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Search Results: 1 - 10 of 12435 matches for " Christopher Flannigan "
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Prolonged rupture of membranes in term infants: should all babies be screened?
Christopher Flannigan, Martina Hogan
Clinical Audit , 2010, DOI: http://dx.doi.org/10.2147/CA.S8425
Abstract: olonged rupture of membranes in term infants: should all babies be screened? Original Research (16666) Total Article Views Authors: Christopher Flannigan, Martina Hogan Published Date February 2010 Volume 2010:2 Pages 1 - 6 DOI: http://dx.doi.org/10.2147/CA.S8425 Christopher Flannigan,1 Martina Hogan,2 1Royal Jubilee Maternity Hospital, Regional Neonatal Unit, Belfast, Northern Ireland; 2Craigavon Area Hospital, Neonatal Unit, Portadown, Northern Ireland Background: Prolonged rupture of fetal membranes (>24 hours) is a major risk factor for early onset sepsis in neonates. In Northern Ireland there is no consistency on the management of this problem and individual clinical guidelines vary widely between neonatal departments. At present in Craigavon Area Hospital all term babies born with prolonged rupture fetal membranes have screening blood analysis performed, regardless of what is found on risk factor assessment. Setting: The neonatal department of Craigavon Area Hospital a district general hospital in Northern Ireland. Objectives: To determine if the current guidelines on the management of prolonged rupture of fetal membranes in term infants are being followed. The audit will also try to determine if the decision on whether to perform screening blood analysis was left up to the individual doctor’s clinical judgment, would they make a safe decision. Design: A prospective audit was carried out over a three-month period between October 2008 and January 2009. Term infants born during this period where fetal membranes had ruptured for more than 24 hours prior to delivery were included in the audit. Results: At present there is 100% compliance with the current hospital guidelines and there is evidence that if the decision of whether to perform screening blood analysis is left up to the individual doctor’s clinical judgment, they will make a sensible decision based on the infants risk factor assessment. None of the infants that the doctor decided they wouldn’t screen came to any harm. Conclusion: Combining the results of the audit and the availability of nationally recognized guidelines it was decided to adopt the National Institute for Health and Clinical Excellence (NICE) guidelines in Craigavon Hospital. To help facilitate this change a neonatal early warning score (NEWS) observation chart has been developed to record the observations recommended by NICE. As there has been a major change in the management of this condition it is planned to re-audit in the near future to ensure that adopting this less invasive strategy does not result in any increase in adverse neonatal outcomes.
Prolonged rupture of membranes in term infants: should all babies be screened?
Christopher Flannigan,Martina Hogan
Clinical Audit , 2010,
Abstract: Christopher Flannigan,1 Martina Hogan,21Royal Jubilee Maternity Hospital, Regional Neonatal Unit, Belfast, Northern Ireland; 2Craigavon Area Hospital, Neonatal Unit, Portadown, Northern IrelandBackground: Prolonged rupture of fetal membranes (>24 hours) is a major risk factor for early onset sepsis in neonates. In Northern Ireland there is no consistency on the management of this problem and individual clinical guidelines vary widely between neonatal departments. At present in Craigavon Area Hospital all term babies born with prolonged rupture fetal membranes have screening blood analysis performed, regardless of what is found on risk factor assessment.Setting: The neonatal department of Craigavon Area Hospital a district general hospital in Northern Ireland.Objectives: To determine if the current guidelines on the management of prolonged rupture of fetal membranes in term infants are being followed. The audit will also try to determine if the decision on whether to perform screening blood analysis was left up to the individual doctor’s clinical judgment, would they make a safe decision.Design: A prospective audit was carried out over a three-month period between October 2008 and January 2009. Term infants born during this period where fetal membranes had ruptured for more than 24 hours prior to delivery were included in the audit.Results: At present there is 100% compliance with the current hospital guidelines and there is evidence that if the decision of whether to perform screening blood analysis is left up to the individual doctor’s clinical judgment, they will make a sensible decision based on the infants risk factor assessment. None of the infants that the doctor decided they wouldn’t screen came to any harm.Conclusion: Combining the results of the audit and the availability of nationally recognized guidelines it was decided to adopt the National Institute for Health and Clinical Excellence (NICE) guidelines in Craigavon Hospital. To help facilitate this change a neonatal early warning score (NEWS) observation chart has been developed to record the observations recommended by NICE. As there has been a major change in the management of this condition it is planned to re-audit in the near future to ensure that adopting this less invasive strategy does not result in any increase in adverse neonatal outcomes.Keywords: prolonged rupture of fetal membranes, neonatal, sepsis, audit
Dashboards in neonatology
Christopher Flannigan, Una Toland, Martina Hogan
Clinical Audit , 2010, DOI: http://dx.doi.org/10.2147/CA.S9469
Abstract: shboards in neonatology Short Report (5383) Total Article Views Authors: Christopher Flannigan, Una Toland, Martina Hogan Published Date July 2010 Volume 2010:2 Pages 79 - 81 DOI: http://dx.doi.org/10.2147/CA.S9469 Christopher Flannigan1, Una Toland2, Martina Hogan2 1Royal Belfast Hospital for Sick Children, 2Craigavon Area Hospital, Neonatal Unit, Northern Ireland Abstract: A clinical dashboard is defined as a toolset of visual displays developed to provide clinicians with the relevant and timely information they need to inform daily decisions that improve quality of patient care. The use of clinical dashboards in the National Hospital Service (NHS) is not a new concept, but it is one that has not been widely adopted throughout neonatology in the United Kingdom. The underuse of dashboards was also noted by the NHS Next Stage Review in 2008. It advocated for the development of dashboards in all clinical areas stating: “Our goal is that every provider of NHS services should systematically measure, analyze, and improve quality. They will need to develop their own quality frameworks, combining relevant indicators defined nationally, with those appropriate to local circumstances”. In this article we outline the advantages to be gained by using dashboards to display information compared to using more traditional methods, using our own neonatal dashboard in Craigavon Hospital as an example.
Can a gentamicin-specific chart reduce neonatal medication errors?
Christopher Flannigan, Sandra Kilpatrick, Jilly Redpath, et al
Clinical Audit , 2010, DOI: http://dx.doi.org/10.2147/CA.S8424
Abstract: n a gentamicin-specific chart reduce neonatal medication errors? Original Research (5871) Total Article Views Authors: Christopher Flannigan, Sandra Kilpatrick, Jilly Redpath, et al Published Date April 2010 Volume 2010:2 Pages 7 - 11 DOI: http://dx.doi.org/10.2147/CA.S8424 Christopher Flannigan1, Sandra Kilpatrick2, Jilly Redpath2, Martina Hogan2 1Royal Jubilee Maternity Hospital, Regional Neonatal Unit, Belfast, Northern Ireland; 2Craigavon Area Hospital, Neonatal Unit, Portadown, Northern Ireland Objective: To evaluate whether the introduction of a gentamicin prescription, administration and monitoring chart reduces the number of medication errors. Setting: The neonatal department of a district general hospital in Northern Ireland. Design: A retrospective audit looking at all the reported clinical incident forms involving gentamicin over a 7-year period between 2002 and 2008. Results: Since the introduction of the new chart in 2005 there was a 16% (0.75) reduction in the average annual number of medication errors involving gentamicin from 4.75 to 4.00. There were no further incidents recorded where the wrong dose of gentamicin was given or where a dose was given despite a high serum concentration. There has also been a 67% reduction in incidents where a gentamicin level was not monitored as required. Conclusion: There has been some improvement in the number of gentamicin-based clinical incidents with the introduction of a gentamicin-specific chart, however errors are still occurring. Recommendations include the introduction of regular training on appropriate gentamicin prescribing for new staff and a mandatory yearly update for permanent staff. There is a plan to re-audit this yearly, with consideration of electronic prescribing.
Coordination Matters: Interpersonal Synchrony Influences Collaborative Problem-Solving  [PDF]
Lynden K. Miles, Joanne Lumsden, Natasha Flannigan, Jamie S. Allsop, Dannette Marie
Psychology (PSYCH) , 2017, DOI: 10.4236/psych.2017.811121
Abstract: Moving in time with others is a central characteristic of social life and has been shown to promote a host of social-cognitive attunements (e.g., person memory, affiliation, prosociality) for those involved. Less attention has been paid, however, to how the effects of coordination can serve higher-order goal-directed social behaviour. Here we explored whether interpersonal synchrony impacts performance on a collaborative problem-solving task. One hundred and ninety two participants completed a short movement exercise in pairs whereby coordination mode was manipulated (in-phase synchrony, asynchrony, control). Each pair then jointly discussed a problem-solving exercise while the degree to which coordination spontaneously emerged was assessed. The results revealed that collaboration was more effective following in-phase coordination. Of theoretical significance, both instructed and spontaneous synchrony were associated with better performance, with the short-term history of each dyad shaping precisely when coordination was functional. Overall, the synchronization of body movements appears to support effective collaboration.
Enhanced Synthesis and Diminished Degradation of Hydrogen Sulfide in Experimental Colitis: A Site-Specific, Pro-Resolution Mechanism
Kyle L. Flannigan, Jose G. P. Ferraz, Rui Wang, John L. Wallace
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0071962
Abstract: Hydrogen sulfide (H2S) is produced throughout the gastrointestinal tract, and it contributes to maintenance of mucosal integrity, resolution of inflammation, and repair of damaged tissue. H2S synthesis is elevated in inflamed and damaged colonic tissue, but the enzymatic sources of that synthesis are not completely understood. In the present study, the contributions of three enzymatic pathways to colonic H2S synthesis were determined, with tissues taken from healthy rats and rats with colitis. The ability of the colonic tissue to inactivate H2S was also determined. Colonic tissue from rats with hapten-induced colitis produced significantly more H2S than tissue from healthy controls. The largest source of the H2S synthesis was the pathway involving cysteine amino transferase and 3-mercaptopyruvate sulfurtransferase (an α-ketoglutarate-dependent pathway). Elevated H2S synthesis occurred specifically at sites of mucosal ulceration, and was not related to the extent of granulocyte infiltration into the tissue. Inactivation of H2S by colonic tissue occurred rapidly, and was significantly reduced at sites of mucosal ulceration. This correlated with a marked decrease in the expression of sulfide quinone reductase in these regions. Together, the increased production and decreased inactivation of H2S at sites of mucosal ulceration would result in higher H2S levels at these sites, which promotes of resolution of inflammation and repair of damaged tissue.
What Role Can Propinquity Play in the Development of New National Allegiances? Immigrant Latinos Establishing Ties to the United States through Out-Group Contact  [PDF]
Christopher Olds
Advances in Applied Sociology (AASoci) , 2012, DOI: 10.4236/aasoci.2012.21002
Abstract: Contact theory has primarily been applied to the study of interactions between Blacks and Whites, with particular emphasis on changes in the attitudes of Whites towards Blacks. How individual contact with an out-group can influence not just attitudes, but also actual behavior, has not been thoroughly explored. Through an analysis of the 2006 Latino National Survey, using a measure that contrasts the intensity of individual social interaction with various ethnic and racial groups, the study shows that a high intensity of friendly social contact with African-Americans increases the likelihood Latino immigrants will establish a closer link to the social and political structures of the United States. Latino immigrants are potentially experiencing movement towards deprovincialization through high levels of friendly social interaction with African-Americans. The development of friendly personal interactions with an out-group stigmatized in the mother country can help Latino immigrants develop an optimistic view of life in the host country.
Net primary production and carbon cycling in coast redwood forests of central California  [PDF]
Christopher Potter
Open Journal of Ecology (OJE) , 2012, DOI: 10.4236/oje.2012.23018
Abstract: A simulation model to estimate net primary productivity (NPP) has been combined with in situ measurements of soil carbon dioxide (CO2) emissions and leaf litter pools in three coast redwood forest stands on the central California coast. Monthly NPP was predicted from the CASA model using 250-meter resolution vegetation index (VI) inputs. Annual NPP was predicted to vary from 380 g·C·m-2·yr-1 to 648 g·C·m-2·yr-1 at central coast redwood sites over the years 2007 to 2010. Measured soil respiration rates at between 0.5 to 2.2 g·C·m-2·d-1 were slightly below the range of measurements previously reported for a second-growth mixed (redwood and Douglas-fir) conifer forests. Although warm monthly temperatures at the southern-most redwood forest sites evidently results in elevated stress levels to sustained redwood growth into the dry summer months of June and July, these redwood stands appear to sequester CO2 from that atmosphere into forest biomass for a net positive ecosystem carbon balance each year.
Ten Years of Vegetation Change in Northern California Marshlands Detected Using Landsat Satellite Image Analysis  [PDF]
Christopher Potter
Journal of Water Resource and Protection (JWARP) , 2013, DOI: 10.4236/jwarp.2013.55048
Abstract:

The Landsat Ecosystem Disturbance Adaptive Processing System (LEDAPS) methodology was applied to detect changes in perennial vegetation cover at marshland sites in Northern California reported to have undergone restoration between 1999 and 2009. Results showed extensive contiguous areas of restored marshland plant cover at 10 of the 14 sites selected. Gains in either woody shrub cover and/or from a recovery of herbaceous cover that remains productive and evergreen on a year round basis could be mapped out from the image results. However, LEDAPS may not be highly sensitive changes in wetlands that have been restored mainly with seasonal herbaceous cover (e.g., vernal pools), due to the ephemeral nature of the plant greenness signal. Based on this evaluation, the LEDAPS methodology would be capable of fulfilling a pressing need for consistent, continual, low-cost monitoring of changes in marshland ecosystems of the Pacific Flyway.

Ex Post Efficient Set Mathematics  [PDF]
Christopher Adcock
Journal of Mathematical Finance (JMF) , 2013, DOI: 10.4236/jmf.2013.31A019
Abstract:

This paper considers efficient set mathematics for the case where the covariance matrix of asset returns is assumed known but ex ante the vector of expected returns is replaced by an estimated or forecast value. It is shown that the ex post mean and variance differ from the standard results. Consequently the maximum Sharpe ratio portfolio also differs from the standard result. However, even with uncertainty about the vector of expected returns, subject to the assumptions made about the joint distribution of actual returns and estimated mean returns, ex post Sharpe ratio maximisers hold the ex post market portfolio. The properties of the zero beta portfolio are similar to the standard results leading to a capital market line. The ex post Capital Asset Pricing Model incorporates an intercept and the betas are not the same as those computed ex ante. The results are illustrated with an example.

 

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