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Biomedical subjects

S Driscoll

Publications and source records attributed to S Driscoll.

18 recordsLinked to original sources
PubMed1993

Suggested approaches for research protocols involving the potential for life-threatening reactions.

These guidelines are intended to reduce the potential for serious or life-threatening reactions when clinical research is conducted. The following issues were addressed: identifying the risks involved in the research, providing adequate safeguards in the protocol design and during withholding of medication, anticipating risks, minimizing the chances for human error, providing resuscitative equipment sufficient to deal with the most serious anticipated life-threatening reactions, planning for medical support in case of a life-threatening emergency, and optimizing the use of medical personnel and expertise to handle emergency situations. The guidelines also discuss important general issues about protocol design and implementation and the human subject consent form, which should facilitate the approval of protocols by the governing institutional review board. The guidelines are not meant to be inflexible or applicable to all research situations. However, it is our hope that they will allow for clinical research to be conducted in a manner that affords the research subjects a high degree of protection from unnecessary and possibly fatal injuries.

Bronchi↗
PubMed1989

Anesthetic-related maternal mortality, 1954 to 1985.

This is a population-based study of the safety of obstetrical anesthesia in the Commonwealth of Massachusetts between 1954 and 1985. We used data collected by the state Committee on Maternal Mortality, which was founded in 1941. There were a total of 37 maternal deaths during the study period due to anesthetic-related complications. During the same time period, there were 886 maternal deaths. Thus, anesthetic-related mortality comprised 4.2% of all deaths, and the mortality rate was 1.5 per 100,000 live births between 1955 and 1964, 1.5 per 100,000 live births between 1965 and 1974, and 0.4 per 100,000 live births between 1975 and 1984. In the first decade of this study, aspiration during administration of a mask anesthetic was the primary cause of death. During the second decade, cardiovascular collapse associated with regional anesthesia was the primary cause of death. During the last decade of this study, all deaths were associated with general endotracheal anesthesia. As a result of this study and having identified the changes in the standard of care in Massachusetts that led to the reduction in maternal mortality, we offer recommendations to further improve the safety of anesthesia for childbirth in this country.

Adolescent↗
PubMed1988

Cesarean section-related maternal mortality in Massachusetts, 1954-1985.

We analyzed the data of the Maternal Mortality Committee of the Massachusetts Medical Society to investigate cesarean section-associated maternal deaths. Between 1954-1985, the number of cesarean section-related deaths per 100,000 live births did not significantly change despite a quadrupling of the cesarean section rate. Between 1976-1984, there were 649,375 births and 121,217 cesarean sections in the state. Seven deaths were directly related to cesarean section, a rate of 5.8 per 100,000 cesarean sections. In contrast, the rate for vaginal deliveries was 10.8 per 100,000 vaginal deliveries. We conclude that the risk of maternal death from cesarean section is low.

Cesarean Section↗
PubMed1984

Gangliosidoses and the fetal retina.

Abnormal membranous cytoplasmic inclusions were found in the retinal ganglion cells of two fetuses with gangliosidosis. One was a documented case of incipient Tay-Sachs disease (Gm2) and the other a case of generalized gangliosidosis (Gm1). Both specimens were obtained iatrogenically in the 20th to 21st week of gestation after amniocentesis had indicated the enzyme deficiency.

Amniocentesis↗
PubMed1977

The radiographic features of early onset Group B streptococcal neonatal sepsis.

The clinical and radiographic features of 27 newborn infants with early onset Group B streptococcal infection as documented by blood culture have been reviewed. Initial chest radiographs revealed a wide spectrum of patterns. These included changes usually associated with the respiratory distress syndrome, extensive pneumonia, and small infiltrates as well as a normal appearance. Premature birth and a fatal outcome were associated with extensive radiographic changes. At autopsy some of the infants with a radiographic appearance of respiratory distress syndrome had pathologic features of Group B streptococcal infection with no apparent evidence of coexisting respiratory distress syndrome.

Humans↗
PubMedDate not supplied

Establishing a new pediatric intensive care unit.

Pediatric intensive care is a collaborative practice of dedicated personnel, advanced technology and a diverse group of support services. Unit design must focus on current patient needs while envisioning the technological and clinical needs of the future. With insight and a cooperative effort, your design team can effectively transform ideas into a unit committed to the care of critically ill children.

Child↗
PubMedDate not supplied

Complexity of change--achieving social equilibrium beyond the restructuring of health services in New Zealand.

Initial and exploratory research (Driscoll, 1993) demonstrates that most of the general public and health professionals have not moved out of Lewins (1951) first stage of unfreezing when attitudes to the current health reforms are appraised. People are bewildered with continual change process in the health system. Any potential benefits are being lost in the perception of loss. The new "managers" with the responsibility of reforming an overworked health system may discover the biggest achievement will be to change attitudes of clients and health professionals so that there can be a renewed, revitalized team approach to a system confident of delivering a quality service.

Attitude to Health↗
PubMedDate not supplied

Nurses' perceptions of their health educator role.

A questionnaire was designed to describe and understand the role of the registered nurse in patient teaching as perceived by nurses. The questionnaire was distributed to 1355 nurses working in an acute care tertiary teaching hospital. The data indicated most nurses expressed strong agreement with the majority of items relating to their skill and educational preparation to teach patients. Selected questions relating to the nurse's role as a patient educator showed nurses viewed their patient education role as satisfying and expected by their patients. Needs relating to their patient education role included: additional time to teach patients, more educational materials, peer feedback regarding teaching effectiveness, and sufficient medical information. Additionally, the majority of nurses perceived that patients did not have sufficient knowledge to care for themselves after leaving the hospital and that too much information about their condition was withheld from them. Summary scales showed significant differences in area of work and position with the nurse's perception of the health educator role.

Clinical Competence↗