bluuebunny/crossref_metadata_2025_split huggingface dataset:
A comparison between ilioinguinal‐iliohypogastric nerve block performed by anaesthetist or surgeon for postoperative analgesia following groin surgery in children
Authors: TROTTER CHRISTOPHER , MARTIN PAUL , YOUNGSON GEORGE , JOHNSTON GRAHAM 
Published: February 2007

SummaryA study was performed to compare postoperative analgesia in children undergoing groin surgery. Patients were randomly allocated to receive ilioinguinal‐iliohypogastric (I‐I) nerve blocks using 0.25% plain bupivicaine (0.5 ml·kg−1) performed either percutaneously by the anaesthetist after the induction of general anaesthesia, before surgery commenced, or intraoperatively, under direct vision, by the surgeon. Analgesia was assessed by pain scoring in the recovery room and at hourly intervals for eight h postoperatively. Analgesic requirement was also noted. Statistical analysis of the results revealed no difference in pain score between groups treated either by anaesthetist or surgeon. However, children under two years of age had significantly higher pain scores than those over two.
Pharmacokinetics of alcuronium in children with acyanotic and cyanotic cardiac disease undergoing cardiopulmonary bypass surgery
Authors: WEEKES L.M. , KENEALLY J.P. , GOONETILLEKE P.H. , RAMZAN I.M. 
Published: February 2007

SummaryThe aim of this study was to determine the pharmacokinetic parameters for alcuronium in children with cyanotic or acyanotic congenital cardiac disease undergoing cardiopulmonary bypass surgery and to compare these parameters with previously reported values in children and adults with normal cardiac function. Seven children with acyanotic disease and seven with cyanotic disease were studied. Alcuronium (base) was administered in an initial dosage of 0.25 mg·kg−1 with additional doses as needed to maintain paralysis. Using time averaged data, cyanotic children had lower mean clearance, elimination half‐life and volume of distribution at steady state than the acyanotic children; none of these differences was, however, statistically significant. In this study, children with acyanotic and cyanotic cardiac disease undergoing bypass, had a diminished clearance (P < 0.05) and a smaller volume of distribution (P < 0.05) than normal children and a shorter elimination half‐life (P < 0.05) than adults. Onset of cardiopulmonary bypass caused an immediate marked decrease in alcuronium plasma concentrations which remained low in the acyanotic children at the completion of bypass.
Intraoperative hyperthermia in a paediatric patient with cystinosis
Authors: PURDAY JONATHAN P. , MONTGOMERY CAROLYNE J. , BLACKSTOCK DEREK 
Published: February 2007

SummaryCystinosis is a rare autosomal recessive inherited disorder of amino acid metabolism. Little is known of the affects of general anaesthesia on the disease (Tobias 1993) and complications relating to anaesthesia have not been previously reported. Infantile cystinosis presents as progressive renal failure and the Fanconi syndrome and metabolic bone disease often develop. We describe the case of a child who presented with signs of apparent malignant hyperthermia (MH) under general anaesthesia and was treated with dantrolene. During a repeat ‘trigger‐free’ general anaesthetic he developed a fever which responded to paracetamol. The metabolic effects of cystinosis and its similarity to MH will be discussed.
Compartment syndrome in a child occurring after femoral artery cannulation
Authors: SELBY IAN R. , DAROWSKI MARK J. 
Published: February 2007

SummaryCompartment syndromes have not been reported in association with femoral artery cannulation for invasive blood pressure monitoring in children. We report a case that presented atypically in a child admitted in extremis due to small bowel obstruction and who had a 20 G femoral arterial cannula sited during resuscitation. The compartment syndrome was diagnosed after repeated measurements of compartment pressures.
A comparison of 4.5% human albumin solution and Haemaccel in neonates undergoing major surgery
Authors: STODDART P.A. , RICH P. , SURY M.R.J. 
Published: February 2007

SummaryIn a randomized blinded study we compared two colloid solutions in 30 neonates undergoing major surgery. Fifteen neonates received 4.5% Human albumin solution (HAS) (mean volume 25.6 ml·kg−1, SD 9.5) and the others received Haemaccel (Hoechst) (24.9 ml·kg−1, SD 10). Pre and postoperative plasma albumin and haemoglobin concentrations and plasma colloid osmotic pressures (COP) were compared. In the group given Haemaccel there was an appreciable and statistically significant decrease in the mean plasma albumin concentration from 34.27 to 28.27 g·l−1 (mean difference 6, CI 3.38 to 8.62) and the mean COP decreased significantly from 22.2 to 19.9 mmHg (mean difference 2.3, CI 0.3 to 4.5). In the HAS group there was no significant change in either the plasma albumin concentration or COP. There was a small but significant decrease in the mean haemoglobin concentration from 15.92 to 14.35 g·dl−1 (mean difference 1.56, CI 0.57 to 2.55) after HAS. We conclude that HAS is the superior colloid for volume replacement in neonates undergoing surgery.
Regional variations in skin perfusion and skin thickness may contribute to varying efficacy of topical, local anaesthetics in neonates
Authors: LARSSON BJÖRN A. , NORMAN MIKAEL , BJERRING PETER , EGEKVIST HENRIK , LAGERCRANTZ HUGO , OLSSON GUNNAR L. 
Published: February 2007

SummaryThe national Swedish screening programme for inborn errors of metabolism includes blood sampling from all neonates. Heel lancing has hitherto been the method of choice for these screening tests. Studies have recently been done to find out whether the use of EMLA can alleviate pain caused by heel lancing. EMLA had little, if any (1, 2) effect when applied to the heel of full term babies. Similar results were reported concerning preterm infants (3, 4). Other authors have found that differences in skin thickness or in skin blood perfusion may influence the effect of EMLA (5, 6). The aim of this study was to establish whether differences in skin thickness or in skin blood perfusion were present in three regions: the forehead, the dorsum of the hand and the heel. Ten healthy full term neonates were included in the study on skin perfusion. Measurements were made with a laser Doppler flux meter. Twenty‐seven healthy full term neonates were included for measurements of skin thickness using a high frequency B‐mode ultrasonic meter. The heel skin perfusion was two to three times higher than the skin perfusion at the dorsum of the hand and at the forehead but there was no significant difference when comparing skin thickness of the heel with the dorsum of the hand and the forehead. A rapid clearance of a topically applied local anaesthetic, due to high cutaneous blood flow, may explain why EMLA seems to be of little value when it is applied to the neonatal heel.
Behavioural changes and children's memories after intravenous, inhalation and rectal induction of anaesthesia
Authors: KOTINIEMI LEENA H. , RYHÄNEN PAULI T. 
Published: February 2007

SummaryNinety two‐to‐seven‐year‐old children admitted for routine day case ENT operations were randomly allocated to have either intravenous thiopentone (group I), halothane inhalation (group II) or rectal methohexitone (group III) for anaesthesia induction. Using a postoperative questionnaire, the parents evaluated the changes in the child's behaviour one day, one week and one month after the operation. Problematic changes were detected in 17 (59%) children in group I, 14 (50%) in group II and 17 (58%) in group III (NS). Although the children in group II behaved most calmly during the induction they had significantly more negative memories of the induction of anaesthesia (six children in group II vs two in group I and one in group III) and of the hospital in general (17 in group II vs 11 in group I and eight in group III) than children in the other groups. Judging from memories of young children, intravenous and rectal inductions are less distressing to them than inhalational induction.
Craniodiaphyseal dysplasia; another cause of difficult intubation
Authors: APPLEBY J.N. , BINGHAM R.M. 
Published: February 2007

SummaryA nine‐year‐old boy with craniodiaphyseal dysplasia (CDD) presented for mandibular reduction. Patients with CDD present problems to the anaesthetist, specifically difficulties with airway management and tracheal intubation. This child was managed using laryngeal mask airway (LMA) guided fibreoptic intubation. Spontaneous respiration was maintained throughout intubation, following which ventilation was controlled and anaesthesia was provided using nitrous oxide, isoflurane and fentanyl. The perioperative management is described.
The incidence of minor sequelae following anaesthesia in children
Authors: SELBY I.R. , RIGG J.D. , FARAGHER B. , MORGAN R.J. , WATT T.C. , MORRIS P. 
Published: February 2007

SUMMARYA survey was performed to estimate the incidence of the minor sequelae of anaesthesia in children. During an eight‐month period 266 children, aged five years and over, were personally interviewed by an anaesthetist following recovery from anaesthesia. At interview the child was questioned to ascertain any morbidity suffered and record was made of the operation performed and the anaesthetic administered. Data were then evaluated, using multivariate analysis, to identify risk factors for the more common sequelae. This study revealed a higher incidence of the minor sequelae of anaesthesia in children than had previously been reported. The three most common sequelae recorded were nausea (48.1%), vomiting (35.0%), and sore throat (31.4%).
Influence of acute alcohol ingestion on the hormonal responses to modest hypoglycaemia in patients with Type 1 diabetes
Authors: Kerr D. , Cheyne E. , Thomas P. , Sherwin R. 
Published: February 2007

AbstractAims  To determine whether mild alcohol intoxication (45–50 mg/dl) influences counterregulatory hormone responses to moderate hypoglycaemia (2.8 mmol/l) in patients with Type 1 diabetes.Methods  Seventeen subjects (14 male, age range 21–46 years) with Type 1 diabetes underwent four hyperinsulinaemic glucose clamps: euglycaemia with placebo; euglycaemia with alcohol (0.4 g/kg); hypoglycaemia (2.8 mmol/l for 65 min) with placebo; and hypoglycaemia (2.8 mmol/l for 65 min) with alcohol (0.4 g/kg). Arterialized venous blood samples were taken for measurement of insulin and counterregulatory hormones.Results  During hypoglycaemia, peak growth hormone concentrations were significantly lower after alcohol compared with placebo (14.3 ± 2.9 vs. 25.9 ± 3.4 µg/l, P < 0.001) associated with reduced insulin sensitivity in both hypoglycaemia and euglycaemia studies.Conclusions  We found an attenuated growth hormone response to hypoglycaemia associated with mild alcohol intoxication. Although this may potentially contribute to impaired recovery of glucose after hypoglycaemia in patients with Type 1 diabetes, it appears to be offset by a reduction in insulin action.
Common polymorphisms of the PAI1 gene do not play a major role in the development of diabetic nephropathy in Type 1 diabetes
Authors: Martin R. J. L. , Savage D. A. , Patterson C. C. , Brady H. R. , Maxwell A. P. 
Published: February 2007

AbstractAim  Plasminogen activator inhibitor 1 (PAI1) plays a key role in the regulation of extracellular matrix (ECM) degradation. The PAI1 gene is therefore an excellent candidate gene for diabetic nephropathy. The aim of this study was to employ gene resequencing to identify common DNA polymorphisms in the PAI1 gene, and subsequently assess haplotype tagged single nucleotide polymorphisms (htSNPs) using a case control design.Methods  All nine exons, exon–intron boundaries, introns 1, 4 and 7 and approximately 3 kb upstream and 5 kb downstream of the PAI1 gene were screened for DNA polymorphisms in 15 case and 15 control subjects using WAVE® denaturing high‐performance liquid chromatography technology and confirmed by DNA sequencing. Polymorphisms were genotyped in 86 healthy individuals using direct sequencing and haplotype tagged single nucleotide polymorphisms (htSNPs) identified. Genotyping of the htSNPs was performed in 583 Type 1 diabetic patients (222 with nephropathy, 361 without nephropathy) using Pyrosequencing.Results  Twenty‐one polymorphisms with a minor allele frequency (MAF) > 1% were identified; 14 had a MAF ≥ 10%. Five htSNPs [c.‐1968_69insG, c.43 G→A (Ala15Thr), c.1092‐105 A→G, c.*1737 G→A, c.*3711 C→T] were identified. Haplotype frequencies were similar in case and control groups (likelihood ratio χ2 test, P = 0.66).Conclusion  It is unlikely that common polymorphisms of the PAI1 gene strongly influence susceptibility to diabetic nephropathy in the White Type 1 diabetic population.
Leisure Policy in France and the Reduction of Social Inequalities
Authors: Hantrais Linda 
Published: February 2007

AbstractIn contemporary French society, despite extensive government intervention over the past half centuv, differential access to free time and to leisure facilities, together with differences in attitudes towards participation in cultural activities, remain good indicators of the social inequalities associated with gender, age, educational training, socio‐occupational status and regional origins. Thejndings from recent government‐sponsored national surueys and from other smaller scale empirical research highlight some of the most salient cultural inequalities persisting in leisure behaviour in France today. The evidence suggests that gender deferences, while still acting as one of the main discriminators in leisure behaviour, are most meaningful when considered in relation to age, correlated in turn with the level of educational attainment, family circumstances and socio‐occupational status. A survey of the leisure policies pursued ly successive French governments in the post‐war period demonstrates how the state has intervened increasingly with the overt objective of reducing social inequalities and breaking down the traditional cultural and economic barriers affecting access to leisure.
Yugoslav Social Policy
Authors: Milosavljević Milosav 
Published: February 2007

AbstractYugoslavia provides an interesting example of a decentralized system of policy‐making which implies the abolition of the state's main role in economic and social affairs. Self‐management is the basic principle of the socio‐political system in Yugoslavia. It involves all levels, processes and fields of social relationships from working organizations (enterprises) and local communities to the communes, republics and Federation. The implications of this system of socio‐political organization for social policy and provision are examined.
The “Three Worlds” of Human Services
Authors: Sugarman Barry 
Published: February 2007

AbstractThe “three worlds” referred to in this article are the three environments in which human services are delivered: the public, private non‐profit, and private for‐profit sectors. This article analyses the situation of human services in the USA, while suggesting that the arrival of privatization in other western industrial societies makes it relevant there too.After defining each of the three environments, an attempt is made to generalize about broad differences in management behaviour that tend to result from the different kinds of pressures inherent in each of the three worlds. Relationships between the three worlds are discussed, with special reference to the field of alcoholism treatment services.
The Why Work? Syndrome
Authors: Mansfield Malcolm 
Published: February 2007

AbstractThis article is an examination of the relationship between the level of welfare benefits and the motivation to work in modern capitalism. The idea that capitalism cannot produce the industrial discipline it requires given welfare benefits above “subsistence” is shown to be untrue. Non‐pecuniary inducements to work centred on the Job Centre can replace low‐level benefits but only under strictly‐defined conditions. The article goes on to examine what happens when Job Centres do not fulfil their disciplinary role.
Patients First — Reality or Rhetoric?
Authors: Williamson Valerie 
Published: February 2007

AbstractThis paper will argue that the NHS, despite its aspirations to provide a universal service of excellence, has not been historically very responsive to the consumers it serves. Under the present Government this attitude has ostensibly changed. “Patients First” has become a catch phrase both nationally and at the local level in Brighton Health District. A recent CHC survey of consumers' rections to service revealed however that many elderly patients were not consulted in any meaningful way about their needs on discharge from hospital. Why does the reality of consumerism not match the rhetoric? A number of potentially explanatory factors are identified and their relevance evaluated in the context of Brighton CHC's research. It is suggested that the currently fashionable consumerism represents a different concept from active participation which would necessarily involve a fundamental realignment of the NHS.
Transition Shock and the Relocation of People from Mental Handicap Hospitals and Hostels
Authors: Booth Tim , Simons Ken , Booth Wendy 
Published: February 2007

AbstractThe process of deinstitutionalisation has been gathering momentum in Britain and the United States since the mid‐1970s. A discussion of these trends provides the background to an examination of “transition shock” as it affects people relocated from mental handicap institutions. The paper explores the theoretical underpinnings of the concept of transition shock and links them to the findings of a follow‐up study of the behavioural consequences of relocation.
Destinations of Social Administration Graduates
Authors: Leaper R. A. B. 
Published: February 2007

AbstractRecently emphasis has been laid on the demands which the changing needs of society place on university studies. An examination of the relevance of Social Policy and Administration studies to employment demands is timely. This article is based on an examination of data obtained from the Universities Statistical Records, on the results of a survey of responses from graduates at Exeter University from 1972 to 1986, and on two recently published reviews of S.P.A. in universities. The appeal of courses to applicants, personal career motivations, field work experience and the structure of the courses are in turn examined for their influence on ultimate employment destinations. Discontinuities of classification in the available statistics of university courses make comparisons over time problematic. In general first degrees in S.P.A. are shown to have wide employment acceptability, a declining relationship with immediate employment in social work, a high level of adaptability to the needs of an economy affected by technological change, and a good educational basis for specialised post‐graduate professional qualifications.
Defining Community Care: realities and myths
Authors: Higgins Joan 
Published: February 2007

AbstractThis article looks critically at the concept of community care and argues that it is unhelpful and redundant. It makes three main points: first, that many care settings have elements of institutional and so‐called community care and that there is no clear dichotomy between the two. Second, it is argued that the real distinction is not between the institution and the community but is between the institution and home. Community care is not provided by anonymous, altruistic others but comes from specific individuals (usually women) in domiciliary settings. The concept and definition of “home” are briefly discussed and it is suggested that most care is delivered either in a home, from home or at home. The third argument is that careful individual assessment is required to ensure that dependent people are not offered housing or residential solutions when what they need (and want) is care and services.
What Can We Afford For the National Health Service?
Authors: Pritchard Colin 
Published: February 2007

AbstractThe annual Gross Domestic Product (GDP) is here used as astandardmeasure against which to compare expenditure on Health & Welfare and Defence budgets, between Conservative and Labour governments and the four largest EC countries 1973/4‐1993/4.An analysis of Mrs Thatcher's governments’ expenditure shows that proportionately less GDP went to General Government Expenditure (GGE) than all the other European Community countries. Mrs Thatcher's first government maintained the unprecedented level of GDP devoted to Health reached in 1978/79, but successive administrations began to reduce, and, plan further reductions of GDP for the NHS. Relative decreases of GDP were also found in relation to expenditure on Social Security, Housing, and Personal Social Services and Defence.The governments of France, Germany and Italy provided more of their GDP to health than Britain, whilst at the same time we spent more on Defence and Law & Order & Public Safety. This raises the question: what can we afford for the NHS?A review of demographic changes shows that the British infant and elderly population, who are associated with demands for health, were proportionately more numerous than in France, Germany and Italy. This suggests the need for more UK health expenditure if Britain is to meet current and future needs.
Social Policy and European Union
Authors: Weale Albert 
Published: February 2007

ABSTRACTWhat social policy developments may be reasonably expected from the European Union? Three possible positions on this question are developed: a market liberal view; a progressive liberal view; and an institutionalist view. None of these positions is obviously the correct one, and in each case a mixture of pragmatic and principled criticisms can be developed. However, it is argued that the progressive liberal position strikes an ethically acceptable balance of competing considerations.
A Disaster Foretold? The Case of the Personal Pension
Authors: Waine Barbara 
Published: February 2007

ABSTRACTWith the creation of the State Earnings Related Pension Scheme (SERPS) in 1975, pensions policy in the UK was characterized by a consensus between the Labour and Conservative parties. By the mid 1980s, under the influence of New Right ideas, the Conservatives had broken with this consensus. Conservative pensions policy now centred on the ideological objectives of promoting individual property ownership and pension provision “independent”of the State. Such objectives were central to the creation of personal pensions under the 1986 Social Security Act. This article examines the political background to the emergence of this policy and seeks to evaluate how far the stated aims have been achieved. It does this by analysing the current controversy over methods of selling personal pensions and by looking at statistical evidence on the incomes of individuals who have taken out personal pensions. The argument concludes that personal pensions have been, predominantly, taken out by groups with low incomes, and the combination of low contributions and transaction costs threatens to lead to inadequate pension provision; such problems are likely to be particularly marked for women. In turn this conclusion, when set in the context of the tax regime applying to personal pensions, raises further doubts over the extent to which “independent”pension provision is likely to be achieved.