Systemic effects of a prolonged continuous infusion of ketamine in healthy horses.

BACKGROUND: Ketamine as continuous rate infusion (CRI) provides analgesia in hospitalized horses. OBJECTIVE: Determine effects of prolonged CRI of ketamine on gastrointestinal transit time, fecal weight, vital parameters, gastrointestinal borborygmi, and behavior scores in healthy adult horses. ANIMALS: Seven adult Thoroughbred or Thoroughbred cross horses, with permanently implanted gastric cannulae. METHODS: Nonblinded trial. Random assignment to 1 of 2 crossover designed treatments. Ketamine (0.55 mg/kg IV over 15 minutes followed by 1.2 mg/kg/h) or lactated Ringer's solution (50 mL IV over 15 minutes followed by 0.15 mL/kg/h) treatments. Two hundred 3 × 5 mm plastic beads administered by nasogastric tube before drug administration. Every 2 hours vital parameters, behavior scores recorded, feces collected and weighed, and beads retrieved. Every 6 hours gastrointestinal borborygmi scores recorded. Study terminated upon retrieval of 180 beads (minimum 34 hours) or maximum 96 hours. Nontransit time data analyzed between hours 0 and 34. RESULTS: No significant (P < .05) differences detected between treatments in vital signs or gastrointestinal borborygmi. Significant (P = .002) increase in behavior score during ketamine infusion (0.381) from hours 24-34 compared with placebo (0). Ketamine caused significant delay in passage of 25, 50, and 75% of beads (ketamine = 30.6 ± 5.3, 41.4 ± 8.4, 65.3 ± 13.5 hours versus placebo = 26.8 ± 7.9, 34.3 ± 11.1, 45.8 ± 19.4 hours), and significant (P < .05) decrease in fecal weight from hours 22 (12.6 ± 3.2 versus 14.5 ± 3.8 kg) through 34 (18.5 ± 3.9 versus 12.8 ± 6.4 kg) of infusion. CONCLUSIONS AND CLINICAL IMPORTANCE: Ketamine CRI delayed gastrointestinal transit time in healthy horses without effect on vital parameters.

Assessing continuing care needs: findings from the Fife Healthcare Assessment for Placement Project for elderly people.

Previous surveys of elderly patients in different continuing care settings suggest considerable overlap between settings. However, re-analysis of this data in terms of patients' profiles of dependency reveals a somewhat different picture, suggesting that overlap is not such a general phenomenon. Further data from new surveys in Fife confirm this view. The findings of these studies raise questions about some of the previous research on "misplacement' of people in long-stay care, and suggest that planners may need to be more discriminating in their analysis of which types of patient to transfer and what continuing care resources might be required. Failure to address these issues may lead to undue pressure on many of the continuing care placements.

What do foster parents think of the natural parents? A comparative study.

By means of standardized case vignettes and rating scales, this study compared attitudes of short-term foster parents, professional social workers and parents in the general population respectively towards birth parents of abused children received into foster care. Significant differences arose between the foster parents and comparison groups on dimensions about issues relating to the desirability of foster care, restrictions on contact with birth parents and conditions under which the abused child might return to its family. Wide variation occurred both between individual foster parents and also in the degree of correspondence of views between the foster parents and each of the comparison groups on individual dimensions. Such an anomalous position, if unacknowledged, might affect outcomes of individual foster placements and hold implications for the recruitment, training and support of foster parents.

Outcome of patients committed to hospital under the Mental Health (Scotland) Act 1960.

All patients formally detained in a Scottish psychiatric hospital between 1974 and 1979 were identified and their outcome determined 2 1/2-8 1/2 years later. A matched group, detained under Emergency Orders only, were also followed-up. Those formally detained had more previous psychiatric contact: functional psychoses were significantly more common in them. They remained in hospital longer, and required extensive community support when discharged. Those detained under Emergency Orders only, consisted of two sub-groups--one who left the area within two years of admission and could not be traced, and the remainder, who continued to require hospital treatment but for shorter times and with less continuous support. Amongst those detained, lack of insight was a predominant feature, which may create difficulty with regard to informed consent to treatment, given the present Amendments to the Mental Health Acts.