bluuebunny/crossref_metadata_2025 huggingface dataset:
Exposure to nitrous oxide in a paediatric dental unit
Authors: GILCHRIST FIONA , WHITTERS C. JOHN , CAIRNS ALISON MARION , SIMPSON MATTHEW , HOSEY MARIE‐THÉRÈSE
Published: February 2007

Objective.  The aim of this study was to evaluate the 8‐h time‐weighted average (8‐h TWA) exposure to nitrous oxide of dentists working in a paediatric dental unit, and to relate this to various operator, patient and environmental factors.

Methods.  This prospective, open‐label study monitored nitrous oxide levels using either a personal dosimeter or an electronic sensor worn by the operator. Information was recorded by three dental operators administering nitrous oxide/oxygen for inhalational sedation. Thirty‐four paediatric dental patients were treated over a total of 17 treatment sessions.

Results.  Active scavenging was used for all children; 23 were treated using the Porter‐Brown scavenging system and 11 with the Accutron system. Exposure to nitrous oxide expressed as an 8‐h TWA ranged from 16 to 374 ppm, with a mean of 151 ppm. The recommended 8‐h TWA of 100 ppm was achieved in only 38% of cases. Ambient nitrous oxide levels apparently increased with restorative treatment, poorer behaviour, when the extractor fan was switched off, with patients over 10 years of age and an increased number of sequential patients.

Conclusions.  This study found that the recommended 8‐h TWA was achieved in only 38% of treatment episodes, despite the use of active scavenging.
Patient autonomy in nurse‐led shared care: a review of theoretical and empirical literature
Authors: Moser Albine , Houtepen Rob , Widdershoven Guy
Published: February 2007

Title. Patient autonomy in nurse‐led shared care: a review of theoretical and empirical literature

Aim.  This paper presents a review of the theoretical and empirical literature addressing patient autonomy and how nurses can support patient autonomy.

Background.  Nurse‐led, shared care settings provide needs‐based care to patients who are encouraged to participate actively in their care. Patient autonomy is a complex ethical concept with many different meanings. As a result, nurses must solve various problems to foster patient autonomy successfully.

Method.  Two methods were used to identify literature for the review: (a) a search of the MEDLINE, Embase, CINAHL and Online Contents databases and the keywords ‘patient autonomy’ in combination with ‘nursing’, and the Dutch Central Catalogue for material published from 1966 to 2005; (b) ethical and nursing literature was selected on the basis of its identification of positive and negative freedom. We reviewed qualitative empirical research to explore the patients’ views of autonomy.

Findings.  Negative freedom emphasizes freedom of action and freedom from interference by others. Positive freedom stresses the idea that people should direct their lives according to their personal convictions and individual reasons and goals. The most prominent theories fitting negative freedom are those defining autonomy as self‐governance and self‐care. Theories fitting positive freedom are those focusing on autonomy in caring, autonomy as identification, autonomy as communication and autonomy as goal achievement. In the empirical literature, two studies centred on patient autonomy in home care, one in nursing home care and three in hospital settings. To achieve autonomy, patients prefer a mixed approach that combines features of negative and positive freedom.

Conclusion.  Nurses cannot rely exclusively on one model of autonomy to foster patient autonomy. Rather, it requires in‐depth knowledge of, and interaction with, patients in the context of each particular nursing encounter because people express their autonomy through particular courses of action.
Activity of the Notch‐signalling Pathway in Circulating Human Chronic Lymphocytic Leukaemia Cells
Authors: Hajdu M. , Sebestyén A. , Barna G. , Reiniger L. , Jánosi J. , Sréter L. , Várkonyi J. , Demeter J. , Kopper L.
Published: February 2007

Dysregulation of the Notch‐pathway has been implicated in the pathogenesis of chronic lymphocytic leukaemia (B‐CLL). We characterized the mRNA expression of Notch pathway elements in circulating normal B‐ and B‐CLL cells, and compared expression profiles with clinical and prognostic data. Similar expression profiles were found in normal B‐cells and B‐CLL cells, however, most B‐CLL samples showed lower Hairy/Enhancer of Split‐1 expression than normal B‐cells, which suggests that the pathway is not over‐activated in B‐CLL. The expression of Notch‐pathway genes did not correlate with other prognostic factors of B‐CLL. The importance of Notch‐signalling in CLL cells in lymphatic tissue microenvironments remains to be determined.
Outcomes of invasive zygomycosis infections in renal transplant recipients
Authors: Forrest G.N. , Mankes K.
Published: February 2007

Abstract: Zygomycosis is an infrequent and difficult‐to‐treat fungal infection that is found in patients with underlying immunocompromised states. The advent of the lipid amphotericin B products has allowed for treatment with higher doses of therapy and less systemic toxicity. We reviewed the outcomes of 6 renal transplant recipients diagnosed with biopsy‐proven invasive zygomycosis who received amphotericin B lipid complex (ABLC) in doses greater than 5 mg/kg between 2000 and 2004. All 6 patients had baseline diabetes mellitus, were receiving immunosuppressive agents, and subsequently underwent concomitant surgery. Three of the 6 patients that survived had undergone significant surgical debridement, reduction of their immunosuppression to minimal prednisone, and received prolonged course of ABLC at 10 mg/kg/day. All survivors lost graft function during the course of their therapy. The 3 patients who died all had delays in diagnosis of their disease and subsequent surgical and appropriate medical therapy. Therefore, in renal transplant recipients the early diagnosis of invasive zygomycosis is imperative along with early therapy with surgical debridement, reduced immunosuppression, and the use of high doses of ABLC.
Resistance to positivist science in nursing: An assessment of the Australian literature
Authors: Holmes Colin A
Published: February 2007

This paper begins with a short review of some of the major sources of the critique of traditional science. It provides a context in which to assess the extent of the challenge posed by Australian nursing to traditional concepts of positivist science and the associated technoscience project. Resistance to scientization in nursing research, education and clinical practice is outlined with specific reference to the substantial and growing Australian literature.
Negotiating realistic and mutually sustaining nurse‐patient relationships in palliative care
Authors: Barthow Christine
Published: February 2007

Barthow C. International Journal of Nursing Practice 1997;3:206–210

Negotiating realistic and mutually sustaining nurse–patient relationships in palliative care

This paper uses a literature review to question the proposition that nurses will be permitted to care for the psychosocial and spiritual needs of patients in the manner that is frequently presented as the nurses role. Second, it will explore qualities in nurse‐patient relationships that can be not only helpful to those who are cared for but also can be a mode of sustenance to the nurse. Issues explored are the social construction of the nurse–patient relationship, reality checking, balancing emotional and cognitive functions in nursing, focus of nursing commitment, power issues, reciprocity and boundaries. Palliative care nursing will be referred to in relation to these themes as it is an area of nursing which highlights the increasing focus on psychosocial care. For this reason questions of what is realistic and sustainable for the nurse are of prime importance.
ENDOVASCULAR REPAIR OF CHRONIC MESENTERIC OCCLUSIVE DISEASE: THE ROLE OF DUPLEX SURVEILLANCE
Authors: Fenwick Joanna L. , Wright Isabel A. , Buckenham Tim M.
Published: February 2007

Background:  Chronic occlusive mesenteric ischaemia can be treated surgically or endovascularly. Endovascular techniques as elsewhere in the vascular tree are limited by restenosis. The aim of this study was to determine if duplex ultrasound proven restenosis correlates with recurrence of symptoms.

Methods:  Our study looks at successful percutaneous revascularization of the mesenteric circulation associated proven restenosis using colour Doppler ultrasound and the relation to recrudescence of symptoms or weight loss. A retrospective review of five patients treated endovascularly at our institution for mesenteric angina secondary to visceral artery stenosis was carried out.

Results:  Technical success was achieved in four out of the five patients in our study. One patient had a procedure complicated by thrombus in the coeliac axis and superior mesenteric artery (SMA) stents, subsequently showed SMA occlusion and 90% stenosis of the CA and inferior mesenteric artery and required an aorto‐mesenteric graft. Three of the four patients with a technically successful procedure had significant (>70%) restenosis of the SMA. All three, including one patient with both SMA restenosis and chronic inferior mesenteric artery occlusion, remain asymptomatic and have maintained their postprocedural weight gain.

Conclusion:  Although ultrasound is a convenient, non‐invasive tool for follow up of endovascular treatment of mesenteric stenosis, its use is unclear as in our study restenosis did not correlate with recrudescence of symptoms.
Gas exchange, metabolic rate and fluid requirements during anaesthesia of acyanotic and cyanotic infants and children with congenital heart malformations
Authors: GRIGSBY E.J. , BEYNEN F.M.K. , LINDAHL S.G.E.
Published: February 2007

In order to study gas exchange and metabolic rate in anaesthetized children scheduled for corrective cardiac surgery and to find out if chronic hypoxaemia influenced gas exchange and energy expenditure, oxygen consumption (V̇O2) and carbon dioxide elimination (Vdot;co2) were measured and energy expenditure (E) was calculated. Infants and children whose haematocrit (Hct) was less than 44% and arterial oxygen saturation (Sao2) on room‐air was greater than 93% were classified as acyanotic (group AC, n= 11, weight range 3.7 to 20 kg), and those whose Hct was higher than 44% and Sao2 less than 93% as cyanotic (group C, n= 14, weight range 3.4 to 24.3 kg). The majority of children in both groups weighed less than the 50th percentile for normal children. There was no difference in V̇o2, V̇co2 and E between the groups. These variables were related to weight according to the following expressions: V̇o2 (ml min−1) = 6.1 × kg + 21.6, r= 0.95; V̇co2 (ml min−1) = 5.7 × kg + 2.9, r= 0.96, and E (kcal h−1) 1.8 × kg + 5.3; E (J h−1) = 7.6 × kg + 22.3, r= 0.96. Fluid volumes (FV) could be calculated according to the expression: FV (ml h−1) = 3.0 × kg + 8.7; r= 0.96. Oxygen consumption was 15 to 20% higher in anaesthetized infants and children with congenital heart malformations than in anaesthetized infants and children with normal cardiopulmonary function. Accordingly, energy expenditure and fluid requirements were also higher. This difference was most probably due to an undernutrition in children with congenital heart malformations which resulted in a compensatory hypermetabolism.
Legal and ethical considerations of informed consent in children: implications for anaesthetists
Authors: PACE N.A.
Published: February 2007

Based on the moral principle of respect for autonomy, the patient or legal guardian must be aware of the general risks of a procedure about to be undertaken. If inadequate information is provided, then the doctor may be held to be negligent. Anaesthetists, because anaesthesia creates an additional risk to the patient, are also directly involved in the concept of ‘informed consent'. How much information needs to be disclosed to avoid a claim of negligence is different in various parts of the world. In some the ‘professional medical standard’ is the accepted test, that is, what other doctors tell their patients. In other areas, the ‘patient‐based material risks’ or what a patient would consider to be a material risk is the accepted test. Both have disadvantages and a balance must be struck between the two concepts.
Legal and ethical considerations of research in children: implications for anaesthetists
Authors: PACE N. A.
Published: February 2007

Undertaking research in children creates many legal and ethical dilemmas and it is essential that paediatric anaesthetists fully understand the complex issues raised. Most commentators agree that therapeutic research is justified. The question of non‐therapeutic research, however, is much more controversial, with widespread disagreement about its ethical justification. The extreme arguments advocating no research at all or justifying it as a duty to society are not acceptable. The middle of the road attitude of balancing the risks to the child with the many advantages to society as a whole should prevail. If risks are significant, research should not be allowed. The law itself appears to offer no statutory guidelines which, therefore, should be implemented.
Diagnosis of clinically unrecognized endobronchial intubation in paediatric anaesthesia: which is more sensitive, pulse oximetry or capnography?
Authors: ROLF N. , COTÉ C. J.
Published: February 2007

In a prospective, randomized, single‐blind study of combined pulse oximetry and capnography in 196 children whose anaesthetic was managed by endotracheal intubation we observed 10 patients with 14 episodes of endobronchial intubation (EBI). Pulse oximetry provided the first diagnostic clue in 13 events; the one event first diagnosed by capnography was also accompanied by oxygen desaturation. Two EBI occurred immediately after the initial intubation (‘primary’ EBI). Twelve episodes of EBI in eight patients occurred after correct initial endotracheal tube position (‘secondary’ EBI). EBI gave rise to eight episodes of ‘minor’ desaturation (oxygen saturation (Spo2) ≤ 95%≥ 60 s); four resulted in ‘major’ desaturation (Spo2≤ 85% for 30 s). Only three EBI events produced clinical signs or symptoms. Seven patients were less than 1 year; EBI was not, however, related to age.

A high frequency (5.1%) of clinically unrecognized EBI was found in infants and children. A persistent yet small, reduction in oxygen saturation provided the early evidence of secondary EBI in the majority of cases. Clinical signs and capnography proved least effective in the early diagnosis of secondary EBI.
The effects of halothane and isoflurane on forearm blood flow in children as determined by venous occlusion plethysmography
Authors: LAIRD C.R.D. , MULHOLLAND D. , CREAN P.M. , BLACK G.W.
Published: February 2007

Comparative studies have not been made of the peripheral vascular effects of halothane and isoflurane in children. Using a water‐filled venous occlusion plethysmograph, measurements of forearm blood flow were made in 2 groups of 19 children exposed to increasing concentrations of these 2 agents. Halothane and isoflurane caused comparable and dose dependent increases in forearm blood flow and reductions in peripheral vascular resistance and arterial pressure. These findings suggest that, in younger children, reductions in peripheral vascular resistance are partly responsible for decreases in arterial pressure when lower concentrations of these agents are used.
Effect of minimizing preoperative fasting on perioperative blood glucose homeostasis in children
Authors: WELBORN L.G. , NORDEN J.M. , SEIDEN N. , HANNALLAH R.S. , PATEL R.I. , BROADMAN L. , RUTTIMANN U.E.
Published: February 2007

Two hundred healthy, unpremedicated children, ages 1–10 years, scheduled for elective outpatient surgery were studied in order to examine the effect of minimizing preoperative fasting on perioperative blood glucose concentrations in paediatric patients. None of the patients ingested solids after midnight. On the day of surgery, the children were assigned to one of two groups. Group A children (n= 113) were not allowed any liquids for at least 6 h prior to surgery (NPO). Children in Group B (n= 87) ingested 10 ml·kg−1 of apple juice 2–4 h prior to the induction of anaesthesia. All patients received lactated Ringer's solution intraoperatively, unless BG at induction was < 50 mg·dl−1 (2.8 m·mol·l−1) in which case dextrose 2.5% in lactated Ringer's solution was administered. None of the patients who received apple juice was hypoglycaemic during induction of anaesthesia. However, two children in the NPO group had blood glucose values ± 50 mg·dl−1 (2.8 m·mol·l−1) at the time of induction of anaesthesia. Thirteen (11%) patients in Group A and 6 (7%) patients in Group B showed either no change or a further decrease in their postoperative BG concentration as compared with their induction values. Two of 43 patients in Group A and 2 of 41 patients in Group B had gastric fluid volumes > 0.4 ml/kg. All patients in both groups had gastric pH < 2.5. This study shows that gastric fluid volume and pH following a 2–4 h fast are not different from the values measured in children who were subjected to a traditional fasting period of 6 h or longer. Moreover, apple juice consumed 2–4 h prior to surgery neither buffers gastric pH nor does it modify intraoperative glucose homeostasis in children.
Intrathecal morphine for pain control in term infants for oesophageal atresia/tracheooesophageal fistula repair
Authors: KRECHEL S.W. , HELIKSON M.A.
Published: February 2007

Three term infants requiring oesophageal atresia with tracheo‐oesophageal fistula repair were managed with intrathecal morphine for postoperative pain control. Excellent pain control was achieved in these infants lasting 22 to 36 h. No complications were noted. As a result of pain control without respiratory depression these infants were extubated immediately postoperatively. The patients were remarkably free of retained secretions, eliminating the need for reintubation and/or repeated suctioning with the associated risk of producing a recurrent tracheo‐oesophageal fistula.
Excessively high plasma bupivacaine concentrations after tonsillar bed and adenoidal injection of 0.25% bupivacaine
Authors: BROWN R.E. , WILHOIT RANDALL D. , SAMUEL MICHAEL P.
Published: February 2007

The injection of local anaesthetics into the tonsillar bed has gained acceptance in the United States as a method for providing postoperative pain relief. A clinical trial was devised in which the tonsillar bed was injected at the upper and lower poles subsequent to the removal of each tonsil. In addition, a small amount of local anaesthetic was sprayed topically by the nares onto the adenoidal beds subsequent to adenoidectomy to alleviate pain from this area. Bupivacaine was used as the local anaesthetic because of its long duration of action. Despite extreme care in the performance of this study, one patient developed ventricular tachycardia subsequent to the injection of bupivacaine. Plasma bupivacaine levels were obtained after tonsillar bed infiltration and nasal instillation post tonsillectomy and adenoidectomy in each of the patients, and though most levels were below toxic ranges, one patient had high serum levels. This high serum level coincided with the development of ventricular tachycardia. On the basis of this finding, we have abandoned this technique for postoperative pain management after tonsillectomy.
The baroreceptor reflex and bradycardia in paediatric craniofacial surgery
Authors: WHITE A. P. , GOAT V. A.
Published: February 2007

Bradycardia associated with craniofacial surgery has been a recognized phenomenon for many years. The mechanism by which this reflex occurs is almost invariably attributed to the ‘trigemino‐cardiac’ reflex. This paper offers evidence that some bradycardias may result from the ‘baroreceptor reflex'.
Chickenpox: an operating room problem?
Authors: MORRISON JOHN E.
Published: February 2007

Varicella (chicken pox), a most common disease, is rarely considered a serious entity by adult oriented anaesthetists and surgeons yet can have an extremely high morbidity and mortality in certain populations. Hospital protocols concerning postponement or cancellation of elective surgery in children suspected of harbouring the disease following exposure in daycare facilities or schools often tend to be ignored. The following is a series of three case reports illustrating different aspects of the problems confronting the anaesthetist and other operating room personnel when a child with varicella enters the surgery suite.
The effects of halothane and isoflurane on hand blood flow in children. (As determined by venous occlusion plethysmography)
Authors: MULHOLLAND D. , LAIRD C.R.D. , CREAN P.M. , BLACK G.W.
Published: February 2007

The effects of increasing concentrations of halothane and isoflurane were studied in two groups of twenty children aged from 2.9 to 9.8 years using the technique of water filled venous occlusion plethysmography. Halothane significantly increased hand blood flow and reduced vascular resistance only at a concentration of 0.5 MAC. However, isoflurane caused significant dose related increases in hand blood flow and reductions in hand vascular resistance at 0.5, 1.0 and 1.5 MAC. These findings suggest that in children isoflurane has a more potent vasodilator effect on the skin circulation than halothane.
Intraoperative somatosensory evoked potential monitoring in achondroplasia
Authors: CUNNINGHAM MICHAEL J. , FERRARI LYNNE R. , KEARSE LEE A. , McPECK KATHLEEN
Published: February 2007

Surgical airway intervention in children with achondroplastic dwarfism poses potential neurological risk secondary to the neck manipulation required for tracheal intubation and operative head positioning. This is particularly true of achondroplastic dwarfs with radiographically documented foramen magnum and spinal canal stenosis. In these children, upper extremity somatosensory evoked potential monitoring establishes the integrity of sensory conduction from peripheral nerve to cortex, providing intraoperative notification of neurologically significant cervicomedullary compression during laryngoscopy and surgical positioning.
Vecuronium titration for muscle relaxation in myotonic dystrophy
Authors: DIEFENBACH CHRISTOPH , ABEL MANFRED , BUZELLO WALTER
Published: February 2007

A 14‐year‐old boy with pronounced myotonic dystrophy and cardiac malformation had a normal ED95 (53 μg·kg−1) of vecuronium, whereas the recovery index (25‐75% twitch recovery) was three times as long as in the absence of neuromuscular disease. We conclude that in young patients with dystrophic muscle disease individual titration of the muscle relaxant with the aid of a nerve stimulator does not preclude a considerable delay in the recovery of neuromuscular transmission.
Pectus excavatum repair in a patient with prune belly syndrome
Authors: HEISLER DAVID B. , LEBOWITZ PHILIP , BARST SAMUEL M.
Published: February 2007

We describe the anaesthetic management of a child with ‘Prune Belly’ syndrome who was presented for repair of pectus excavatum. In addition to having severe restrictive lung disease, the patient was also asthmatic. Prior surgical procedures had resulted in long term debilitation because of pulmonary complications. Principles of anaesthetic management first described more than twenty years ago were utilized and combined with an effective perioperative pain management plan to provide for a smooth and satisfactory postoperative outcome. Repair of the patient's pectus excavatum deformity improved his respiratory mechanics, while the use of thoracic epidural anaesthesia in the immediate perioperative period allowed rapid improvement in pulmonary function.
Anticholinergic prophylaxis does not prevent emesis following strabismus surgery in children
Authors: CHISAKUTA A. M. , MIRAKHUR R. K.
Published: February 2007

One hundred and twenty‐one children were studied in this prospective, randomized double‐blind, placebo‐controlled comparison of the effectiveness of anticholinergic prophylaxis for the prevention of emetic symptoms following strabismus surgery. The children were allocated to three groups, to receive placebo (n= 40), glycopyrrolate (n= 40) or atropine (n= 41). The incidence of intraoperative oculocardiac reflex (OCR) and of postoperative emetic symptoms for 24 h was recorded. The incidence of OCR was 55% in the placebo group compared with 5% and 2% in the glycopyrrolate and atropine groups respectively (P < 0.05). Thirty percent (12/40) of patients in the placebo group, 25% (10/40) in the glycopyrrolate group, and 22% (9/41) in the atropine group experienced nausea and/or vomiting (difference not significant). It is concluded that prophylactic administration of anticholinergic agents during strabismus surgery in children despite being effective against the occurrence of the oculocardiac reflex, does not reduce the incidence of emetic symptoms.
Propofol reduces the incidence of vomiting after tonsillectomy in children
Authors: M. BARST SAMUEL , MARKOWITZ AVRAM , YOSSEFY YORAM , ABRAMSON ALLAN , LEBOWITZ PHILIP , S. BIENKOWSKI ROBERT
Published: February 2007

We compared the effect of a propofol‐based anaesthetic to an isoflurane‐based anaesthetic on the incidence of postoperative vomiting in children following tonsillectomy. Thirty‐nine children were enrolled in the study and randomized to receive one of the proposed anaesthetics. All patients underwent a mask induction with halothane, nitrous oxide, and oxygen. Intravenous access was established and all children received fentanyl (2–4 μg·kg‐1) i.v., mivacurium (0.3 mg·kg‐1) i.v. and acetaminophen (10–15 mg·kg‐1) p.r. Following tracheal intubation, patients received either isoflurane (0.8–1.6%) or propofol (120–180 μg·kg‐1 min‐1) i.v. with nitrous oxide 70%/oxygen 30% for maintenance of anaesthesia. Vital signs were maintained within 20% of baseline. All patients were extubated in the operating room. PACU nursing staff recorded episodes of vomiting for 4–6 h prior to discharge. A telephone interview the following day was also used for data recovery. Age, sex, and duration of the procedure were not significantly different between the two study groups. Of 19 patients who received propofol, four vomited (21%); in contrast, of the 20 patients who received isoflurane, 11 vomited (55%). This difference is significant (P= 0.048 two‐tailed Fisher's Exact Test). These data suggest that using propofol for anaesthesia can diminish the incidence of vomiting following tonsillectomy.
Paediatric ventilatory effects of morphine and buprenorphine revisited
Authors: OLKKOLA KLAUS , LEIJALA MAURI , MAUNUKSELA EEVA‐LIISA
Published: February 2007

The study describes long term ventilatory effects of 50 or 100 μg·kg‐1 of morphine or 1.5 or 3.0 μg·kg‐1 of buprenorphine when given in repeated intravenous (i.v.) doses, in a double blind fashion, to achieve equal levels of analgesia after thoracotomy. The patients were 56 children, six months to six years of age. Ventilatory rate (VR) was measured over the 24 h study period, and arterial carbon dioxide tension (Paco2) was measured on arrival in the Paediatric Intensive Care Unit (PICU) and at 1, 6, 12 and 18 h. In the buprenorphine groups VRs progressively decreased during the first 2 h and remained significantly lower (P < 0.05) than in the morphine groups for 7 h. For the rest of the study period there were no differences. The Paco2 values did not differ significantly at any point. For safety, prolonged observation of children is needed after intravenous administration of buprenorphine to ensure the ventilatory rate has stabilized.
Official Statistics and Social Interaction
Authors: MENNELL STEPHEN
Published: February 2007

THE USE OF OFFICIAL STATISTICS IN SOCIOLOGY, by Barry Hindess

UNDERSTANDING EVERYDAY LIFE, edited by Jack D. Douglas

ETHNOMETHODOLOGY, edited by Roy Turner

ON THE BEGINNING OF SOCIAL INQUIRY by P. McHugh, S. Raffel, D. C. Foss and A. F. Blum
The Comparative Study of Social Care
Authors: Collins Doreen
Published: February 2007

The Study of Social Policy By BARBARA RODGERS WITH ABRAHAM DORAN AND MICHAEL JONES.
The Comparative Dimension in Social Welfare
Authors: Rodgers Barbara
Published: February 2007

The Meaning of Social Policy: The Comparative Dimension in Social Welfare BY BERNICE Q. MADISON.
The Cost of High Unemployment
Authors: Fraser Neil , Sinfield Adrian
Published: February 2007

In response to R. A. B. Leaper's challenge in the last issue of this journal we present a report which we have just prepared for the BBC North‐East. We believe that a better understanding of the costs of high unemployment to the country is needed to inform decisions on how much we can afford to pay to tackle the problem. In the final section of the paper we show how this evidence can be of value in costing policy options.

The last detailed costings of unemployment were published in 1982 for the financial year 1981/82. In February 1982 it appears that a political decision was taken not to publish the latest Treasury estimate updating their 1981 calculations. Since then numerous parliamentary questions on the subject have received very limited answers disputing the validity of the whole exercise.
Industrialization and Welfare: The Case of the Four Little Tigers
Authors: Midgley James
Published: February 2007

Established theories of welfare and industrialization have been abstracted from the historical experience of the Western countries and no attempt has been made to assess their empirical validity with reference to the newly industrializing countries (NICs) of the Third World. Reviewing the industrial development and social services of Hong Kong, Korea, Singapore and Taiwan (the four little tigers) it is argued that social policy development in these countries cannot be attributed to the effects of the conditions of industrialization in which political elites respond proactively to the demands of industrial change. Instead, social policy in the Asian NICs is largely incremental in character and the consequence of a variety of causal events which are not accounted for by established theories.
Care for Elderly People in the European Community
Authors: Henrard Jean‐Claude
Published: February 2007

All EEC countries are faced with an ageing population, which means an increase of people in some way handicapped in everyday activities. A comparison of the solutions adopted by several EEC countries in the sectors of housing, home care services, residential and nursing homes shows that a real medico‐social policy has been worked out only in Denmark and the Netherlands. In France and the United Kingdom, public authorities have certainly defined policies which lay claim to providing overall coverage but they have not provided corresponding resources. In Germany and in Italy there is no clearly defined policy. Here we discuss the various factors which may account for these differences.
Tenure Differences in Income and Housing Benefit in Later Life
Authors: Gibbs Ian , Kemp Peter
Published: February 2007

The first half of this article examines the distribution of income among older people in different housing tenures using secondary analysis of the 1988 Family Expenditure Survey (FES). The use of the term “older household” refers to those where the head of household is aged 55 and over. Income has been adjusted in order to take account of the size and composition of elderly households. The second half of the article examines the effects on the distribution of income when the definition of income is widened to include housing benefit.

In 1988 the average weekly income of older households who were owner occupiers was twice that of older households who were renters. While the addition of housing benefit to the definition of income has only a marginal effect in reducing income inequality among all older households it had a more significant impact in reducing income inequalities among older renters more of whom, in comparison to older owner occupiers, were located in the lower income groups.
Family Leave Policy in the United States
Authors: Wisensale Steven K.
Published: February 2007

Between 1987 and 1993 twenty states and the federal government adopted family leave policies. None included any wage replacement. The similarities and differences among these policies are discussed within the context of six major categories: employees covered, company size, length of leave, eligibility, coverage of benefits, and job guarantee. Also discussed is the feasibility of adopting some type of wage replacement as well as the future of family leave in light of the changing demographics of America's families.
Professional Power and Managerial Control: The Case of GP Assessments of the Over‐75S
Authors: Glendinning Caroline , Chew Carolyn , Wilkin David
Published: February 2007

The creation of Family Health Services Authorities from the old Family Practitioner Committees in 1990 marked a turning point in the introduction of managerialism into primary health care services. One of the FHSAs' first responsibilities was the administration of a new Contract for General Practitioners, which had generated considerable opposition from within the profession. This Contract included a new requirement for GPs to make, each year, a written offer of a health check, at home, to all patients aged 75 and over.

Particular scepticism was expressed by GPs about the value and effectiveness of routine annual assessments's of this kind. Drawing on interviews with FHSA managers and their professional medical and nursing advisors, this paper examines the strategies adopted by FHSAs in tackling the administration of this particularly controversial requirement. Although apparently effective in the short‐term, the paper concludes that these strategies may have considerable longer‐term short‐comings. The constraints and pressures experienced by FHSAs and the strategies employed to deal with them provide a useful insight into the tensions generated in the course of developing a managerial relationship with professional practitioners who have traditionally enjoyed very high levels of autonomy and independence.
Probation Partnerships, Voluntary Action and Community Justice
Authors: Nellis Mike
Published: February 2007

Having been offered — and prepared to accept — a “centre‐stage”role in the operation of the criminal justice system as recently as 1991, the Probation Service in England and Wales seems increasingly to be marginalized by politicians who, in a more punitive climate, have changed their minds about what is expected of it. As a probation spokesperson has recently said: “the big vision has gone”. One strand of policy which the Probation Service was expected to develop in 1991 was increased partnership with voluntary organizations, but, although progress has been made, it is a policy about which the Service has been very ambivalent, fearing that it may lead in the longer term to privatization of their work. This paper will outline the origins and implications of the policy, note how some local Services have so far responded to it, and suggest that, if pursued in certain fields of activity, partnership could contain an alternative vision to the one that has been lost.
A Different Sort of Doctor: The Police Surgeon in England and Wales
Authors: Bradshaw Yvonne , Savage Stephen P. , Moon Graham , Kelly Kathleen
Published: February 2007

Police surgeons occupy a neglected and potentially influential role in the criminal justice system, falling between medical and legal functions. This article considers the implications of this role which operates at the interface of two major areas of social policy concern. Drawing evidence from a unique survey of police surgeons in England and Wales, it considers specifically, the professional background of police surgeons, the administration and management of the police surgeon service, surgeons' attitudes to aspects of their professional practice and the impact of this role on civil liberties. The paper concludes with a brief discussion of the possibilities for the reform of the police surgeon service.
Oral ulceration: an unusual manifestation of Churg–Strauss syndrome
Authors: Delplace D , Da Costa LM , Goffin L , ME Wechsler , Sass U , André J , Dangoisse C , Song M
Published: February 2007

Churg–Strauss Syndrome (CSS) is a relatively rare entity characterized by asthma, transient pulmonary infiltrates, eosinophilia and systemic vasculitis. Oral ulceration is a possible clinical manifestation of some systemic vasculitides, such as Wegener's granulomatosis (WG) or giant cell arteritis, but has never been reported with Churg–Strauss syndrome. We report the first observation of a palatine ulceration in a 15‐year‐old girl with Churg–Strauss syndrome.
Including everyone in research: The Burton Street Research Group
Authors: Abell Simon , Ashmore Jackie , Beart Suzie , Brownley Peter , Butcher Adam , Clarke Zara , Combes Helen , Francis Errol , Hayes Stefan , Hemmingham Ian , Hicks Kerry , Ibraham Amina , Kenyon Elinor , Lee Darren , McClimens Alex , Collins Michelle , Newton John , Wilson Dorothy
Published: February 2007

Accessible summary

We are people with and without learning disabilities doing research together.

In this paper we talk about the good bits and the bad bits of doing research together.

In our paper we talk about what it is like to be a group of people with and without learning disabilities researching together. We describe the process of starting and maintaining the research group and reflect on the obstacles that we have come across, and the rewards such research has brought us. Lastly we put forward some ideas about the role of professionals in such a group that we hope people might find useful.
A COMPARISON OF SKIN POTENTIAL AND SKIN RESISTANCE RESPONSES AS MEASURES OF EMOTIONAL RESPONSIVITY
Authors: Burstein Kenneth R. , Fenz Walter D. , Bergeron James , Epstein Seymour
Published: February 2007

The purpose of this study was to compare gradients of skin resistance (SR) and skin potential (SP) responses generated by differing degrees of psychologically disturbing stimuli, and to determine the significance of the different wave forms of skin potential.

SR and SP were simultaneously recorded during a word‐association test that included three levels of psychologically disturbing verbal stimuli.

In addition to the a and b waves of the SP response, a second negative wave form, a2, was recorded.

SR and all SP wave forms yielded positive gradients as a function of increasing stimulus intensity. Gradients based upon SR and total SP were close to identical. Magnitude measures, which include zero responses, of the SP wave forms yielded steeper gradients than measures of amplitude or frequency. The relative contribution of different SP wave forms to total SP varied with stimulus level.
THE EFFECTS OF EPINEPHRINE AND NOREPINEPHRINE ON AN ASPECT OF COLOR VISION
Authors: Keeler Martin H. , Doehne Edward F.
Published: February 2007

With a test involving image and after‐image relation, it is demonstrated that epinephrine differentially affects reactivity to green (530 mμ) and red (625mμ) stimuli and that most of the response is accounted for by altered response to the green stimulus. Norepinephrine effect was in the same direction but not statistically significant and might be accounted for by endogenous epinephrine secretion.
CORTICAL RESPONSE TO A TACTILE STIMULUS DURING ATTENTION, MENTAL ARITHMETIC AND FREE ASSOCIATIONS
Authors: SHEVRIN HOWARD , RENNICK PHILLIP
Published: February 2007

Attention to a stimulus appears to be associated with amplitude fluctuations in 100‐msec or later components of the cortical compound evoked potential (CEP). In this study, changes in amplitude and latency of the CEP to the same tactile stimulus were investigated under three conditions: attention, free associations, and mental arithmetic. In the attention condition Ss were asked to estimate varying time intervals between stimuli on a 2‐ to 6‐sec scale. Ss were 12 pairs of twins. It was found that the amplitudes of two negative electrocortical potentials were greater when Ss were estimating lengths of time intervals between stimuli than during free association or mental arithmetic. Peak latency of the second negative potential was greater in attention than in the other two conditions. Free association CEPs were distinguished by the incidence of a bursts. The results support the hypothesis that attention is associated with certain parameters of the electrocortical response and suggest which aspects of the electrocortical response are most likely to be related to attention.
SKIN POTENTIAL RESPONSES AND THE SPAN OF ATTENTION
Authors: Solley Charles M. , Thetford Paul E.
Published: February 2007

Experiment I tested whether an alerting signal would increase the span of visual attention. Female Ss (16) were presented an array of letters exposed for 2 sec by a tachistoscope. Half of the Ss had a series of trials with a loud tone contiguous with the tachistoscope, followed by a series of trials with tachistoscope only. The remaining Ss received a reverse procedure—half the trials with no tone initially, followed by tone. The group receiving only tachistoscope followed by a series of tachistoscope plus tone trials showed a significant improvement in the number of letters correctly reported. Experiment II repeated the above with skin potential (SP) recording throughout the session to test that the tone would generate a momentary state of arousal (an orienting response) and an increase in the span of attention. Tone significantly produced larger positive SP amplitudes and more diphasic SP responses, and increased the number of letters correctly reported. All differences disappeared during the second trial series.
THE EFFECT OF MEPROBAMATE ON THE SOMATIC RESPONSES OF ANXIOUS PATIENTS AND NORMAL CONTROLS
Authors: Williams James G. L. , Williams Barbara
Published: February 2007

The skeletal muscle activity and digital volume pulse of anxious psychiatric patients and normal controls were used as measures to confirm the hypothesis that meprobamate would reduce the level of muscle activity and autonomic responsivity of the patients to that of the controls when both groups experienced a mild “stress”—delayed auditory feedback (DAF).
OPERANT CONDITIONING OF TWO STRAINS OF THE POINTER DOG1
Authors: Murphree Oddist D. , Dykman Roscoe A. , Peters John E.
Published: February 2007

Within the pointer breed of dog two strains have been developed by selective mating and line breeding. The goal is that of producing behaviorally distinct stable and unstable (nervous) strains to measure hereditary effects including dominance and sex linkage, if present. Some behavioral difference emerged early. Measures of operant conditioning and other behavioral tests have little overlap. We conclude that genetic controls are important for behavioral research, even within a single breed, and that temperamental variables have strong genetic factors as well as environmental ones.
RANDOM OUTPUT SELECTOR FOR THE LABORATORY1
Authors: Tart Charles T.
Published: February 2007

A random selector, whose output is in the form of switch closures, is described. On each activation one of N outputs is selected and remains closed until the next activation. Each output is equally probable and independent of the previously selected output. The selector can be constructed from the off‐the‐shelf components of one manufacturer in approximately 1 hr.
ANALYSIS OF AUTONOMIC REACTION PATTERNS
Authors: Wilson Ronald S.
Published: February 2007

Analysis‐of‐variance models are presented for use with autonomic data. Applications are illustrated for experiments where either single variable or multiple variable autonomic recordings are obtained. The analysis provides a test of significance for both transient responses to a stimulus and the more sustained effects that persist for some time. Consistency and stability of idiosyncratic reaction patterns are expressed by intraclass correlation coefficients. Multiple group comparisons are suggested as a method of evaluating differential reaction patterns induced by separate stressors. Three independent dimensions of autonomic activity are isolated by analysis of variance: sustained activity, reactivity, and nonspecific variability. Individual Ss can be assigned scores on each dimension, and these scores can be processed by multiple regression procedures to predict Ss’ performance on other behavioral tasks or personality scales.
DIGITAL VASOMOTOR CONDITIONING AND BODY HEAT REGULATION
Authors: Teichner Warren H. , Levine Jerrold M.
Published: February 2007

Human subjects were conditioned to a tone‐shock sequence during heat or cold exposure and then given 10 trials of experimental extinction in the heat. In the heat, while exhibiting a general peripheral as well as a digital vasodilatation, vasoconstriction developed as a conditioned response; the response did not extinguish. In the cold, with general peripheral and digital vasoconstriction, vasodilatation developed as the conditioned response. Since the cold‐conditioned Ss did not recover completely from their cold exposure during the following heat equilibritun period, the extinction data of this group could not be accepted. A comparison was also made of the differences in thermoregulation and in conditioned responses of preselected Ss varying in latency of cold‐induced digital vasodilatation. Although these Ss did differ in their thermophysiological reactions, they did not differ in regard to the nature of the conditioned response developed.
THERMAL CHANGES IN PALMAR SKIN RESISTANCE PATTERNS
Authors: Neumann Eva
Published: February 2007

In contrast to the usual description of a uniformly low basal skin resistance at the human palmar surface as compared with other parts of the body (Richter, Woodruff, & Eaton, 1943; Wilcott, 1963), the present studies reveal skin resistance patterns (SRPs) with different resistance values at different subregions of palm and forearm. The shape of these patterns is related to the season in which the experiment was performed.

Three basic SRPs are described, for winter, summer, and prolonged summer heat spell, respectively: (a) an alternating pattern, (h) an oblique pattern, (c) a so‐called summer reversal pattern. The distinguishing factor for this categorization is the reciprocal electrodermal behavior of the mid‐palm and arm regions. The resistance of the palm is relatively low in the winter, intermediate in the early summer, and high in a summer heat spell, while the resistance of the arm is high in winter and summer and low in the heat spell. Experimental heating and cooling leads to independent variation of the skin resistance values at different subregions and differs as a function of the basic seasonal SRP. A follow‐up study shows that children have a less differentiated pattern, which, at all seasons tested, is similar to the oblique summer pattern of adults. The studies are considered exploratory.
DIFFERENCES AMONG AGE AND SEX GROUPS IN ELECTRODERMAL CONDITIONING
Authors: Shmavonian B. M. , Miller L. H. , Cohen S. I.
Published: February 2007

Four groups, Young Males, Young Females, Aged Males and Aged Females, were run in a discrimination conditioning paradigm with a variety of autonomic and central measures. This paper deals primarily with Electro‐Dermal Responses. The findings indicate that in all measures the Young Males and Young Females show the best discriminated conditioning, followed by Aged Females and Aged Males.

In the GSP there are hints that the negative wave of the response might be related to the orienting phenomena whereas the positive wave is what becomes discriminately conditioned in the experiment.

A cognitive questionnaire was accurately answered in the same rank order as the conditioning, that is. Young Males, Young Females, Aged Females and Aged Males.