Economics, National Policy, and Military Strategy: The Growing Linkage in the 1990s

The challenge now is to prepare for non-specific and changing threats that require robust response capabilities. This imposing task is further complicated by the fact that fewer dollars are available for defense

Intravenous conscious sedation in patients under 16 years of age. Fact or fiction?

Recently published guidelines on the use of conscious sedation in dentistry have published varying recommendations on the lower age limit for the use of intravenous conscious sedation. There are a large number of dentists currently providing dental treatment for paediatric patients under intravenous conscious sedation. The 18 cases reported here (age range 11-15 years), were successfully managed with intravenous conscious sedation. The experience in this paper is not sufficient evidence to recommend the wholesale use of intravenous conscious sedation in patients who are under 16 years. The fact that a range of operators can use these techniques on paediatric patients would suggest that further study should be carried out in this population. The guidance should be modified to say there is insufficient evidence to support the use of intravenous conscious sedation in children, rather than arbitrarily selecting a cut off point at age 16 years

The effect of transmucosal 0.2mg/kg Midazolam premedication on dental anxiety, anaesthetic induction and psychological morbidity in children undergoing general anaesthesia for tooth extraction

<b>Background:</b> The project aims were to evaluate the benefit of transmucosal Midazolam 0.2mg/kg pre-medication on anxiety, induction behaviour and psychological morbidity in children undergoing general anaesthesia (GA) extractions. <b>Method:</b> 179 children aged 5-10 years (mean 6.53 years) participated in this randomised, double blind, placebo controlled trial. Ninety children had Midazolam placed in the buccal pouch. Dental anxiety was recorded pre operatively and 48 hours later using a child reported MCDAS-FIS scale. Behaviour at anaesthetic induction was recorded and psychological morbidity was scored by the parent using the Rutter Scale pre-operatively and again one-week later. Subsequent dental attendance was recorded at one, three and six months after GA. <b>Results:</b> Whilst levels of mental anxiety did not reduce overall, the most anxious patients demonstrated a reduction in anxiety after receiving midazolam premedicationmay (p=0.01). Neither induction behaviour nor psychological morbidity improved. Irrespective of group, parents reported less hyperactive (p= 0.002) and more prosocial behaviour (p=0.002) after the procedure:;, older children improved most (p=0.048), Post GA Dental attendance was poor and unrelated to after the procedure and unaffected by premedication. <b>Conclusion:</b> 0.2mg/kg buccal Midazolam provided some evidence for reducing anxiety in the most dentally anxious patients. However, induction behaviour, psychological morbidity and subsequent dental attendance were not found to alter between the premedication groups

Triggered Electrical Stimulation Cueing to Address Hypofunctioning Peroneus Muscle in the Treatment of Chronic Ankle Instability: Two Repeated Single Case Designs

Background: Approximately two million ankle sprains occur in the United States annually. Lateral ankle sprains (LAS) account for 85% of all ankle sprains, 74% of those individuals report continued symptoms following the initial insult. Persistent pain and instability following ankle sprain is indicative of chronic ankle instability (CAI). There are many interventions to address hypofunctioning muscle including electrical stimulation (ES) and it is known that peripheral ES changes muscle behavior. The purpose of this pilot study was to investigate the effect of electrical stimulation of the peroneal muscles combined with 3 exercises for the treatment of CAI.Methods: Two participants with CAI were recruited for this repeated single case design. The Cumberland Ankle Instability Tool (CAIT), the modified Star Excursion Balance Test (mSEBT), and center of pressure (CoP) was measured. A single limb hop to stabilization protocol and single limb stance activities were combined with manual triggered electrical stimulation for six sessions.Results: Improvements in CAIT scores for both patients were observed. There was no statistically significant change in mSEBT scores. Center of Pressure measurement improvements varied between subjects. For subject 1, there was no significant change in CoP in eyes open and eyes closed conditions. For subject 2, there was a significant change in the anterior/posterior CoP data points in both conditions.Discussion: In individuals with CAI, the addition of electrical stimulation to a single limb stance and hop stabilization protocol for hypofunctioning peroneal muscles led to positive CAI outcomes as measured by improved CAIT scores and improved CoP measurement in one subject

Keeper-animal interactions: differences between the behaviour of zoo animals affect stockmanship

Stockmanship is a term used to describe the management of animals with a good stockperson someone who does this in a in a safe, effective, and low-stress manner for both the stock-keeper and animals involved. Although impacts of unfamiliar zoo visitors on animal behaviour have been extensively studied, the impact of stockmanship i.e familiar zoo keepers is a new area of research; which could reveal significant ramifications for zoo animal behaviour and welfare. It is likely that different relationships are formed dependant on the unique keeper-animal dyad (human-animal interaction, HAI). The aims of this study were to (1) investigate if unique keeper-animal dyads were formed in zoos, (2) determine whether keepers differed in their interactions towards animals regarding their attitude, animal knowl- edge and experience and (3) explore what factors affect keeper-animal dyads and ultimately influence animal behaviour and welfare. Eight black rhinoceros (Diceros bicornis), eleven Chapman’s zebra (Equus burchellii), and twelve Sulawesi crested black macaques (Macaca nigra) were studied in 6 zoos across the UK and USA. Subtle cues and commands directed by keepers towards animals were identified. The animals latency to respond and the respective behavioural response (cue-response) was recorded per keeper-animal dyad (n=93). A questionnaire was constructed following a five-point Likert Scale design to record keeper demographic information and assess the job satisfaction of keepers, their attitude towards the animals and their perceived relationship with them. There was a significant difference in the animals’ latency to appropriately respond after cues and commands from different keepers, indicating unique keeper-animal dyads were formed. Stockmanship style was also different between keepers; two main components contributed equally towards this: “attitude towards the animals” and “knowledge and experience of the animals”. In this novel study, data demonstrated unique dyads were formed between keepers and zoo animals, which influenced animal behaviour