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Biomedical subjects

M Farrell

Publications and source records attributed to M Farrell.

At least 91 records · Page 5Linked to original sources
PubMed1995

The effect of a child's hospitalisation on the parental role.

Hospitalisation of a child is likely to lead to emotional, social and environmental disturbance for the family and will affect the parental role. A number of factors may influence parental adaptation to the situation. It is essential that health-care staff build caring relationships with the sick child's parents.

Adult↗
PubMed1995

Prehospital actions by health-care providers and physicians.

Extensive worldwide experience and literature exist on the benefits of early intervention in patients with an acute myocardial infarction. To make these benefits available to as much of the population as possible a number of goals have to be accomplished. Patients and bystanders must be taught to recognize the significance of symptoms and call immediately for assistance. Local emergency medical service has to dispatch appropriate personnel and equipment to the scene expeditiously. Transport without unacceptable delays must occur to appropriate facilities along with rapid initiation of treatment. A program to achieve these goals would be expected to substantially reduce morbidity and mortality. Attention is directed to prehospital actions by health-care providers including dispatch of personnel and equipment to the scene, stabilization and treatment in the field, and triage and transport of the patient to the most appropriate medical facility.

Emergency Medical Services↗
PubMed1995

The aesthetic nose: do we agree?

The surgeon and patient use the preoperative consultations to develop an agreement regarding the aesthetic goals of a rhinoplasty. This study was designed to evaluate whether people do agree on what makes a nose attractive. Computerized video-imaging technology was used to create nine case studies. The graphics software permitted precise modification to either tip projection, tip rotation, or size of the dorsal hump. Only one parameter was altered in each case. Two hundred fifty judges were asked to identify the most attractive image in each case study. Significant trends were observed in each case, but every image received the preference of some judges. Most judges preferred midrange values in eight of nine cases, but overrotation of the tip was preferred to tip droop, overremoval of the dorsal hump was preferred to underremoval, and overprojection of the tip was preferred to underprojection. The discrepancy in what constitutes an aesthetic nose reinforces the need for the surgeon to clearly understand the patient's specific requests rather than to aim to produce a "standard nose.".

Humans↗
PubMed1994

The spectrum of bile duct complications in pediatric liver transplantation.

It has been noted that reduced-size liver transplants are associated with increased rates of biliary complications, and it has been suggested that some of these complications can be handled nonoperatively. In a 6-year period, 91 orthotopic liver transplants were performed in 77 children. The medical records were reviewed to analyze the effect of reduced-size grafts on the incidence of bile duct complications and to investigate the utility of interventional radiology techniques for treatment. Forty-two children received 47 whole-organ transplants, and 35 children received 44 reduced-size transplants. The median age and weight were greater for children receiving whole-organ transplants (age, 4.25 years; weight, 16 kg) than for those receiving reduced-size grafts (age, 1.0 year; weight, 8 kg). The overall incidence of bile duct complications was 19.5% (n = 15). The incidence was not different between the whole organ group (17%) and the reduced-size group (16%). Four of the children with bile duct complications had associated hepatic artery thrombosis, two of whom had another transplant. Complications included anastomotic stricture (n = 6), anastomotic leak (n = 5), intraparenchymal biloma (n = 3), and multiple strictures (n = 1). Twelve of 15 children presented within 3 months of transplantation. Six children had initial percutaneous drainage or placement of transanastomotic stents (external). Operative repair was eventually required for all 15 children, three of whom received a second transplant. There was a 40% incidence of cytomegalovirus infection involving the liver or extrahepatic bile ducts near the time of presentation.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1994

Hungarian midwives and their practice: a national survey.

In 1975 the Hungarian educational system for midwives was shortened from a three year programme to one of ten months duration in order to provide a more immediate supply of midwives in a relatively short period of time, and to reduce the costs associated with midwifery education. Ten years after the educational programme change, a national survey of Hungarian midwives (n = 290) was conducted by the European Regional Office of the World Health Organization and the Hungarian Ministry of Health. This study describes the effects of the two educational programmes and years of practice on Hungarian midwives' self-perception of competency, satisfaction and summative score of responsibility and autonomy. Significantly different group mean scores on variables related to competency and satisfaction were found for the two groups.

Adult↗
PubMed1994

Opiate withdrawal.

Opiate withdrawal is one of the longest studied and most well described withdrawal syndromes. Opiate withdrawal has been described as akin to a moderate to severe flu-like illness. Opiate withdrawal is appropriately described as subjectively severe but objectively mild. This paper describes the mechanisms of opiate dependence and opiate withdrawal and reviews the available instruments for the measurement of withdrawal. The time course of assisted and unassisted withdrawal is described and the range of options for the management of assisted withdrawal are described. This review concludes that the most effective and least time- and resource-consuming approach to opiate withdrawal will substantially contribute to the overall social management of opiate dependence.

Animals↗
PubMed1994

Innovations in case flow analysis: using midlier variance analysis.

This article presents the use of midlier and case flow analysis during a retrospective chart review to study the costs of hospital length of stay. The results showed that considerable savings can be realized by using these methods for one group of patients with the same diagnosis. We were able to redefine and track patients during their pre-, peri-, and postoperative period and estimated the time and cost opportunities for work flow improvement. We concluded that considerable savings are possible by extending the analysis to patients in other DRG groups.

Analysis of Variance↗
PubMed1994

Influencing physician behavior with CQI: a case study.

Health care reform will require unprecedented levels of cooperation among physicians, health care administrators, and other providers in order to ensure high-quality, affordable care for all. At the University of Massachusetts Medical Center, CQI techniques helped engage physicians in an effort to substantially alter ordering patterns to cut costs and achieve quality goals.

Academic Medical Centers↗
PubMed1994

Positive social interdependence and classroom climate.

We explored the relationship between student perceptions of social interdependence and social support. Attitudinal responses to the Classroom Life Instrument (Johnson & Johnson, 1983; Johnson, Johnson, & Anderson, 1983; Johnson, Johnson, Buckman, & Richards, 1985) were gathered in Canada from four classes totaling 123 eighth-grade students learning geometry in cooperative groups. We extended previous findings by examining the relationships among the classroom climate variables, causal attributions, and achievement, and explored the consistency among the four classroom climate studies using statistical methods for meta-analysis to determine overall effect magnitudes and the degree of study-to-study variability. Social support from the teacher and fellow students was moderately related to perceptions of positive interdependence, but social interdependence factors were less important predictors of student learning than was student self-esteem.

Achievement↗
PubMed1994

Continuous improvement, quality control, and cost containment in clinical laboratory testing. Enhancement of physicians' laboratory-ordering practices.

In 1991, the University of Massachusetts Medical Center, in Worcester, developed a model for change by using a program of continuous quality improvement to enhance physicians' laboratory-ordering practices, particularly the test for bleeding times. We describe a model that was developed through a seven-step continuous quality improvement process, and we discuss our success in increasing the appropriateness of ordering the tests for bleeding times while significantly reducing the costs for patients and hospitals. The following factors contributed to the program's success: an advisory structure; presentations to the medical staff; focused feedback sessions; and most important, well-documented guidelines with institutional support for new behavior.

Clinical Laboratory Techniques↗