bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patient controlled analgesia (PCA) in paediatric surgery: a prospective study following laparoscopic and open appendicectomy
Authors: TILL H. , LOCHBÜHLER H. , LOCHBÜHLER Ha. , KELLNAR St. , BÖHM R. , JOPPICH I. 
Published: February 2007

SummaryPatient controlled analgesia (PCA) has not yet gained universal acceptance for the management of postoperative pain in paediatric surgery. In a prospective study we evaluated feasibility and complications of PCA following 90 cases of laparoscopic or open appendicectomy. PCA proved to be a safe and feasible method with few complications (2% of medical complications, no abort of application, 17 technical checks in a total running time of 4125 h). Acceptance by patients was high and children of all age groups worked the system properly. Assessment of application protocols showed, that the consumption of analgesics was significantly reduced following laparoscopic appendicectomy (P < 0.05). PCA is a safe and feasible method for the management of postoperative pain in children and PCA recording provides an excellent insight into the consumptional behaviour of patients, enabling staff to evaluate postoperative pain for various procedures.
Nicardipine to control mean arterial pressure during extracorporeal membrane oxygenation
Authors: TOBIAS JOSEPH D. , PIETSCH JOHN B. , LYNCH AMY 
Published: February 2007

SummaryThe authors present the use of nicardipine to control mean arterial pressure (MAP) in a 19–month‐old boy who required venoarterial extracorporeal membrane oxygenation for 11 days for treatment of hydrocarbon aspiration. Nicardipine is an intravenously administered dihydropyridine calcium channel antagonist whose primary physiological action includes vasodilatation. Unlike other calcium channel blockers, it has limited effects on the inotropic and dromotropic function of the myocardium. Nicardipine was started at 5 μg·kg−1·min−1 and within five min lowered the MAP from a maximum value of 108 mmHg back to the baseline range of 60 to 80 mmHg. Once the MAP had returned to baseline values, infusion requirements varied from 1 to 3 μg·kg−1·min−1 to maintain the MAP at 60 to 80 mmHg during the 11 days of ECMO. No increase in dose requirements were noted during the 11 days.
Anaesthetic management of a neonate with nesidioblastosis
Authors: BELLWOAR COLETTE , SCHWARTZ ROY , STAYER STEPHEN 
Published: February 2007

SummaryNesidioblastosis is a disorder which is characterized by autonomous insulin secretion that is not affected by decreases in blood glucose. Patients usually present during the neonatal or infantile period with hypoglycaemia associated with hyperinsulinaemia. Most cases of nesidioblastosis are sporadic; however, familial forms appear to be inherited in an autosomal recessive manner. We discuss the anaesthetic management of a patient with nesidioblastosis who presented for near total pancreatectomy and review the literature pertinent to the anaesthesiologist.
Parents in the anaesthetic room: a questionnaire survey of departments of anaesthesia
Authors: McCORMICK A.S.M. , SPARGO P.M. 
Published: February 2007

SummaryThirty departments of paediatric anaesthesia in the United Kingdom were sent a questionnaire about their policies and practices regarding parental presence in the anaesthetic room. Of 22 respondents, 100% left the decision about whether a parent should be present for induction of anaesthesia to the individual anaesthetist and only 14% had written policy guidelines. All departments permitted parental presence at induction for elective surgery, compared with 77% for emergency surgery and 55% for a rapid sequence induction. The minimum age of child below which parents were not allowed at induction varied between no age limit and one year.
Rocuronium in infants, children and adults during balanced anaesthesia
Authors: TAIVAINEN TOMI , MERETOJA OLLI A. , ERKOLA OLLI , RAUTOMA PEKKA , JUVAKOSKI MARKKU 
Published: February 2007

SUMMARYWe studied 20 infants, 20 children and 20 adults during balanced anaesthesia to compare the neuromuscular blocking effects of rocuronium in these age groups. Neuromuscular function was recorded by adductor pollicis emg and a cumulative log‐probit dose‐response curve of rocuronium was established. Thereafter, full spontaneous recovery of the neuromuscular function was recorded. Onset time of the first dose of rocuronium was shorter in children than in infants or adults. The potency of rocuronium was greatest in infants and least in children; the ED50 doses (mean ± SD) being 149 ± 36 μg˙kg−1 in infants, 205 ± 52 μg˙kg−1 in children and 169 ± 47 μg˙kg−1 in adults (P<0.05 between infants and children) and the ED95 doses being 251 ± 73 μg˙kg−1, 409 ± 71 μg˙kg−1 and 350 ± 77 μg˙kg−1, respectively (P<0.05 between all groups). The emg recovery following an average 94.5 ± 4.8% neuromuscular blockade established by rocuronium was roughly similar in all study groups. Thus, one ED95 dose of rocuronium, unlike vecuronium, acts as an intermediate‐acting agent in all age groups.
Recovery of psychomotor function following general anaesthesia in children: a comparison of propofol and thiopentone/halothane
Authors: SCHRÖTER J. , MOTSCH J. , HUFNAGEL A. R. , BACH A. , MARTIN E. 
Published: February 2007

SUMMARYThe present study was undertaken to compare immediate recovery and recovery of complex psychomotor function in 20 children (aged 6–12 years) following general anaesthesia with either thiopentone/halothane or propofol. Early recovery of psychomotor skills was significantly faster in the propofol group than in the thiopentone/halothane group. Compared to preanaesthesia baseline the sedation and cooperation scores, the reaction time to visual and auditory stimuli as well as the postbox test and the flicker fusion frequency were less impaired after propofol than after thiopentone/halothane anaesthesia up to 120 min postoperatively. In the propofol group most tests reached preanaesthesia levels after 120 min, while in the thiopentone/halothane group these levels were not reattained throughout the entire study period. The results indicate that the recovery of psychomotor function in paediatric patients following general anaesthesia with propofol is significantly faster than with thiopentone/halothane. This has important implications for parental satisfaction, the time over which patients need to be monitored in the recovery room and for the discharge criteria after daycase surgery.
Regurgitation and aspiration of gastric contents in a child during general anaesthesia using the laryngeal mask airway
Authors: ISMAIL‐ZADE I.A. , VANNER R.G. 
Published: February 2007

SUMMARYWe present a case report of a child who underwent general anaesthesia for elective surgery in whom regurgitation and aspiration of gastric contents were associated with the use of the laryngeal mask airway (LMA). Bronchospasm developed but mechanical ventilation was not required. The possible mechanisms causing regurgitation are discussed.
Ethnic differences in the timely diagnosis of children with Type 1 diabetes mellitus in the Netherlands: clinical presentation at onset
Authors: Van Laar J. J. N. , Grishchenko M. , Van Wouwe J. P. , Stronks K. 
Published: February 2007

AbstractAims  Little is known about ethnic differences in the timely diagnosis of Type 1 diabetes mellitus (Type 1 DM). This study aimed to assess ethnic inequalities in the timely diagnosis of Type 1 DM, as indicated by a more adverse clinical condition at onset. In addition, we assessed whether these differences could be explained by differences in socio‐economic status.Methods  From a national register, we selected 3128 children aged < 15 years with newly diagnosed Type 1 DM. Ethnic differences in serum glucose, blood pH, bicarbonate, presence of ketonuria, level of consciousness, hydration status, and diabetic ketoacidosis were assessed by logistic regression. A measure of socio‐economic status based on postal codes was used as an explanatory variable.Results  The risk of adverse clinical presentation was 1.5–2 times higher in non‐Western immigrants than Dutch children, while Western immigrant children did not differ from Dutch children. Blood pH, bicarbonate level, and level of consciousness were lower in Turkish and Antillean children in particular. The adverse socio‐economic position of immigrant children contributed very little to these differences in clinical presentation.Conclusions  Non‐Western children were likely to be sicker at first presentation of Type 1 DM, and thus diagnosis may have been delayed. These disparities were not accounted for by differences in socio‐economic status. Possible explanations may be difficulties in recognition of symptoms, failure of GPs to take symptom reporting seriously and lack of awareness of the fact that Type 1 DM occurs more often in certain ethnic groups.
A Response to Social Problems in Developing Countries
Authors: Kaseke Edwin 
Published: February 2007

AbstractThis paper considers social development as a relatively new concept, and new practice model. Its definition still lacks concreteness. Here it is viewed as a process of planned institutional change to bring about a better fit between human needs and social policies and programmes (Sanders, 1982); it is not satisfactory to measure development in purely economic terms, for this has resulted in the marginalization of the majority of the population in developing countries. The curative and remedial functions adopted by the social work profession in accordance with the dictates of the modernization approach, have rendered social work unable to address itself meaningfully to the problem of marginalization or mass poverty. Social development rests upon social policies that are promotive of human needs and this is only possible in circumstances where such policies are a product of the people's participation.
The Reform of the Local Social Services In Israel: 1984 Compared to 1977
Authors: Cnaan Ram A. , Korazim Josef , Meller Yassef , Rosenfeld Jona M. 
Published: February 2007

AbstractIn 1977, there was a nationwide reform of the Local Departments of Social Services (LDSS) in Israel. This article reports on the findings of two independent and complementary studies which sought to evaluate the consequences of this comprehensive planned change. To determine what changes if any, occurred from 1977 to 1984, the first seven years following the reform, the article presents seven major foci of change. Each reflects an objective set forth by those who planned the change at the Ministry of Labour and Social Affairs. Preceding the report of these changes are a review of the historical background of the reform and a summary of the components of this planned change. This article focuses on the changes identified in these studies and concludes with a discussion of policy and organizational implications.
Devolution and Centralism in the National Health Service
Authors: Paton Calum 
Published: February 2007

AbstractThe reforms to the NHS following the White Paper, Working for Patients, were presented by the Conservative government as promoting devolution, defined as “decisions … taken at the lowest possible level” by Douglas Hurd (1991) — reflecting a senior Minister's interpretation of the overall policy agenda, including health. It was further claimed that such policies (“reforms in hospitals, in schools and in housing”) were a way to “empower citizens”. This approach was naturally an attempt to present the Conservatives' policy as pro‐community and ‘practical’ rather than ‘ideological’ or free‐market obsessed.It is worth renewing the debate about whether power and/or responsibility were devolved in the NHS — or, indeed, to the NHS from the Department of Health. Rudolf Klein, in the first edition of his The Politics of the National Health Service (1983), had no sooner pointed to the ‘devolution’ inherent in the 1982 reorganization of the NHS (based on the document Patients First (HMSO, 1981) when the Griffiths Inquiry recommendations were accepted. As a result, he was soon to observe that the pendulum — at that time — had quickly swung back to centralism, an observation reiterated after a few years when The Politics of the National Health Service came out in its second edition (Klein, 1989).In other words, there may be a cycle from centralism to devolution and back, or at least an interpretation of events as such in health policy, which makes a current reassessment timely. Which direction did the NHS Act of 1990 and related initiatives embody?
By What Authority? Ethics and Policy Analysis*
Authors: Donnison David 
Published: February 2007

ABSTRACTBy what authority do social policy analysts evaluate institutions and propose reforms? They have often relied on past traditions of political and moral philosophy, briefly reviewed here, to answer that question. These sources of authority are now failing, and many analysts are moving reluctantly towards a relativist or historicist standpoint which they nevertheless find unattractive. However, by studying institutions, practices and the traditions developed within them, it is possible to formulate and defend a socially embedded morality which will be helpful to policy analysts. Principles derived from it are contestable and liable to change as social circumstances change. But this is a strength, not a weakness, of the approach. Aesthetic reasoning offers helpful paradigms for policy analysis. Social policies and programmes may be derived from moral and political values, but they also help to change them. Indeed, that may be their most important achievement. The paper concludes with questions which teachers and researchers may wish to explore with the help of the concepts set forth here.
Secrecy and Openness in Adoption: An Historical Perspective
Authors: Ryburn Murray 
Published: February 2007

ABSTRACTThe issue of whether there should be continuing contact between those who are adopted and their birth relatives is one of the most contentious issues in current adoption practice (see for example DoH, 1993; McWhinnie and Smith 1994). The view traditionally taken is that adoption in England and Wales has been secret since its legal origins in 1926 and any moves to more fully disclosed information and indeed contact between the parties in adoption is a recent development (see for example DoH 1992). This article considers the history of birth family contact and access to records in adoption from 1926 to the 1958 Adoption Act and examines the factors that favoured the development of closed models of practice where there was no contact between the parties and records became secret. In doing so it challenges the accepted view that adoption has always provided for secrecy in England and Wales and establishes that both the thinking of policy makers and the legislation itself until 1949 provided for more open forms of adoption than we enjoy today. Secrecy, it is claimed, developed as a consequence of a collusion between professionals and the judiciary which disregarded the legal rights of birth parents and failed to respect their entitlement to a proper say in the decisions about the future of their children.
Social Justice and the Reform of Social Security
Authors: Wilson Dorothy J. , Wilson Thomas 
Published: February 2007

ABSTRACTThere have been massive increases over the years in expenditure on the public services loosely grouped together as the “welfare state”, but widespread dissatisfaction persists. This article is a critique of the proposals for reform presented in the Report of the Commission on Social Justice, set up by the late John Smith. The report contains a sweeping condemnation of existing arrangements and puts forward a series of recommendations ranging from the health service to decentralization in government and from employment policy to benefits for the elderly. As was perhaps inevitable, some are more precisely presented than others.An important example of the more fully specified proposals is one to establish what would, in effect, be a means‐tested “pension guarantee”but with “means”so defined as to exclude capital and with much improved “disregards”. Another is the endorsement of the proposals to extend social insurance to part‐time workers—a proposal which raises some controversial issues.There is much in this report that deserves close attention, and it is, therefore, all the more unfortunate that its proposals are not presented in the form of a quantified plan for social policy. Even for the first five years or so of the fifteen the Commission has in mind, there is no attempt at quantification. The importance of economic growth is rightly stressed, but “faster growth”can become a panacea that obscures the need for choice, not only between private and public expenditure but also between the various components of public policy itself.
The Purchaser/Provider Split in Social Care: Is It Working?
Authors: Lewis Jane , Bernstock Penny , Bovell Virginia , Wookey Fiona 
Published: February 2007

This paper reviews the ideas of public choice theory that provided the rationale for introducing the purchaser/provider split and suggests that the notion of provider self‐interest is as undifferentiated a concept as its rival: public ethos or duty. Using data from eighteen months' observation and interviewing in five local authorities, it then goes on to address the huge amount of work involved in separating purchasing from providing. We trace the changing understanding of the purpose of the split, problems of defining who is a purchaser and who a providers, problems of working the new relationship between purchasers and providers, and difficulties in developing the purchasing function.We then seek to examine what are believed to be the main benefits of the purchaser/provider split, asking whether there is evidence that purchasers are doing a better job of identifying needs than providers, and whether there is evidence of competition involving multiple providers and multiple suppliers. Finally, we investigate whether there has been an increase in responsiveness, taking home care as an example. The paper concludes that while increased competition among suppliers has been one important factor in two authorities in securing a more responsive service, the evidence is equivocal as to whether the purchaser/provider split has been the key to securing competition.
EGO STRENGTH AND RESPONSE STEREOTYPY
Authors: Roessler Robert , Greenfield N.S. , Alexander A. A. 
Published: February 2007

ABSTRACTThe incidence of specificity and stereotypy was examined among 36 Ss'responses to six intensities of a 1000‐cps tone. It was found that stereotypy occurred in 26 of the 36 Ss and was significantly less frequent among subjects in an intermediate range of ego strength. When a significant hierarchical patterning of ranks was found (stereotypy), there was marked individual variation in the order of ranks among physiological variables and the order was not related to ego strength. Specificity of response was less frequent, occurring in 16 of the 36 Ss. There was significantly more specificity in a high ego strength group as compared to middle and low Ea groups. Specificity occurred most frequently on heart rate but not significantly more frequently.
AN IMPROVED SIAVLOMETER
Authors: Feather Ben W. 
Published: February 2007

ABSTRACTA high resolution, liquid‐displacement apparatus for monitoring salivary flow is described, and details of its construction from standard laboratory items are provided. The results of a quantitative evaluation indicate: (1) sensitivity to variations in intraglandular pressure of less than 1 mm Hg; (2) instrument time lag of less than 500 msec; and (3) resolution of 0.003 ml. A comparison with previously described liquid‐displacement sialometers indicates an increase in resolution by a factor of 3.
AN AUTOMATIC ANALYZER OF STATES OF VIGILANCE
Authors: Berger Ralph. J. , Meier Gilbert W. 
Published: February 2007

ABSTRACTAn assemblage of relay‐operated, commercially available programming modules is described. It is capable of discriminating among the states of vigilance wakefulness (W): high‐voltage, slow‐wave sleep (HVS); and low‐voltage, fast‐wave sleep (LVF) and it requires information from only the nuchal electromyogram (EMG) and the electrooculogram (EOG).
THE INTERACTION OF RESPONSES IN THE BRAIN TO SEMANTIC STIMULI
Authors: Cohen Jerome , Walter W. Grey 
Published: February 2007

ABSTRACTLong time‐constant EEG recording during paired stimuli has led to the discovery of the contingent negative variation or expectancy wave (Walter, 1964). This effect is produced when a conditional stimulus signals that an imperative stimulus demanding action, decision, or attention will follow at a short, constant time interval.Symbolic and meaningful stimuli were presented to subjects tachistoscopically, and the evoked responses in the brain were electronically averaged. The cerebral evoked responses to such psychological stimuli are more complex than to flashes. A slow negative DC potential shift (CNV) was seen during the interval between an auditory ready signal and the visual exposure if recognition of the stimulus was required, or if it was interesting. Following the visual exposure, a slow positive DC shift occurred. The method has been developed to study the brain responses to psychological stimuli. The amplitude of the responses relates to the information content and subjective factors rather than to the physical strength of the stimulus.
EFFECTS OF SOME DRUGS ON ELECTROENCEPHALOGRAPHIC FAST ACTIVITY AND DREAM TIME
Authors: Lester B. K. , Guerrero‐Figueroa R. 
Published: February 2007

ABSTRACTThe purpose of this study was to test the hypothesis that latency of REM onset is a negative function of drug‐induced precentral fast (18 to 26 cps) activity in the EEG. Chlorpromazine increased this activity during sleep and wakefulness and decreased latency of REM sleep, whereas α‐chloralose, pentothal, and phenobarbital were associated with a decrease of this activity during sleep, increased slow wave sleep, and increased latency of REM sleep. Phenobarbital and pentothal increased this fast activity during wakefulness and drowsiness, respectively. However, 18 to 26 cps precentral activity was reduced during sleep with α‐chloralose and pentothal. A supporting study in cats demonstrates apparent synchrony of fast activity in the limbic system and cortex during wakefulness, and chlorpromazine increases fast activity in the limbic system. It is speculated that chlorpromazine enhances the effect of the limbic system on cortical (primarily precentral) activity. The sedatives are thought to potentiate the spontaneous slow wave sleep pattern.
EEG AMPLITUDE CHANGES DURING DIFFERENT COGNITIVE PROCESSES INVOLVING SIMILAR STIMULI AND RESPONSES
Authors: MacNeilage Peter F. 
Published: February 2007

ABSTRACTIn order to investigate the effects on electroencephalographic (EEG) amplitude of cognitive processes, as distinct from direct effects of sensory stimulation and motor response, subjects were given three different tasks in which the stimuli were always similar sets of spoken numbers and the responses were always written numbers. In response to 61 regularly occurring, randomly ordered, single‐digit numbers, seven Ss wrote, on successive trials, (1) the sum of every 4 consecutive numbers, (2) every fourth number, and (3) every “7” and “9” heard. Since the physical stimuli were the same and the movements of response were similar for the three tasks, intertask pattern differences in EEG alpha and beta amplitude would presumably be due to differences in the cognitive processes required in the tasks. No differences due to cognitive factors were found. All short‐term variations in both alpha and beta appeared related to widespread effects of response and preparation for response. Preresponse effects seemed related to motor set which was distinguished from attentional factors. The results suggest the necessity for a greater emphasis on motor effects in EEG studies.