Epidural opioid analgesia after caesarean section: a comparison of patient-controlled analgesia with meperidine and single bolus injection of morphine

The quality of analgesia, patient satisfaction and incidence of side effects following a single bolus of epidural morphine were compared with patient-controlled epidural analgesia (PCEA) with meperidine during the first 24 hr after elective Caesarean section. Seventy-five women were randomly assigned to three equal groups. Group I received 30 mg epidural meperidine after delivery and PCEA with meperidine; Group 2 received 3 mg epidural morphine after delivery and PCEA with saline in a double-blind fashion. Group 3 received 3 mg epidural morphine after delivery without saline PCEA. Visual analogue pain scores (VAS) were higher with PCEA meperidine from 8-16 hr post-operatively (P < 0.05) than in both epidural morphine groups. Two patients in Group 1 and one in Group 3 required supplemental parental analgesia. The incidence of nausea was 16% in Group 1, compared with 52% in Group 2 and 56% in Group 3 (P < 0.01). Pruritus occurred in 24% of Group 1 patients, 84% of patients in Group 2 and 68% of patients in Group 3 (P < 0.001). Forty-six percent of patients in Group 1 were very satisfied with pain management, compared with 77% in Group 2 and 79% in Group 3. Nurse workload was higher in the PCEA study groups than in Group 3 (P < 0.05). A single bolus of epidural morphine provides superior analgesia and satisfaction at low cost, but with a higher incidence of nausea and pruritus than PCEA with meperidine.     

A New Criteria Decision Applied on the Primary Synchronization in the DS-WCDMA Interface of the UMTS System

In DS-WCDMA mobile systems such the UMTS, asynchronous cell site operation,assigning different long spreading code to each cell, yields the advantageof flexible system deployment. We can design an indoor system basedon an outdoor one. However, in general, much longer search time isrequired in asynchronous operation than in synchronous. This paperproposes three techniques to take decisions about synchronizationbased on observation of correlated signals. Classical decision criterialike maximum and threshold criterion are presented. A new decisioncriteria that we call Threshold&Max combined decision criteriais analyzed. The results of this new introduced technique is comparedwith the classical ones.     

Effect of sampling density on the measurement of stream condition indicators in two lowland Australian streams

There is widespread application of indicators to the assessment of environmental condition of streams. These indicators are intended for use by managers in making various comparative and absolute assessments and often have a role in resource allocation and performance assessment. Therefore, the problem of formally defining confidence in the results is important but difficult because the sampling strategies used are commonly based on a compromise between the requirements of statistical rigour and the pragmatic issues of access and resources. It is rare to see this compromise explicitly considered and consequently there is seldom quantification of the uncertainty that could affect the confidence a manager has in an indicator. In this paper, we present a method for quantitatively assessing the tradeoffs between sampling density and uncertainty in meeting various monitoring objectives. Assessments using judgement‐based representative reaches are shown to be unreliable; instead a sampling approach is recommended based on the random selection of measuring sites. A detailed dataset was collected along two streams in Victoria, Australia, and the effect of sampling density was assessed by subsampling from this dataset with precision related to the number of sites assessed per reach length and the intensity of the sampling at each site. The sampling scheme to achieve a given precision is shown to depend on the monitoring objective. In particular, three objectives were considered: (1) making a baseline assessment of current condition; (2) change detection; and (3) detection of a critical threshold in condition. Change detection is shown to be more demanding than assessing baseline condition with additional sampling effort required to achieve the same precision. Sampling to detect a critical threshold depends on nominating acceptable values of Type I and II error and the size of the effect to be detected. Copyright © 2006 John Wiley & Sons, Ltd.     

Moral value transfer from regulatory fit: What feels right is right and what feels wrong is wrong.

People experience regulatory fit (E. T. Higgins, 2000) when the strategic manner of their goal pursuit suits their regulatory orientation, and this regulatory fit feels right. Fit violation feels wrong. Four studies tested the proposal that experiences of fit can transfer to moral evaluations. The authors examined transfer of feeling wrong from fit violation by having participants in a promotion or prevention focus recall transgressions of commission or omission (Studies 1 and 2). Both studies found that when the type of transgression was a fit violation, participants expressed more guilt. Studies 3 and 4 examined transfer of feeling right from regulatory fit. Participants evaluated conflict resolutions (Study 3) and public policies (Study 4) as more right when the means pursued had fit. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Optimisation of antibiotic therapy in cystic fibrosis patients. Pharmacokinetic considerations

Antibiotic therapy plays a central role in the medical management of patients with cystic fibrosis. While totally convincing efficacy data are lacking, antibiotics probably have a pronounced beneficial effect on both morbidity and mortality. Much has been learned in the past 20 years about antibiotic use in this population. At the same time, new antimicrobial agents with the potential to treat this condition have become available for use. The pharmacokinetics of a number of antibiotic classes, including beta-lactams, aminoglycosides and quinolones, are altered in this patient population. Increased total body clearance is a common occurrence but is not always changed enough to warrant altered dosages. Nonetheless, in light of altered pharmacokinetics in the cystic fibrosis population, appropriate dosage and monitoring parameters for a number of antibiotics have been determined.     

Specific heat of thin helium films in a cylindrical geometry

We report measurements of the specific heat of thin helium films adsorbed in the 0.2 µm pores of Anopore membranes. Over the temperature range of these studies, two specific heat anomalies, strongly dependent on helium film thickness, were found.     

The COMMIT dental model: tobacco control practices and attitudes

The National Cancer Institute's program to help dentists reduce tobacco use among their patients is part of the Community Intervention Trial for Smoking Cessation, a 22-community, randomly controlled trial of an intervention program for smoking cessation. Results of COMMIT baseline surveys of dentists in the 11 intervention communities are presented.