澳大利亚的犯罪预防因它在一些重要领域的重大革新和所获得的成就而闻名。但是,澳大利亚巩固这些成就的能力却受到其自身一些结构性因素的限制,比如,各州与联邦之间的持续分裂;联邦政府统一且强有力的领导的缺失,以及两者不同的犯罪预...澳大利亚的犯罪预防因它在一些重要领域的重大革新和所获得的成就而闻名。但是,澳大利亚巩固这些成就的能力却受到其自身一些结构性因素的限制,比如,各州与联邦之间的持续分裂;联邦政府统一且强有力的领导的缺失,以及两者不同的犯罪预防目标,各级政府在执政方向和战略重点上的不断变化;从计划到实施方案间的短期准备;核心部门间的合作和凝聚力(尤其是警察部门)的缺失。此外,也没有足够的证据支持主要的战略性的犯罪预防模式——社区预防模式。本文将逐一讨论澳大利亚各级政府在安排犯罪预防未来工作中遇到的各种问题,并对可预见的未来的发展趋势做出预测,以及对现存问题提供解决方案。我们尤其关注的是为发展和完善犯罪预防而越来越强调运用的"政府全面参与"(whole of government)模式,以"市区重建"(urban renewal)模式为框架来推广和强化的"社区犯罪预防"模式,警察在犯罪预防中的角色转变,以及建立完善的证据基础来支持犯罪预防实践的重要性。展开更多
Background: Propofol is often the drug of choice for ambulatory orthopedic cases. However, propofol can be associated with apnea or other events requiring airway interventions. Dexmedetomidine (Dex) has the unique pha...Background: Propofol is often the drug of choice for ambulatory orthopedic cases. However, propofol can be associated with apnea or other events requiring airway interventions. Dexmedetomidine (Dex) has the unique pharmacologic profile of providing sedation without respiratory depression. This is particularly relevant in patients with morbid obesity and/or challenging airways. The hypotheses were: 1) Propofol would cause more apnea or require more airway manipulations than dexmedetomidine;2) Propofol would have shorter post anesthesia unit recovery times;and 3) Dexmedetomidine would be associated with more bradycardia and hypotension. Methods: After IRB approval, 50 patients were randomized to receive either propofol or Dex for Total Intravenous anesthesia (TIVA) after interscalene brachial plexus block was performed preoperatively under ultrasound guidance. The main end points that we measured where: airway interventions, intra-operative bradycardia, hypotension, and PACU length of stay. Results: There were more airway interventions in the propofol group compared to the Dex group. Additionally, the Dex group had significantly longer PACU stays. Conclusion: We would recommend that Dex should be preferentially considered for patients predisposed to airway obstruction;however, the standard use of Dex over Propofol needed to reconsider since the use of Dex as the agent for TIVA was associated with longer PACU stays.展开更多
文摘澳大利亚的犯罪预防因它在一些重要领域的重大革新和所获得的成就而闻名。但是,澳大利亚巩固这些成就的能力却受到其自身一些结构性因素的限制,比如,各州与联邦之间的持续分裂;联邦政府统一且强有力的领导的缺失,以及两者不同的犯罪预防目标,各级政府在执政方向和战略重点上的不断变化;从计划到实施方案间的短期准备;核心部门间的合作和凝聚力(尤其是警察部门)的缺失。此外,也没有足够的证据支持主要的战略性的犯罪预防模式——社区预防模式。本文将逐一讨论澳大利亚各级政府在安排犯罪预防未来工作中遇到的各种问题,并对可预见的未来的发展趋势做出预测,以及对现存问题提供解决方案。我们尤其关注的是为发展和完善犯罪预防而越来越强调运用的"政府全面参与"(whole of government)模式,以"市区重建"(urban renewal)模式为框架来推广和强化的"社区犯罪预防"模式,警察在犯罪预防中的角色转变,以及建立完善的证据基础来支持犯罪预防实践的重要性。
文摘Background: Propofol is often the drug of choice for ambulatory orthopedic cases. However, propofol can be associated with apnea or other events requiring airway interventions. Dexmedetomidine (Dex) has the unique pharmacologic profile of providing sedation without respiratory depression. This is particularly relevant in patients with morbid obesity and/or challenging airways. The hypotheses were: 1) Propofol would cause more apnea or require more airway manipulations than dexmedetomidine;2) Propofol would have shorter post anesthesia unit recovery times;and 3) Dexmedetomidine would be associated with more bradycardia and hypotension. Methods: After IRB approval, 50 patients were randomized to receive either propofol or Dex for Total Intravenous anesthesia (TIVA) after interscalene brachial plexus block was performed preoperatively under ultrasound guidance. The main end points that we measured where: airway interventions, intra-operative bradycardia, hypotension, and PACU length of stay. Results: There were more airway interventions in the propofol group compared to the Dex group. Additionally, the Dex group had significantly longer PACU stays. Conclusion: We would recommend that Dex should be preferentially considered for patients predisposed to airway obstruction;however, the standard use of Dex over Propofol needed to reconsider since the use of Dex as the agent for TIVA was associated with longer PACU stays.
