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911.
912.
913.
We have examined acetaminophen (paracetamol) dosing for outpatient management of posttonsillectomy pain in children. Forty children, 5-15 years of age, undergoing tonsillectomy and their parents were randomly assigned to use a scheduled administration of acetaminophen in weight appropriate doses, 60 mg.kg-1.24h-1 orally, 90 mg.kg-1.24h-1 rectally, or to use acetaminophen 'as needed' according to present standards (control group). Postoperative pain was assessed by the child using the poker chip tool for the first three days after discharge. The prevalence of pain amongst all the children was high. The second day after discharge 22%-64% of the children in the study group and 36%-73% of the children in the control group rated severe pain. Recommended dose ranges of acetaminophen do not provide sufficient pain relief in children following tonsillectomy. Further studies are required to determine, whether higher doses of acetaminophen or analgesics with different analgesic properties will lead to improved analgesia in children following tonsillectomy.  相似文献   
914.
915.
Tested the hypothesis that Ss with severe mental illnesses would achieve better vocational outcomes with an accelerated approach to supported employment (AASE), as compared to gradual approaches (GA) with prevocational training. 86 Ss (mean age 35.1 yrs) with a diagnosis of a serious mental illness, were randomly assigned to either the AASE, or the GA, which included a minimum of 4 mo prevocational training. Data were obtained on indicators of vocational outcomes over 2 yrs, and for a limited number of Ss (n=36), during the 4th yr of inception into the program. Initially, only 5% of Ss preferred prevocational training. After 1 yr, AASE Ss showed better outcomes for a range of indicators, including achievement of competitive employment, duration of employment and mean earnings. During the 4th yr, 59% of these Ss were competitively employed, as compared to only 6% of GA Ss. Rehabilitation is more effective using AASE than GA. (PsycINFO Database Record (c) 2010 APA, all rights reserved)  相似文献   
916.
Socially amoral economic forces now drive health system change. The authors, assisted by a panel of experts on employers, health plans, providers, and consumers, discuss current drivers such as (1) employers' price-focused purchasing, without good quality/value measures; (2) health plans' growing successes and market clout; (3) providers declining prospects and fears about their future; and (4) consumers' worries about less choice. Future influences will include Medicare reforms, better information, and pro-consumer regulation of managed care, as well as rising social distress. The health system's future is now open for resolution in an evolving, imperfect market.  相似文献   
917.
918.
The participation of sarcoplasmic reticulum Ca2+ release channels in the activation of Ca(2+)-sensitive K+ currents (IK(Ca)) by cyclic dibutyryl GMP was investigated in smooth muscle cells from the circular layer of guinea-pig gastric fundus. All experiments were performed in the presence of 3 microM nicardipine into the bath and low Ca2+ buffering capacity of the pipette-filling solution (pCa 7.4). Ruthenium red (10 microM) as well as its combination with 10 microM heparin abolished the cyclic GMP-induced activation of IK(Ca), while 10 microM heparin remained ineffective. Ryanodine (10 microM) and the subsequently added 1 microM thapsigargin induced a relatively small increase in IK(Ca) amplitudes. The addition of 10 microM ryanodine to 1 microM thapsigargin-containing bath solution caused a vast increase in IK(Ca). It is hypothesyzed that protein kinase G-induced vectorial Ca2+ flux from the cell bulk and sarcoplasmic reticulum Ca2+ stores toward the plasma membrane is realized by a spontaneous Ca(2+)-induced Ca2+ release from a superficially situated Ca2+ store.  相似文献   
919.
A solution to autonomous lateral vehicle guidance using a neurocontroller that can learn from measured human-driving data without knowledge of the physical car parameters is discussed. Simulations and practical tests confirm that a small-size feedforward autonomous neural network (21 neurons) can learn to steer a vehicle at high speeds only from looking at human-driving examples. In this way, the network learns the total closed-loop behavior, including the nonlinear dynamics of the vehicle and the driver's individual driving style. The main result of practical investigations is that the neutral controller trained on human-driving examples exhibits an aperiodic behavior that does not vanish at higher speeds (tests performed up to 130 km/h) and produces fewer lateral deviations than the linear state controller  相似文献   
920.
Following two years operation of the 100 kW grid-connected installation N13 near Domat/Ems, Switzerland, considerable data are available. The yield of the installation was calculated on the basis of long-term meteorological data and of the Meteonorm model. The findings show a close correlation between the forecast and the measured yields. With 100% availability of the inverter in 1991, the performance of the installation rose from 59% in 1990 to 79% in 1991. With standardized analysis of the data, the performance of the grid-connected installation N13 can be compared with other grid-connected installations irrespective of size and location.  相似文献   
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