Postoperative residuial block after intermediate-acting neuromuscular blocking drugs

Summary The frequency and duration of postoperative residual neuromuscular block on arrival of 150 patients in the recovery ward following the use of vecuronium (n = 50), atracurium (n = 50) and rocuronium (n = 50) were recorded. Residual block was defined as a train-of-four ratio of 0.8 after arrival in the recovery ward were 9.2 [1-61], 6.9 [1-24] and 14.7 [1.5-83] min for the vecuronium, atracurium and rocuronium, respectively. None of the 10 patients who did not receive neuromuscular blocking drugs had train-of-four ratios

Neostigmine antagonism of rocuronium block during anesthesia with sevoflurane, isoflurane or propofol

Purpose: To examine the influence of continuing administration of sevoflurane or isoflurane during reversal of rocuronium induced neuromuscular block with neostigmine. Methods: One hundred and twenty patients, divided into three equal groups, were randomly allocated to maintenance of anesthesia with sevoflurane, isoflurane or propofol. Neuromuscular block was induced with rocuronium and monitored using train-of-four (TOF) stimulation of the ulnar nerve and recording the force of contraction of the adductor pollicis muscle. Neostigmine was administered when the first response in TOF had recovered to 25%. At this time the volatile agent administration was stopped or propofol dosage reduced in half the patients in each group (n = 20 in each group). The times to attain TOF ratio of 0.8, and the number of patients attaining this end point within 15 min were recorded. Results: The times (mean ± SD) to recovery of the TOF ratio to 0.8 were 12.0 ± 5.5 and 6.8 ± 2.3 min in the sevoflurane continued and sevoflurane stopped groups, 9.0 ± 8.3 and 5.5 ± 3.0 min in the isoflurane continued and isoflurane stopped groups, and 5.2 ± 2.8 and 4.7 ±1.5 min in the propofol continued and propofol stopped groups (P <0.5- 01). Only 9 and 15 patients in the sevoflurane and isoflurane continued groups respectively had attained a TOF ratio of 0.8 within 15 min (P <0.001 for sevoflurane). Conclusions: The continued administration of sevoflurane, and to a smaller extent isoflurane, results in delay in attaining adequate antagonism of rocuronium induced neuromuscular block.

Steric effects in the selective hydrogenation of cinnamaldehyde to cinnamyl alcohol using an Ir/C catalyst

The liquid phase selective hydrogenation of cinnamaldehyde to cinnamyl alcohol has been carried out over a graphite-supported iridium catalyst. The effect of reaction parameters such as temperature, pressure, concentration of reactant, the effect of addition of product to the feed and pre-reduction of the catalyst were studied. In situ pre-reduction of the catalyst with hydrogen had a very significant enhancing effect on the conversion of cinnamaldehyde and selectivity of the catalyst to cinnamyl alcohol. Kinetic analysis of the pre-reduced catalyst showed that the reaction is zero order with respect to cinnamaldehyde and first order with respect to hydrogen. The reaction follows an Arrhenius behaviour with an activation energy of 37 kJ mol(-1). Detailed analysis of the reaction showed that hydrogenation of the C=C double bond to give hydrocinnamaldehyde predominantly occurred at low conversions of cinnamaldehyde (

Child Welfare Interventions: Patterns of Social Work Practice

Some 10 years ago one of the authors embarked on a research study examining the potential for social workers to shift from a child protection to a child welfare practice orientation (Spratt, 2000; 2001; Spratt and Callan, 2004). The research reported here develops that work; examining how social workers respond to ‘child care problems’ (CCPs). The results indicate that Northern Irish Health and Social Services Trusts (equivalent to Local Authorities in England and Wales) have responded to social policy goals to balance the protection of a lesser number of children whilst meeting the welfare needs of the greater by reducing the number of referrals designated ‘child protection investigations’ (CPIs) and increasing the number of CCPs. Closer analysis reveals, however, that a filtering system has been developed by social workers to address perceived child protection risks within CCP cases. Paradoxically, this leads to early closure of the more concerning cases, with service provision largely confined to the least concerning. The authors argue that the ways in which social workers balance social policing and supportive functions in practice may indicate possible responses to an increase in referred families anticipated within Every Child Matters (Chief Secretary to the Treasury, 2003).

An Innovative Model for the Provision of Practice Learning Opportunities in Family and Child Care: Newry Student Unit, Southern Health and Social Care Trust.

This article describes the work of Newry Student Unit which operates in the Southern Health and Social Care Trust. The background to the unit is outlined and its development is discussed in the context of practice learning provision in Northern Ireland. The operation of the unit in providing Family and Child Care practice learning opportunities (PLOs) for student social workers is outlined and findings from evaluation questionnaires completed by students, college tutors and team leaders are presented. The paper highlights both the advantages and disadvantages of this model of PLO provision and concludes that it is a valuable resource for practice learning. Proposals for the development of the unit are discussed and it is suggested that the model has the potential be replicated in other areas of Northern Ireland.

Relations between premise similarity and inductive strength

According to the diversity principle, diverse evidence is strong evidence. There has been considerable evidence that people respect this principle in inductive reasoning. However, exceptions may be particularly informative. Medin, Coley, Storms, and Hayes (2003) introduced a relevance theory of inductive reasoning and used this theory to predict exceptions, including the nondiversity-by-property-reinforcement effect. A new experiment in which this phenomenon was investigated is reported here. Subjects made inductive strength judgments and similarity judgments for stimuli from Medin et al. (2003). The inductive strength judgments showed the same pattern as that in Medin et al. (2003); however, the similarity judgments suggested that the pattern should be interpreted as a diversity effect, rather than as a nondiversity effect. It is concluded that the evidence regarding the predicted nondiversity-by-property-reinforcement effect does not give distinctive support for relevance theory, although this theory does address other results.

Further reflections on Habermas's contribution to discourse in child protection: An examination of power in social life

Hayes and Houston's positive review of Habermas's contribution to discourse in family group conferences (in this journal) has been challenged by Garrett. In this paper, one of the authors replies to Garrett but extends the analysis through a more considered, developed and detailed examination of Habermas's thoughts on power in social life. This leads to a conceptual framework that enables the participants in the conference to exercise power in a positive manner. In developing this earlier analysis, the paper also acknowledges Garrett's argument that Bourdieu helps us to understand the nature of constraining social structures in child protection. However, Bourdieu's ideas are subsequently challenged on the grounds that they lack a competent formulation on human agency - a faculty that Habermas cogently elucidates. This enlarged understanding of agency, it is argued, offers a theoretical resource that fits better with the ethos of emancipatory social work.

Dealing with post-traumatic stress disorder: The psychological sequelae of bloody Sunday and the response of state services

Objective: This article describes the political context of health and social care services in Northern Ireland at a the of intense social conflict. Method: Concepts from post-traumatic stress disorder (PTSD) and other relevant international psychological literature are then used to study the experience of the Bloody Sunday families, victims of a traumatic event that happened in Derry in January 1972. Results: High levels of psychological morbidity within this population are reported, alongside some evidence that families had not received services that may have helped resolve the trauma. Conclusions: The authors noted that new services planned as a result of the current peace process may offer social workers and other professionals new ways to address the unmet needs of people traumatized by the Troubles.

The Relevance Framework for Category-Based Induction: Evidence From Garden-Path Arguments

Relevance theory (Sperber & Wilson. 1995) suggests that people expend cognitive effort when processing information in proportion to the cognitive effects to be gained from doing so. This theory has been used to explain how people apply their knowledge appropriately when evaluating category-based inductive arguments (Medin, Coley, Storms, & Hayes, 2003). In such arguments, people are told that a property is true of premise categories and are asked to evaluate the likelihood that it is also true of conclusion categories. According to the relevance framework, reasoners generate hypotheses about the relevant relation between the categories in the argument. We reasoned that premises inconsistent with early hypotheses about the relevant relation would have greater effects than consistent premises. We designed three premise garden-path arguments where the same 3rd premise was either consistent or inconsistent with likely hypotheses about the relevant relation. In Experiments 1 and 2, we showed that effort expended processing consistent premises (measured via reading times) was significantly less than effort expended on inconsistent premises. In Experiment 2 and 3, we demonstrated a direct relation between cognitive effect and cognitive effort. For garden-path arguments, belief change given inconsistent 3rd premises was significantly correlated with Premise 3 (Experiment 3) and conclusion (Experiments 2 and 3) reading times. For consistent arguments, the correlation between belief change and reading times did not approach significance. These results support the relevance framework for induction but are difficult to accommodate under other approaches.