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Biomedical subjects

D Southall

Publications and source records attributed to D Southall.

At least 19 recordsLinked to original sources
PubMed2000

Maternal behaviors associated with smothering: a preliminary descriptive study.

OBJECTIVES: To describe maternal behavior in 15 women identified as having smothered their children. DESIGN: A descriptive study of maternal behavior and interaction with her child, using videotapes of mother and child together. These were obtained by covert video surveillance in a hospital setting. Maternal behavior was rated using an assessment schedule designed to be used with video. RESULTS: The mothers showed a range of behaviors. Three groups emerged; one whose interaction with the child resembled normal maternal behavior, a second who interacted in a hostile way, and a third who showed a paucity of interaction. CONCLUSION: These preliminary data suggest that smothering may reflect more than one type of abnormal maternal relationship or attitude towards children. This may have implications for treatment and prognosis.

Adult↗
PubMed1999

The experiences and views of parents who care for ventilator-dependent children.

Discussion in this paper is drawn from the literature examining the management of children with long-term assisted ventilation, and a study of parents' experiences and views of caring for their ventilator-dependent child at home. Difficulties in undertaking research into this group of children are highlighted. Recommendations are proposed regarding future multidisciplinary, multiagency service development in order to meet the needs of ventilator-dependent children and their families.

Adaptation, Psychological↗
PubMed1999

Haemodynamic effects of altering arterial oxygen saturation in preterm infants with respiratory failure.

AIMS: To examine the haemodynamic effects of brief alteration in arterial oxygenation in preterm infants with respiratory failure. METHODS: Eighteen preterm infants with respiratory failure, aged 9-76 hours, underwent detailed Doppler echocardiographic assessment at 86%, 96%, and 100% SaO2, achieved by altering the FIO2. Sixteen were receiving intermittent positive pressure ventilation, median FIO2 0.45 (0.20-0.65), median mean airway pressure 12 cm H2O (0-20). SaO2 was stable for 15 minutes at each stage. Four parameters of pulmonary arterial pressure were measured: peak velocity of tricuspid regurgitation and peak velocity of left to right ductal flow, TPV:RVET ratio and PEP:RVET ratio, measured at the pulmonary valve, along with flow velocity integrals at the aortic and pulmonary valves, and systemic arterial pressure. Ductal size was graded into closed, small, moderate, large with imaging, pulsed and continuous wave Doppler. RESULTS: Between 86% and 96% SaO2, there were no consistent changes, but in three of the 12 with a patent ductus arteriosus (PDA) there was ductal constriction, with complete closure in one. Between 96% and 100% SaO2, peak ductal flow velocity rose significantly in four of eight with a PDA. Ductal constriction occurred in four infants; in three this was associated with a significant fall in aortic flow integral and a rise in aortic pressure (4-6 mm Hg). Overall, 11 infants went from 86% to 100% SaO2 and pulmonary arterial pressure fell significantly in seven. CONCLUSION: A brief rise in SaO2 within the range maintained by most neonatal units can cause significant ductal constriction. The fall in pulmonary arterial pressure with 100% SaO2 seen in most infants was associated with a fall in pulmonary blood flow (or no change), rather than a rise, indicating that the dominant haemodynamic effect was ductal constriction rather than pulmonary vasodilation.

Confidence Intervals↗
PubMed1998

Increased amplitude modulation of continuous respiration precedes sudden infant death syndrome -detection by spectral estimation of respirogram.

The immaturity of the control of the autonomic nervous system has been suggested as one of the key factors in the pathophysiology of sudden infant death syndrome (SIDS). Therefore, the attenuated control of respiration may also cause more slow oscillatory breathing among infants at risk of SIDS. In this study, patterns of respiratory activity (RAV) and heart rate variability (HRV) were examined in Medilog-records prospectively obtained from 22 tape recordings made on 16 babies subsequently suffering from SIDS and from 22 matched control babies. A total of 248 signal segments, 120 s in duration, representing the state of regular breathing were visually selected for further analysis. The digitised signal sets were detrended, Fast-Fourier-transformed and autospectra as well as cross-spectra for the HRV and HRV were computed. The RAV and HRV were examined at two spectral bands: (1) a low frequency (LF) band 0.03-0.17 Hz (1.8-10 cycles/min) and (2) a high frequency (HF) band 0.3-1.3 Hz (18-90 cycles/min). Different parameters of each band were tested in the spectral analysis of cardiorespiratory control. The LF/HF-ratio of the spectral peak area of the respiratory activity and the LF/HF-ratio of the spectral band area of the respiratory activity were greater in the SIDS group when compared to the controls. No significant intergroup differences were found in the parameters of HRV, or the cross-spectral parameters. Interestingly, the technique appeared helpful in displaying that the victims of SIDS had a significantly greater amount of slow oscillation in the continuous respiratory signal (1.05+/-1.89 vs. 0.41+/-0.57, P=0.02). In the victims of SIDS the respiratory control system seems to be less stable and cause more slow oscillatory breathing and this can be detected using spectral analysis of respiratory activity even during breathing that visually seems to be regular.

Autonomic Nervous System↗
PubMed1996

Home monitoring of infants at increased risk of sudden death.

Home apnoea and cardiorespiratory monitors are commonly used in the UK, the rest of Europe and USA in infants at increased risk of 'sudden infant death'. The efficacy of apnoea and cardiorespiratory monitors remains unknown. The use of transcutaneous oxygen monitoring is presented as an alternative method of home monitoring. Recommendations are proposed regarding nursing practice and the future of home monitoring in infants at increased risk of sudden death.

Attitude to Health↗