Impact of gestational age on preterm motor development at 4 months chronological and adjusted ages

A cohort of 62 low-risk preterm infants was identified and followed prospectively through the first 4 months of life to assess whether motor development is determined by biological maturity or the duration of the extrauterine experience. After identification, the cohort was subdivided into two groups according to gestational age at birth: less than 32 weeks gestation (n = 23) and greater than or equal to 32 weeks gestation (n = 39). Neuromotor assessments were performed on every infant at both 4 months chronological and 4 months adjusted ages. Analyses revealed that (1) the two groups of infants differed significantly at 4 months chronological age in terms of tone, primitive reflexes and volitional movement, but not in automatic reactions, and (2) the two groups of infants differed significantly at 4 months adjusted age in terms of primitive reflexes, but not in tone, automatic reactions or volitional movement. These findings suggest that the development of volitional movement and tone appear to evolve according to biological maturity alone. In contrast, primitive reflexes and automatic reactions in the preterm infant may be influenced by both biological maturation and environmental experience.     

Employees' reactions to an interactive website assessing alcohol use and risk for alcohol dependence,stress level and coping

Objective We assessed employee's reactions to using a website‐based intervention designed to identify moderate and high‐risk drinkers and to reduce their problematic drinking.

Methods One hundred and eighty‐seven participants completed a prewebsite‐intervention survey, website intervention, and a follow‐up survey assessing participants' reactions to the website. The website provided feedback regarding participants' alcohol use, risk of lifetime or current alcohol dependence, stress level, and coping style. Participants identified as at ‘low’ or ‘moderate’ risk for alcohol‐related problems were randomly assigned to receive either ‘limited individualized feedback’ or ‘full individualized feedback’. High‐risk participants were given the full individualized feedback intervention.

Results Twenty‐three per cent were identified to be at high risk of having alcohol‐related problems, and 17% were at moderate risk. Most participants viewed the site information as interesting and easy to use. High‐risk participants were more interested in alcohol‐related information than were other participants. Eight per cent of the respondents reported a change in their drinking with this brief intervention.

Conclusion These findings demonstrate the potential of the Internet to attract and engage persons who are high‐ or moderate‐risk for alcohol‐related problems in learning more about their risk as well as about their stress and their strategies for coping.     

PROPOFOL OR THIOPENTONE: EFFECTS ON INTRAOCULAR PRESSURE ASSOCIATED WITH INDUCTION OF ANAESTHESIA AND TRACHEAL INTUBATION (FACILITATED WITH SUXAMETHONIUM)

Changes in intraocular pressure (IOP) were studied in patientsgiven propofol 2.1 mg kg^–1 (n =30) or thiopentone 4.9mg kg^–1 (n = 30) followed by suxamethonium 1.0 mg kg^–1and tracheal intubation. Half the patients in each group receivedan additional smaller dose of the same induction agent (propofol1.0 mg kg^–1 or thiopentone 2.0 mg kg^–1) immediatelybefore intubation. Both agents produced significant decreasesin IOP which were slightly more marked with propofol. The administrationof suxamethonium produced an increase in IOP in all groups,more so in those given thiopentone, in whom it exceeded thecontrol values. Intubation of the trachea produced the greatestincrease in IOP, averaging about 25% above control in all groupsexcept in the group given the additional dose of propofol, inwhom IOP remained below control values throughout the processof induction and intubation. Ten patients (33%) experiencedpain on injection with propofol. A decrease in systolic arterialpressure of more than 30% was observed in 12 patients (40%)receiving propofol, compared with three (10%) of those giventhiopentone.