ABSTRACT
Global warming has caused widespread surface lowering of mountain glaciers. By comparing two firn cores collected in 2018 and 2020 from Corbassière glacier in Switzerland, we demonstrate how vulnerable these precious archives of past environmental conditions have become. Within two years, the soluble impurity records were destroyed by melting. The glacier is now irrevocably lost as an archive for reconstructing major atmospheric aerosol components.
ABSTRACT
This double-blind prospective study was designed to determine the best dose variables for patient-controlled epidural analgesia (PCEA) and to compare bolus-only PCEA with continuous infusion epidural analgesia (CIEA) during the first stage of labour. Five groups of parturients self-administered 0.125% bupivacaine with 1:400,000 epinephrine and fentanyl 2.5 micrograms.ml-1 using PCA pumps programmed as follows: Group A, 2 ml bolus/10 min lockout interval (LI); Group B, 3 ml bolus/15 min LI; Group C, 4 ml bolus/20 min LI; Group D, 6 ml bolus/30 min LI; Group E, 8 ml.hr-1 continuous infusion. Hourly assessments included: VAS scores for pain and satisfaction, sensory and motor block, bupivacaine and fentanyl consumption. Blood samples were collected at birth for maternal and fetal fentanyl concentrations. Data from 68 patients showed no differences among groups in pain relief or maternal satisfaction. Most patients received excellent analgesia and those requiring extra epidural supplements were evenly distributed across groups. There was higher consumption of bupivacaine and fentanyl in Group E than in any of the other four groups: bupivacaine mg.hr-1, mean (SD), 9.4 (2.7) in Group E vs 5.2 (1.7) in Groups A-D inclusive (P < 0.0001); fentanyl microgram.hr-1, 19.6 (4.6) in group E vs 12.6 (7.5) in Groups A-D inclusive (P < 0.05). Motor block was minimal, whereas sensory levels were higher at the 3- and 4-hour assessments in Groups D and E than in all other groups (P < 0.05). Plasma fentanyl concentrations were < 0.5 ng.ml-1 in all samples and no sequelae from fentanyl were observed, apart from mild pruritus.(ABSTRACT TRUNCATED AT 250 WORDS)
Subject(s)
Analgesia, Epidural , Analgesia, Obstetrical , Analgesia, Patient-Controlled , Bupivacaine/administration & dosage , Fentanyl/administration & dosage , Adult , Apgar Score , Delivery, Obstetric , Double-Blind Method , Female , Fentanyl/blood , Humans , Infant, Newborn , Infusion Pumps , Pain Measurement , Patient Satisfaction , Pregnancy , Prospective Studies , Sensation/drug effects , Time FactorsABSTRACT
Using the NCAST Feeding, Teaching, and HOME Scales, we tested 37 high-risk infants matched with 37 healthy infants on gender, race, and socioeconomic status. All infants were 8 months old. A one-to-one matched case-control design was used to determine whether increased risk of impaired mother-infant interaction was associated with case status. Conditional logistic regression was used to control for possible confounding and to evaluate interaction. Of the 37 high-risk infant-mother dyads, 25 had a low score on one or more scales while only 10 of the control dyads had a low score on one or more of the three scales. The Feeding scale was the only assessment in which the association found in the univariate analysis persisted after adjusting for other variables. Because of its low cost and high efficiency, the NCAST battery appears to be valuable for directing more specialized intervention services in a high-risk infant population.
Subject(s)
Developmental Disabilities/epidemiology , Mother-Child Relations , Nursing Assessment/standards , Adolescent , Adult , Case-Control Studies , Child, Preschool , Cues , Developmental Disabilities/nursing , Developmental Disabilities/psychology , Feeding Behavior , Female , Humans , Infant , Infant Care/standards , Male , Nursing Evaluation Research , Predictive Value of Tests , Reproducibility of Results , Risk Factors , Teaching/standardsSubject(s)
Medical History Taking , Nursing Assessment/economics , Pediatric Nursing , Professional-Family Relations , Adolescent , Adult , Child , Child, Preschool , Cost-Benefit Analysis , Female , Humans , Male , Middle Aged , United StatesSubject(s)
Altitude , Preventive Medicine , Acclimatization , Altitude Sickness/prevention & control , Diet , Humans , Nepal , Wounds and Injuries/therapySubject(s)
Attention Deficit Disorder with Hyperactivity , Activities of Daily Living , Attention Deficit Disorder with Hyperactivity/diagnosis , Attention Deficit Disorder with Hyperactivity/etiology , Attention Deficit Disorder with Hyperactivity/psychology , Attention Deficit Disorder with Hyperactivity/therapy , Child , Female , Humans , Male , Parent-Child Relations , Parents/education , Prognosis , SyndromeABSTRACT
Two hundred and forty-five infants with a mean age of nine months were given screening tests in private pediatric offices by two nurses. Low scores on the BOEL test, a measure of selective attention developed at the Karolinska Institute in Sweden, were found to be significantly associated with the presence of otitis media. Of the 12 items on the BOEL, only the four relating to auditory orienting behavior were discriminative. As a screening device for otitis media, these four items had a validity of 87 percent correct predictions, with 11 percent false positives but only two percent false negatives. BOEL scores also had positive correlations with three of four areas tested by the Denver Developmental Screening Test, but these relationships were modest in magnitude, suggesting that the BOEL and the DDST measure different aspects of the infant's behavior.
