Epidural versus patient-controlled analgesia with morphine for postoperative pain after orthopaedic procedures in children.
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Biomedical subjects
Publications and source records attributed to J Aronson.
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Policy making and service organization in long term care for frail elderly people are dominated by concern with reducing institutional costs and increasing the use of relatively inexpensive home care services. Little attention has been focussed on the implications of cost cutting for those at the point of home care service delivery. A qualitative study of visiting homemakers sought to explore these implications. A sample of visiting homemakers working in southern Ontario took part in semi-structured interviews about their work experiences. Analysis of interview transcripts revealed the exploitative potential and tensions introduced by funding restraint, and suggested that home care workers' ability to deliver high quality, personalized care is compromised by organizational practices that speed up and intensify their work. Further research on home care providers and their elderly clients is needed to document the outcomes of economically driven public policies for those who deliver and receive them.
One-hundred and thirty-two children with 139 femur fractures were treated with external fixation from 1984 to 1993. Average age at presentation was 8.97 years. All fractures were followed until union, with an average time of external fixation of 11.4 weeks. There were no nonunions. Of 18 patients with definitive radiographic measurements at 2-year follow-up, 15 patients developed overgrowth (average, 8.7 mm) and three demonstrated shortening (average, 7.7 mm). No patient required treatment for residual leg-length discrepancy. Although pin-tract inflammation was common, pin-tract infection requiring intravenous antibiotics occurred in only six patients (4.5%). No patient developed osteomyelitis. Two fractures (1.4%) were not healed at the time of elective fixator removal, necessitating additional time in the fixator. There were two refractures (1.4%) and one fracture through a healing pin tract after fixator removal (0.7%).