yawning is not triggered by lack of oxygen or by excess carbon dioxide, leaving alveolar collapse as the most likely possibility. A more extensive form of alveolar collapse is termed atelectasis and this involves a serious state of hypoxia which, if deepened or prolonged, can be fatal. Therefore, if the hypothesis is correct, yawning may prevent the development of atelectasis and save lives. This paper is not concerned with other indirect ways in which yawning may be induced, nor with the mechanism and neural circuitry of the yawn, nor with social aspects of yawning, only with the immediate trigger. My aim is to get better evidence for the hypothesis put forward here and also to study the behaviour of the pulmonary alveoli in normal respiration.

Quantum-Optical Foundations of Massive and Massless Particles  [PDF]
Burke Ritchie
Journal of Modern Physics (JMP) , 2014, DOI: 10.4236/jmp.2014.59091

A source of the divergences in QED is proposed, and a theory in which the Lamb shift and electron’s anomalous magnetic moment are calculated free of divergences is reviewed. It is shown that Dirac’s equation for a relativistic electron can be inferred from a Lorentz invariant having the form of the Lorentz gauge equation, \"\", on identifying a carrier-wave energy \"\" with the electron’s rest mass energy

Use of Quantum Trajectories in Computational Molecular Bioscience  [PDF]
Burke Ritchie
Computational Molecular Bioscience (CMB) , 2014, DOI: 10.4236/cmb.2014.41002
A spin-dependent quantum trajectory methodology is outlined which achieves electron exchangecorrelation on an ab initio basis. The methodology is intended to give workers in electronic structure the same computational capability which has been available for decades in classical dynamics.
The Ionic Composition of Nasal Fluid and Its Function  [PDF]
William Burke
Health (Health) , 2014, DOI: 10.4236/health.2014.68093
Abstract: The aim of the experiments reported here is to increase our understanding of the function of the nasal fluid. It is generally accepted that the nasal fluid assists in the humidification of the inspired air. It also assists in the capture of inspired particles such as pollen, preventing them getting lodged in the lungs. It is also known to contain antibacterial substances which keep the nose, nasopharynx and respiratory passages relatively free of infection. There are other features of the nasal fluid that are not understood. In cold weather, is it the fluid that collects in the nostrils pure water or nasal fluid? Why does nasal fluid have an exceptionally high potassium concentration? Does nasal fluid secreted during the common cold have the same composition as at other times? My objectives are to try to answer these questions. My method is to collect my nasal fluid in several different ways and have the ionic composition of each determined accurately. My findings are that nasal fluid is similar in composition however it is secreted. In cold weather, if expiration is via the nose, the nasal fluid is diluted by condensed water. The high concentration of potassium in the nasal fluid is not a way of controlling the level of potassium in the body but I suggest that it may assist in maintaining the antibacterial property of the nasal fluid.
Compatibility of Quantum Entanglement with the Special Theory of Relativity  [PDF]
Burke Ritchie
Journal of Quantum Information Science (JQIS) , 2014, DOI: 10.4236/jqis.2014.42009

The Einstein-Podolsky-Rosen paradox is resolved dynamically by using spin-dependent quantum trajectories inferred from Dirac’s equation for a relativistic electron. The theory provides a practical computational methodology for studying entanglement versus disentanglement for realistic Hamiltonians.

The Regulatory Dilemma Surrounding Interstate Practice
Gaffney, T
Online Journal of Issues in Nursing , 1999,
Abstract: One of the changes with which all health care providers and regulators are grappling is the increasing use of telecommunication technology in the health care delivery system. Historically, regulation of health professionals has been a state-based function. However, the combination of telehealth and the current state-based model of regulation poses a potential problem of widespread unlicensed practice. This paper will offer an historical overview of health care regulation and identify four specific areas of concern related to the regulation of interstate nursing practice, namely, state sovereignty, discipline, information sharing and regulation of advanced practice registered nurses.
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