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  1. Article ; Online: Preventing pediatric catheter-associated urinary tract infections utilizing urinary catheter Kamishibai cards (K-cards).

    Lehane, Renee / Svensson, Catherine / Ormsby, Jennifer A / Yuen, Jenny Chan / Priebe, Gregory P / Sandora, Thomas J / Vaughan-Malloy, Ana M

    American journal of infection control

    2022  Volume 51, Issue 8, Page(s) 919–925

    Abstract: Background: We instituted Kamishibai (K-card rounding) with the goals of improving indwelling ... quality improvement project from January 2019 to June 2021 after developing a K-card based on our urinary catheter ... maintenance bundle. Auditors used K-cards to ask standardized questions during weekly rounds. Bundle ...

    Abstract Background: We instituted Kamishibai (K-card rounding) with the goals of improving indwelling urinary catheter maintenance bundle reliability and decreasing catheter-associated urinary tract infection (CAUTI) rates.
    Method: In a free-standing children's hospital, we undertook a hospital-wide quality improvement project from January 2019 to June 2021 after developing a K-card based on our urinary catheter maintenance bundle. Auditors used K-cards to ask standardized questions during weekly rounds. Bundle reliability and CAUTI rates were analyzed prospectively.
    Results: During the study period, 826 K-card audits were performed for 657 unique patients. While overall maintenance bundle reliability remained stable at 84%, there was a statistically significant improvement in reliability to the bundle element "medical discussion of need for the urinary catheter" from 88% to 94% (P = .01). The hospital-wide CAUTI rate significantly decreased (incidence rate ratio, 0.38; 95% CI, 0.15-0.93; P = .04).
    Discussion: Hospital-wide urinary catheter K-card rounding facilitated standardized data collection, discussion of reliability and real-time feedback to nurses. Maintenance bundle reliability remained stable after implementation, accompanied by a significant decrease in the CAUTI rate.
    Conclusions: Implementation of hospital-wide urinary catheter K-card rounding was associated with reduction in CAUTI rates. The project demonstrated likelihood of reproducibility with support of a multidisciplinary team.
    MeSH term(s) Humans ; Child ; Urinary Catheters/adverse effects ; Catheter-Related Infections/epidemiology ; Catheter-Related Infections/prevention & control ; Reproducibility of Results ; Urinary Tract Infections/epidemiology ; Urinary Tract Infections/prevention & control ; Urinary Tract Infections/complications ; Quality Improvement ; Urinary Catheterization/adverse effects ; Cross Infection/epidemiology ; Cross Infection/prevention & control ; Cross Infection/etiology
    Language English
    Publishing date 2022-12-02
    Publishing country United States
    Document type Journal Article
    ZDB-ID 392362-9
    ISSN 1527-3296 ; 0196-6553
    ISSN (online) 1527-3296
    ISSN 0196-6553
    DOI 10.1016/j.ajic.2022.11.019
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Central venous catheter bundle adherence: Kamishibai card (K-card) rounding for central-line-associated bloodstream infection (CLABSI) prevention.

    Ormsby, Jennifer A / Cronin, Julie / Carpenter, Jane / Graham, Dionne A / Potter-Bynoe, Gail / Vaughan, Ana M / Weir, Lindsay / Flaherty, Kathleen A / Chandonnet, Celeste J / Priebe, Gregory P / Sandora, Thomas J

    Infection control and hospital epidemiology

    2020  Volume 41, Issue 9, Page(s) 1058–1063

    Abstract: Objective: To institute facility-wide Kamishibai card (K-card) rounding ... were included.: Intervention: A K-card was developed based on 7 core elements in our CVC maintenance ... bundle. During monthly audits, auditors used the K-cards to ask bedside nurses standardized questions and ...

    Abstract Objective: To institute facility-wide Kamishibai card (K-card) rounding for central venous catheter (CVC) maintenance bundle education and adherence and to evaluate its impact on bundle reliability and central-line-associated bloodstream infection (CLABSI) rates.
    Design: Quality improvement project.
    Setting: Inpatient units at a large, academic freestanding children's hospital.
    Participants: Data for inpatients with a CVC in place for ≥1 day between November 1, 2017 and October 31, 2018 were included.
    Intervention: A K-card was developed based on 7 core elements in our CVC maintenance bundle. During monthly audits, auditors used the K-cards to ask bedside nurses standardized questions and to conduct medical record documentation reviews in real time. Adherence to every bundle element was required for the audit to be considered "adherent." We recorded bundle reliability prospectively, and we compared reliability and CLABSI rates at baseline and 1 year after the intervention.
    Results: During the study period, 2,321 K-card audits were performed for 1,051 unique patients. Overall maintenance bundle reliability increased significantly from 43% at baseline to 78% at 12 months after implementation (P < .001). The hospital-wide CLABSI rate decreased from 1.35 during the 12-month baseline period to 1.17 during the 12-month intervention period, but the change was not statistically significant (incidence rate ratio [IRR], 0.87; 95% confidence interval [CI], 0.60-1.24; P = .41).
    Conclusions: Hospital-wide CVC K-card rounding facilitated standardized data collection, discussion of reliability, and real-time feedback to nurses. Maintenance bundle reliability increased after implementation, accompanied by a nonsignificant decrease in the CLABSI rate.
    MeSH term(s) Bacteremia ; Catheter-Related Infections/epidemiology ; Catheter-Related Infections/prevention & control ; Catheterization, Central Venous/adverse effects ; Central Venous Catheters/adverse effects ; Child ; Cross Infection/epidemiology ; Cross Infection/prevention & control ; Humans ; Infection Control ; Patient Care Bundles ; Reproducibility of Results
    Language English
    Publishing date 2020-06-04
    Publishing country United States
    Document type Journal Article
    ZDB-ID 639378-0
    ISSN 1559-6834 ; 0195-9417 ; 0899-823X
    ISSN (online) 1559-6834
    ISSN 0195-9417 ; 0899-823X
    DOI 10.1017/ice.2020.235
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Is the prescription right? A review of non-vitamin K antagonist anticoagulant (NOAC) prescriptions in patients with non-valvular atrial fibrillation. Safe prescribing in atrial fibrillation and evaluation of non-vitamin K oral anticoagulants in stroke prevention (SAFE-NOACS) group.

    Pharithi, Rebabonye B / Ranganathan, Deepti / O'Brien, Jim / Egom, Emmanuel E / Burke, Cathie / Ryan, Daniel / McAuliffe, Christine / Vaughan, Marguerite / Coughlan, Tara / Morrissey, Edwina / McHugh, John / Moore, David / Collins, Ronan

    Irish journal of medical science

    2018  Volume 188, Issue 1, Page(s) 101–108

    Abstract: Background: Non-vitamin K antagonist oral anticoagulants (NOACs) are a major advance for stroke ... prevention in atrial fibrillation (AF). Use of the vitamin K antagonist (VKA), warfarin, has dropped 40 ...

    Abstract Background: Non-vitamin K antagonist oral anticoagulants (NOACs) are a major advance for stroke prevention in atrial fibrillation (AF). Use of the vitamin K antagonist (VKA), warfarin, has dropped 40% since 2010 in our institution. There is limited Irish hospital data on NOAC prescribing for stroke prevention.
    Method: Single centre, retrospective observational cohort study of consecutive AF patients at increased risk of stroke and/or awaiting electrical cardioversion. Data on prescribed NOACs from February 2010 till July 2015 was collected from the electronic inpatient record. Appropriateness of prescriptions was based on CHA2DS2-VASC score and accuracy on individual NOAC SPCs. Potential drug interactions and bleeding risk were also quantified.
    Results: A total of 348 patients AF and increased risk of stroke (CHA2DS2-VASC score > 1 for men and > 2 for women) were studied. Forty-eight percent were female with a mean age 71 ± 18.6 years, 52% of whom were > 75. Mean CHA2DS2-Vasc and HAS-BLED scores were 4.1 ± 1.8 and 1.4 ± 0.8, respectively. Rivaroxaban, dabigatran and apixaban were prescribed to 154 (54.2%), 106 (34.3%) and 41 (13.2%) patients, respectively. 20.4% had inaccurate prescriptions; 92.9% (n = 65) underdosed and 7.1% (n = 5) on inappropriately higher doses. Neither choice of NOAC, age, history of anaemia, previous bleeding or co-prescribed antiplatelets influenced the accuracy of prescription (p = NS), but decreased renal function appeared to do so (p = 0.05).
    Conclusion: Our study highlights significant inaccuracies in NOAC prescribing. Patients commenced on NOACs should be assessed and followed up in a multidisciplinary AF clinic to ensure safe and effective prescribing and stroke prevention.
    MeSH term(s) Administration, Oral ; Aged ; Aged, 80 and over ; Anticoagulants/administration & dosage ; Anticoagulants/therapeutic use ; Atrial Fibrillation/drug therapy ; Dabigatran/therapeutic use ; Female ; Humans ; Inappropriate Prescribing/statistics & numerical data ; Male ; Medical Audit ; Middle Aged ; Prescriptions/statistics & numerical data ; Pyrazoles/therapeutic use ; Pyridones/therapeutic use ; Retrospective Studies ; Rivaroxaban/therapeutic use ; Stroke/prevention & control
    Chemical Substances Anticoagulants ; Pyrazoles ; Pyridones ; apixaban (3Z9Y7UWC1J) ; Rivaroxaban (9NDF7JZ4M3) ; Dabigatran (I0VM4M70GC)
    Language English
    Publishing date 2018-06-02
    Publishing country Ireland
    Document type Journal Article ; Observational Study
    ZDB-ID 390895-1
    ISSN 1863-4362 ; 0021-1265
    ISSN (online) 1863-4362
    ISSN 0021-1265
    DOI 10.1007/s11845-018-1837-7
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: ApoE deficiency exacerbates the development and sustainment of a semi-chronic K/BxN serum transfer-induced arthritis model.

    Archer, Amy M / Saber, Rana / Rose, Shawn / Shaffer, Alexander / Misharin, Alexander V / Tsai, FuNien / Haines Iii, G Kenneth / Dominguez, Salina / Eren, Mesut / Vaughan, Douglas E / Cuda, Carla M / Perlman, Harris

    Journal of translational medicine

    2016  Volume 14, Issue 1, Page(s) 170

    Abstract: ... and atherosclerosis in mice lacking ApoE.: Methods: K/BxN serum transfer-induced arthritis (STIA ...

    Abstract Background: The risk for developing cardiovascular disease is greater in patients with rheumatoid arthritis (RA) than in the general population. While patients with RA also have dyslipidemia, the impact of dyslipidemia on the severity of inflammatory arthritis and associated cardiovascular disease is unclear. Currently, there are conflicting results regarding arthritis incidence in apolipoprotein E (ApoE) deficient mice, which spontaneously exhibit both hyperlipidemia and atherosclerosis. Here, we utilize a distinct approach to investigate the contribution of a hyperlipidemic environment on the development of arthritis and atherosclerosis in mice lacking ApoE.
    Methods: K/BxN serum transfer-induced arthritis (STIA) was assessed in C57BL/6 (control) and ApoE(-/-) mice using clinical indices and immunohistochemical staining. Ankle synoviums were processed for flow cytometry. Aortic atherosclerosis was quantitated using Sudan IV staining. Serum cholesterol and cytokine levels were determined via enzymatic and luminex bead-based assays, respectively.
    Results: ApoE(-/-) mice developed a sustained and enhanced semi-chronic inflammatory arthritis as compared to control mice. ApoE(-/-) mice had increased numbers of foamy macrophages, enhanced joint inflammation and amplified collagen deposition versus controls. The presence of arthritis did not exacerbate serum cholesterol levels or significantly augment the level of atherosclerosis in ApoE(-/-) mice. However, arthritic ApoE(-/-) mice exhibited a marked elevation of IL-6 as compared to non-arthritic ApoE(-/-) mice and arthritic C57BL/6 mice.
    Conclusions: Loss of ApoE potentiates a semi-chronic inflammatory arthritis. This heightened inflammatory response was associated with an increase in circulating IL-6 and in the number of foamy macrophages within the joint. Moreover, the foamy macrophages within the arthritic joint are reminiscent of those within unstable atherosclerotic lesions and suggest a pathologic role for foamy macrophages in propagating arthritis.
    MeSH term(s) Animals ; Apolipoproteins E/deficiency ; Arthritis, Experimental/blood ; Arthritis, Experimental/pathology ; Cholesterol/blood ; Chronic Disease ; Disease Models, Animal ; Disease Progression ; Disease Susceptibility ; Female ; Inflammation/pathology ; Interleukin-6/blood ; Macrophages/pathology ; Male ; Mice, Inbred C57BL ; Serum ; Synovial Membrane/pathology
    Chemical Substances Apolipoproteins E ; Interleukin-6 ; Cholesterol (97C5T2UQ7J)
    Language English
    Publishing date 2016-06-10
    Publishing country England
    Document type Journal Article
    ISSN 1479-5876
    ISSN (online) 1479-5876
    DOI 10.1186/s12967-016-0912-y
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Parallel excitation in the human brain at 9.4 T counteracting k-space errors with RF pulse design.

    Wu, Xiaoping / Vaughan, J Thomas / Uğurbil, Kâmil / Van de Moortele, Pierre-François

    Magnetic resonance in medicine

    2009  Volume 63, Issue 2, Page(s) 524–529

    Abstract: ... when measuring k-space trajectories prior to parallel transmit RF pulse design (acceleration x4). Excitation ...

    Abstract Multidimensional spatially selective radiofrequency (RF) pulses have been proposed as a method to mitigate transmit B1 inhomogeneity in MR experiments. These RF pulses, however, have been considered impractical for many years because they typically require very long RF pulse durations. The recent development of parallel excitation techniques makes it possible to design multidimensional RF pulses that are short enough for use in actual experiments. However, hardware and experimental imperfections can still severely alter the excitation patterns obtained with these accelerated pulses. In this note, we report at 9.4 T on a human eight-channel transmit system, substantial improvements in two-dimensional excitation pattern accuracy obtained when measuring k-space trajectories prior to parallel transmit RF pulse design (acceleration x4). Excitation patterns based on numerical simulations closely reproducing the experimental conditions were in good agreement with the experimental results.
    MeSH term(s) Algorithms ; Artifacts ; Brain/anatomy & histology ; Humans ; Image Enhancement/methods ; Image Interpretation, Computer-Assisted/methods ; Information Storage and Retrieval/methods ; Magnetic Resonance Imaging/methods ; Reproducibility of Results ; Sensitivity and Specificity ; Signal Processing, Computer-Assisted
    Language English
    Publishing date 2009-12-17
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 605774-3
    ISSN 1522-2594 ; 0740-3194
    ISSN (online) 1522-2594
    ISSN 0740-3194
    DOI 10.1002/mrm.22247
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: THE EFFECT OF STRESS ON THE MMPI SCALES K AND D.

    VAUGHAN, R P

    Journal of clinical psychology

    2003  Volume 19, Page(s) 432

    MeSH term(s) Catholicism ; Humans ; MMPI ; Mental Disorders ; Stress, Physiological
    Language English
    Publishing date 2003-07-08
    Publishing country United States
    Document type Journal Article
    ZDB-ID 219160-x
    ISSN 1097-4679 ; 0021-9762
    ISSN (online) 1097-4679
    ISSN 0021-9762
    DOI 10.1002/1097-4679(196310)19:4<432::aid-jclp2270190419>3.0.co;2-8
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: A synchrotron-radiation study of the lactone form of rhodamine B at 120 K

    Kvick / Vaughan / Wang / Sun / Long

    Acta crystallographica. Section C, Crystal structure communications

    2000  Volume 56 Pt 10, Page(s) 1232–1233

    Abstract: ... xanthene-9, 3'-isobenzofuran]-1'-one, C(28)H(30)N(2)O(3), has been determined at 120 K using synchrotron ...

    Abstract The structure of the lactone form of rhodamine B, 3, 6-bis(diethylamino)-1',3'-dihydrospiro[xanthene-9, 3'-isobenzofuran]-1'-one, C(28)H(30)N(2)O(3), has been determined at 120 K using synchrotron radiation at a wavelength of 0.496 A. The structure contains two independent rhodamine B molecules with virtually identical geometry. The xanthene main planes of the molecules are inclined at an angle of 41.6 (2) degrees to one another. Molecule 2 has a statistically disordered ethyl group, with 71% in one orientation and 29% in a second orientation. The lactone C-O bonds are 1.497 (1) and 1.495 (1) A. There are no classical hydrogen bonds, but the structure is stabilized by two short C.O interactions. The crystals of the lactone form were produced by a novel hydrothermal reaction.
    Language English
    Publishing date 2000-10
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2025703-X
    ISSN 1600-5759 ; 2053-2296 ; 0108-2701
    ISSN (online) 1600-5759 ; 2053-2296
    ISSN 0108-2701
    DOI 10.1107/s0108270100008404
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article: Affordability of an NGO-government partnership for community-based disability rehabilitation.

    Vaughan, Kelsey R / Thapa, Ram K

    African journal of disability

    2023  Volume 12, Page(s) 1283

    Abstract: Background: Tunafasi is a community-based rehabilitation (CBR) programme for persons with disability, implemented by a local non-governmental organisation in Uvira, Democratic Republic of Congo, in partnership with government. To assess affordability ... ...

    Abstract Background: Tunafasi is a community-based rehabilitation (CBR) programme for persons with disability, implemented by a local non-governmental organisation in Uvira, Democratic Republic of Congo, in partnership with government. To assess affordability and support discussions with the government about continued financing and implementation, Tunafasi representatives commissioned a cost-effectiveness study of the programme's health component.
    Objectives: This study aimed to estimate the programme's impacts, costs, cost per disability-adjusted life year (DALY) averted and affordability of the health component implemented from February 2019 to December 2021.
    Method: Health-related improvements were assessed for a sample of 511 persons with disability and converted to DALYs averted. Total expenditure during the period February 2019 to December 2021 was estimated from audited financial statements. The cost per DALY averted was estimated by dividing total programme expenditure by the sum of DALYs averted and compared against newly generated, country-specific thresholds to assess affordability.
    Results: The programme cost $55 729.00 to implement from February 2019 to December 2021 and averted 234 DALYs in 511 persons, at a cost per DALY averted of $224.00. This falls above the affordability threshold of $54.00 - $199.00.
    Conclusion: While the cost per DALY averted is higher than what thresholds consider affordable for Democratic Republic of Congo, improved engagement from CBR facilitators and greater possibilities for treatment in the post-pandemic era should improve results.
    Contribution: This new CBR implementation modality offers a possibly affordable solution to African governments struggling to operationalise disability commitments such as United Nations Convention on the Rights of Persons with Disabilities.
    Language English
    Publishing date 2023-12-22
    Publishing country South Africa
    Document type Journal Article
    ZDB-ID 2733893-9
    ISSN 2226-7220 ; 2223-9170
    ISSN (online) 2226-7220
    ISSN 2223-9170
    DOI 10.4102/ajod.v12i0.1283
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Conference proceedings ; Online: Maximising the power of diversity and inclusion within the CGIAR family

    Vaughan, Kathleen

    2022  

    Abstract: The purpose of the Diversity and Inclusion Conference is to draw attention to the areas where there is still room for improvement with respect to (gender) diversity and inclusion, and to find ways together to work on these improvements both in research ... ...

    Abstract The purpose of the Diversity and Inclusion Conference is to draw attention to the areas where there is still room for improvement with respect to (gender) diversity and inclusion, and to find ways together to work on these improvements both in research and in the workplace. February 2017
    Keywords research ; gender ; improvement ; inclusion ; power ; diversity ; agricultural research
    Language English
    Publishing date 2022-08-23T17:34:39Z
    Publisher QED Consulting
    Publishing country fr
    Document type Conference proceedings ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  10. Article: A short period of hypoxia produces a rapid and transient rise in [K+]e in rat hippocampus in vivo which is inhibited by certain K(+)-channel blocking agents.

    Zetterström, T S / Vaughan-Jones, R D / Grahame-Smith, D G

    Neuroscience

    1995  Volume 67, Issue 4, Page(s) 815–821

    Abstract: Extracellular potassium concentrations, [K+]e, were measured in vivo in the rat dorsal hippocampus ... from 20% O2/80% N2 to 10-0% O2/90-100% N2 for 0.5-2 min. Resting [K+]e in the dorsal hippocampus was 3.4 ... 0.09 mM; 0.5, 1 or 2 min of 100% N2 administration caused a rapid rise of [K+]e to 0.75, 1.9 and 15 ...

    Abstract Extracellular potassium concentrations, [K+]e, were measured in vivo in the rat dorsal hippocampus using valinomycin-based double-barrelled ion-selective microelectrodes. Experiments were conducted under chloral hydrate anaesthesia. The microelectrodes were implanted stereotaxically, after which different gas mixtures were administered by inhalation. Transient hypoxia was induced by changing the inspired gas from 20% O2/80% N2 to 10-0% O2/90-100% N2 for 0.5-2 min. Resting [K+]e in the dorsal hippocampus was 3.4 +/- 0.09 mM; 0.5, 1 or 2 min of 100% N2 administration caused a rapid rise of [K+]e to 0.75, 1.9 and 15 mM, respectively. Following 0.5 min of 100% N2, the switch back to 20% O2/80% N2 produced an almost instantaneous return to normal levels. The return of [K+]e to basal levels was more delayed after 1 or 2 min of 100% N2 inhalation. The rise of hippocampal [K+]e induced by hypoxia was influenced by body temperature, the increase being five-fold higher in rats whose body temperature was raised from 33 to 37 degrees C using a heating blanket. Three potassium-channel blocking agents, quinine, 4-aminopyridine and gliquidone, were tested for their action on the increase in [K+]e, induced by inhalation of 100% N2 for 0.5 min. Both 4-aminopyridine and quinine, administered systemically, attenuated the anoxia-induced rise in [K+]e by 70 and 35%, respectively. In contrast, gliquidone, given by intracerebroventricular injection, had no effect, suggesting that ATP-sensitive potassium channels are not involved in this very early change in [K+]e.
    MeSH term(s) Animals ; Hippocampus/physiopathology ; Hypoxia ; Male ; Nitrogen/pharmacology ; Potassium/metabolism ; Potassium Channel Blockers ; Pulmonary Gas Exchange ; Quinine/pharmacology ; Rats ; Rats, Sprague-Dawley ; Sodium Chloride/pharmacology ; Time Factors
    Chemical Substances Potassium Channel Blockers ; Sodium Chloride (451W47IQ8X) ; Quinine (A7V27PHC7A) ; Nitrogen (N762921K75) ; Potassium (RWP5GA015D)
    Language English
    Publishing date 1995-08
    Publishing country United States
    Document type Journal Article
    ZDB-ID 196739-3
    ISSN 1873-7544 ; 0306-4522
    ISSN (online) 1873-7544
    ISSN 0306-4522
    DOI 10.1016/0306-4522(95)00107-t
    Database MEDical Literature Analysis and Retrieval System OnLINE

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