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Search Results: 1 - 10 of 121275 matches for " Patrick O’Connell "
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The Value of Positive Pressure Ventilations for Clients in Acute Respiratory Distress as a Result of Cardiac and Pulmonary Issues  [PDF]
Patrick OConnell
Open Journal of Respiratory Diseases (OJRD) , 2015, DOI: 10.4236/ojrd.2015.52005
Abstract: Objective: Research was conducted to examine benefits to using non-invasive ventilation (NIV) or continuous positive airway pressure (CPAP) early in the treatment of respiratory distress caused by pulmonary edema, chronic obstructive pulmonary disease (COPD) and asthma. Limitations to successful NIV and CPAP therapy were evaluated to determine how prolonged initiation of treatment may lead to hypoxemia (decreased oxygen in the blood) and hypercapnia (increased carbon dioxide in the blood) resulting in poor outcomes. Method: Reviews of literature from nursing and allied health data bases (CINAHL and ProQuest) with terms pulmonary edema, positive pressure device and non-invasive ventilation from 2010 to 2014 were used. Studies were conducted in the hospital and prehospital settings. Results: The literature search located 7 articles from CINAHL and 25 articles from ProQuest. A total of 6 of these articles were analyzed. Additional sources of data were obtained from Ignatavicius and Workman (2013) Medical-Surgical Nursing Patient-Centered Collaborative Care 7th edition and American Journal of Nursing (02/2013) Volume 113: 2. Conclusion: All of the articles concluded that early initiation of continuous positive airway pressure ventilations in the short-term was beneficial; however, late initiation of therapy required additional interventions. The studies indicated that early use of positive airway pressure in acute respiratory distress improved breath rate, heart rate and blood pressure. The use of positive airway pressure for respiratory distress may decrease the need for endotracheal intubation.
Peregrinación de Luz del Día: La desilusión de Juan Bautista Alberdi
OConnell,Patrick L.;
Acta literaria , 2004, DOI: 10.4067/S0717-68482004002900006
Abstract: in peregrinación de luz del día (1871), juan bautista alberdi (1810-1884) debaes domingo faustino sarmiento?s (1811-1888) dichotomy "civilización-barbarie" and employs irony, through the allegorical voyage of the hermaphroditic "luz del día", to critize the civilizing concept similar to sarmiento?s found in james fenimore cooper?s (1789-1851) notions of the americans (1848). in this essay, the "mitología de exclusión" used by literary critic nicolás shumway in the invention of argentina (1991) to expose argentina?s foundational fictions, the importance of alberdi?s literary contributions, and cooper and sarmiento?s contrasting political esthetic to that of alberdi, will be investigated in order to study alberdi?s dialectical vacillation between political reality and utopian imagination
Una llamada (colectiva) por cobrar: El perpetuo exilio en Cobro revertido de José Leandro Urbina
Patrick L. O'Connell
Acta Literaria , 2001,
Abstract:
Peregrinación de Luz del Día: La desilusión de Juan Bautista Alberdi
Patrick L. OConnell
Acta Literaria , 2004,
Abstract: En Peregrinación de Luz del Día (1871), Juan Bautista Alberdi (1810-1884) cuestiona la dicotomía civilización-barbarie planteada por Domingo Faustino Sarmiento (1811-1888) e ironiza, por medio del viaje alegórico de su personaje hermafrodita Luz del Día, el concepto civilizador que propone James Fenimore Cooper (1789-1851) en Notions of the Americans (1848). La "mitología de exclusión" en la Argentina manejada por el crítico literario Nicolás Shumway en The Invention of Argentina (1991) para exponer las ficciones fundacionales de la nación, la importancia de las contribuciones literarias de Alberdi y la contrastante estética política de Cooper y Sarmiento se se alarán en este ensayo por desarrollar el juego dialéctico de Alberdi entre realidad política e imaginación utópica In Peregrinación de Luz del Día (1871), Juan Bautista Alberdi (1810-1884) debaes Domingo Faustino Sarmiento’s (1811-1888) dichotomy "civilización-barbarie" and employs irony, through the allegorical voyage of the hermaphroditic "Luz del Día", to critize the civilizing concept similar to Sarmiento’s found in James Fenimore Cooper’s (1789-1851) Notions of the Americans (1848). In this essay, the "mitología de exclusión" used by literary critic Nicolás Shumway in The Invention of Argentina (1991) to expose Argentina’s foundational fictions, the importance of Alberdi’s literary contributions, and Cooper and Sarmiento’s contrasting political esthetic to that of Alberdi, will be investigated in order to study Alberdi’s dialectical vacillation between political reality and utopian imagination
Costs and Savings Associated With Community Water Fluoridation Programs in Colorado
Joan M. OConnell, PhD,Diane Brunson, RDH, MPH,Theresa Anselmo, RDH,Patrick W. Sullivan, PhD
Preventing Chronic Disease , 2005,
Abstract: Introduction Local, state, and national health policy makers require information on the economic burden of oral disease and the cost-effectiveness of oral health programs to set policies and allocate resources. In this study, we estimate the cost savings associated with community water fluoridation programs (CWFPs) in Colorado and potential cost savings if Colorado communities without fluoridation programs or naturally high fluoride levels were to implement CWFPs. Methods We developed an economic model to compare the costs associated with CWFPs with treatment savings achieved through averted tooth decay. Treatment savings included those associated with direct medical costs and indirect nonmedical costs (i.e., patient time spent on dental visit). We estimated program costs and treatment savings for each water system in Colorado in 2003 dollars. We obtained parameter estimates from published studies, national surveys, and other sources. We calculated net costs for Colorado water systems with existing CWFPs and potential net costs for systems without CWFPs. The analysis includes data for 172 public water systems in Colorado that serve populations of 1000 individuals or more. We used second-order Monte Carlo simulations to evaluate the inherent uncertainty of the model assumptions on the results and report the 95% credible range from the simulation model. Results We estimated that Colorado CWFPs were associated with annual savings of $148.9 million (credible range, $115.1 million to $187.2 million) in 2003, or an average of $60.78 per person (credible range, $46.97 to $76.41). We estimated that Colorado would save an additional $46.6 million (credible range, $36.0 to $58.6 million) annually if CWFPs were implemented in the 52 water systems without such programs and for which fluoridation is recommended. Conclusion Colorado realizes significant annual savings from CWFPs; additional savings and reductions in morbidity could be achieved if fluoridation programs were implemented in other areas.
Galaxy Formation In The Reionization Epoch As Hinted By Wide Field Camera 3 Observations Of The Hubble Ultra Deep Field
Haojing Yan,Rogier Windhorst,Nimish Hathi,Seth Cohen,Russell Ryan,Robert O'Connell,Patrick McCarthy
Physics , 2009, DOI: 10.1088/1674-4527/10/9/003
Abstract: We present a large sample of candidate galaxies at z~7--10, selected in the HUDF using the new observations made by the HST/WFC3. Our sample is composed of 20 z-dropouts, 15 Y-dropouts, and 20 J-dropouts. The surface densities of the z-dropouts are close to what predicted by earlier studies, however, those of the Y- and J-dropouts are quite unexpected. While no Y- or J-dropouts have been found at AB < 28.0 mag, their surface densities seem to increase sharply at fainter levels. While some of these candidates seem to be close to foreground galaxies and thus could possibly be gravitationally lensed, the overall surface densities after excluding such cases are still much higher than what would be expected if the luminosity function does not evolve from z~7 to 10. Motivated by such steep increases, we tentatively propose a set of Schechter function parameters to describe the LFs at z~8 and 10. As compared to their counterpart at z~7, here L* decreases by ~ 6.5x and Phi* increases by 17--90x. Although such parameters are not yet demanded by the existing observations, they are allowed and seem to agree with the data better than other alternatives. If these LFs are still valid beyond our current detection limit, this would imply a sudden emergence of a large number of low-luminosity galaxies when looking back in time to z~10, which, while seemingly exotic, would naturally fit in the picture of the cosmic hydrogen reionization. These early galaxies could easily account for the ionizing photon budget required by the reionization, and they would imply that the global star formation rate density might start from a very high value at z~10, rapidly reach the minimum at z~7, and start to rise again towards z~6. In this scenario, the majority of the stellar mass that the universe assembled through the reionization epoch seems still undetected by current observations at z~6. [Abridged]
Measurements of the acid-binding capacity of ingredients used in pig diets
Peadar G Lawlor, P Brendan Lynch, Patrick J Caffrey, James J O'Reilly, M Karen O'Connell
Irish Veterinary Journal , 2005, DOI: 10.1186/2046-0481-58-8-447
Abstract: In the pig, protein digestion begins in the stomach with the action of pepsins, secreted as the enzyme precursors - pepsinogens - by stomach mucosa. Conversion of pepsinogen to pepsin occurs rapidly at pH 2.0 but only slowly at pH 5.0 to 6.0. In turn, pepsins work best in an acidic environment, pH 2.0 to 3.5, and activity declines rapidly above this pH. Carbohydrate hydrolysis in the stomach occurs by the action of salivary amylase, which, in contrast to pepsin, is inactivated once pH falls to 3.5 [14,18,22].In the suckling pig, acid secretion is low and the principal source of acidity is bacterial fermentation of lactose from sows milk to lactic acid [9,10,14]. A high level of lactate in the stomach tends to inhibit HCl secretion [10,22]. Ingestion of solid feed reduces the level of lactic acid in the stomach [22] and stimulates HCl production [10,7] but, in practice, creep feed consumption is low and variable at least up to four weeks of age [15].At weaning, a combination of low acid secretion, lack of lactose substrate, and consumption of large meals at infrequent intervals can result in elevated pH, often to over 5.0 and it may remain high for several days [14]. The high acid-binding/buffering capacity of the feed (its ability to neutralise feed acid) helps to further raise the stomach pH [20,13,6]. Inclusion of whey or lactose in the starter diet ensures continuation of bacterial fermentation and some, though reduced, lactic acid production [14,11]. Development of HCl secretory capacity occurs more rapidly in the weaned pig than in the suckling pig [8].Lowering the acid-binding capacity of diets for newly-weaned pigs can help ease the transition from milk to solid food at weaning.Raised stomach pH after weaning results in reduced digestion of feed which will then be fermented in the hind gut and may provoke diarrhoea. A high gastric pH will also allow pathogens to survive and allow them greater opportunity to colonise the digestive tract [6,22].The concept of m
Homozygosity by descent mapping of blood pressure in the Old Order Amish: evidence for sex specific genetic architecture
Patrick F McArdle, Harvey Dytch, Jeffery R O'Connell, Alan R Shuldiner, Braxton D Mitchell, Mark Abney
BMC Genetics , 2007, DOI: 10.1186/1471-2156-8-66
Abstract: Areas of two chromosomes were identified as suggestive of linkage to SBP and 5 areas to DBP in either the overall or sex specific analyses. The strongest evidence for linkage in the overall sample was to Chromosome 18q12 (LOD = 2.6 DBP). Sex specific analyses identified a linkage on Chromosome 4p12-14 (LOD in men only = 3.4 SBP). At Chromosome 2q32-33, an area where we previously reported significant evidence for linkage to DBP using a conventional identity by descent approach, the LOD was 1.4; however an appreciable sex effect was observed with men accounting for most of the linkage (LOD in men only = 2.6).These results add evidence to a sex specific genetic architecture to blood pressure related traits, particularly in regions of linkage on chromosome 2, 4 and 18.Hypertension is a common chronic condition in the United States and leads to severe morbidity and mortality through heart disease, stroke, congestive heart failure, end stage renal disease and peripheral vascular disease. Among these, heart disease and stroke are two of the leading cause of death in the United States [1,2]. Much effort and expense has been spent attempting to identify genes responsible for blood pressure variation and hypertension. At this point nearly all human chromosomes have been linked to hypertension related traits through linkage analysis [3-6]. It seems clear that a single gene is not responsible for hypertension and that etiology is a complex combination of both genetic and environmental risk factors [7,8]. Sex may be an important and easily identifiable "environmental" risk factor that may interact with putative genetic factors to increase risk [9].To attempt to identify genetic causes to blood pressure variation and other complex diseases, we have studied a population of Old Order Amish (OOA) in Lancaster County, Pennsylvania. The OOA are a closed founder population with several beneficial qualities for the genetic study of complex diseases [10]. A relatively homogenous lifesty
Biomarkers Predict Relapse in Granulomatosis with Polyangiitis
Patrick C. P. Hogan,Robert M. OConnell,Simone Scollard,Emmett Browne,Emer E. Hackett,Conleth Feighery
Journal of Biomarkers , 2014, DOI: 10.1155/2014/596503
Abstract: Granulomatosis with polyangiitis (GPA) is a small blood vessel vasculitic disorder with a high mortality rate if undiagnosed or treated inadequately. Disease relapse is a key feature of this disease and early identification of relapse episodes is very important in limiting end-organ damage. The advent of indirect immunofluorescence to detect antineutrophil cytoplasmic antibody (ANCA) with specific reactivity against the enzyme proteinase-3 (PR3) has been very useful in the diagnosis of GPA but is less helpful in predicting relapse. Indeed, up to date no satisfactory biomarker has been identified that can reliably predict relapse. This study assessed the probability of the occurrence of a relapse when a change was noted in a range of commonly used laboratory tests. These tests included levels of C-reactive protein (CRP), anti-PR3 antibodies, ANCA titre, and the neutrophil count. A group of 30 GPA patients with a total of 66 relapse episodes was investigated and a novel clinical yield score was devised. When a combined rise in CRP, anti-PR3 antibodies, and neutrophil count was observed in the 6-month period before a relapse event, 59% of patient relapses could be predicted. Monitoring changes in this set of parameters helps identify disease relapse. 1. Introduction Granulomatosis with polyangiitis (GPA) is an autoimmune vasculitis primarily affecting the respiratory tract and kidneys and is characterised by necrosis and granulomatous lesions involving small to medium sized blood vessels. The principal autoantibody associated with the disease is the antineutrophil cytoplasmic antibody (ANCA), usually directed against the enzyme proteinase-3 (PR3) [1, 2]. Long term survival in GPA has greatly improved since the introduction of disease modifying agents such as cyclophosphamide, with a ten-year survival of approximately 75% [3]. Disease relapse is a major cause of morbidity and mortality in patients with GPA, with some 50% of patients experiencing relapse at five-year followup [4]. Prediction of disease relapse is therefore an important goal of clinical management. Certain patient and disease factors have been identified as increasing the risk of relapse. For example, it has been shown that lung involvement, infection with staphylococcus aureus, and cardiac or renal involvement increase the chance of relapse [5–7]. The identification of biomarkers that predict relapse in GPA has proven elusive. While a change in ANCA titre may be associated with disease activity, it is not sufficiently specific nor sensitive to be an effective predictor of relapse [8] and
A 5-Year Review of Gynaecological Oncology Patients Managed by a Fast Track Surgery Program  [PDF]
Jonathan Carter, Shannon Philp, Rachel OConnell
International Journal of Clinical Medicine (IJCM) , 2014, DOI: 10.4236/ijcm.2014.51008
Abstract:

Introduction: The aim of this study is to provide a comprehensive 5-year audit of patients undergoing laparotomy for suspected or confirmed gynaecological malignancy to document the frequency and incidence of adverse events and to investigate factors associated with shorter length of stay and readmission to hospital. Methods: A 5-year surgical audit of the period commencing 2008 and concluding 2012. All patients undergoing laparotomy were included in the audit without exclusions. Approval was granted by the local Ethics Review Committee. Results: Four hundred and twenty-seven patients underwent laparotomy for suspected or confirmed gynaecological malignancy and were managed by Fast Track Surgery (FTS) principles. Average age was 54.8 years and average weight and BMI were 73.4 kg and 28.1 respectively. Ultimately 254 (59%) patients had confirmed malignancy. Average surgery duration was 2.36 hours and average estimated blood loss (EBL) at surgery was 262 mL. Median and mean LOS was 3.0 and 3.5 days respectively with 125 (29%) patients discharged on day 2. Overall transfusion rate was 5%. Other adverse events in decreasing frequency were hospital readmission (3.7%), significant wound infection (3%) and unplanned High Dependency Unit (HDU) admission (1.4%). All other adverse events were uncommon with rates <0.5%. Factors associated with a short LOS included year of surgery, age, performance status, malignant vs benign pathology, the use of COX-2 inhibitors, operation time, incision type, transfusion, and radical hysterectomy, at least 1 complication, if patients tolerated early oral feeding (EOF). In multivariable analysis, year, age, performance status, the use of COX-2 inhibitors, operation time and incision type were significant. Factors associated with readmission included the use of COX-2 inhibitors, operation time, performance of a lymph node dissection, return to operating theatre, operation category at least 1 complication, and in multivariable analysis lymph node dissection and the occurrence of at least 1 complication were significant. Conclusions: This 5-year audit is important in establishing a contemporary incidence and the prevalence rate of serious adverse events for patients with suspected or confirmed gynaecological cancer undergoing laparotomy and managed by FTS principles. The community can be reassured that the incidence of serious adverse events is low when managed by FTS principles.

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