The objective of this research was to examine the speed of onset and effectiveness of pain relief between oral and intravenous morphine in acutely injured children. An observational study of children aged 3 to 13 years with closed forearm fractures was performed in three accident and emergency departments. The study gathered information on age, gender, body weight, time of arrival, dose, route and time of morphine administration. Pain assessment using a Faces Scale was documented on arrival and repeated at 10, 30 and 60 minutes after morphine was given. Forty-seven children were studied. Of these, 25 were given intravenous morphine, 22 were given oral morphine. There was no statistically significant difference in age, body weight or time until morphine was administered. The change in median pain scores was analysed using the Mann-Whitney U test. This showed that there was a statistically significant reduction in pain score in the intravenous group compared with the oral group between arrival and 10 minutes after giving morphine and between arrival and 60 minutes after giving morphine. Intravenous morphine appears to give more rapid onset and more prolonged pain relief than oral morphine for children with acute injuries. We recommend that in accident and emergency departments where staff are experienced in paediatric cannulation, morphine should be given via the intravenous route in acutely injured children. However we do not advocate inexperienced staff attempting multiple venepunctures in a child resulting in increased anxiety.
Bushfires are the leading cause of death and injuries from natural disasters in Australia, are responsible for hundreds of millions dollars in economic losses every year and seriously affect the country's ecosystems. National data shows that half of these fires are deliberately lit with a significant proportion of these ignitions due to arson. This indicates the importance of arson research in any attempt to reduce unplanned fires. Strategies to prevent bushfire arson are examined from a criminological perspective. Much of the research on bushfire arson to date has focussed on identifying the motivations of arsonists and the paper shows the lack of utility of this approach. The difficulty of screening arsonists from employment with fire agencies is also discussed. More productive strategies include identifying and working with communities with high arson potential and early interventions with known arsonists or those at high risk of becoming one. The deterrence value of higher penalties is examined. The paper concludes that better data on bushfire ignitions and working with high risk communities and individuals offer the best chance of minimising bushfire ignitions in Australia at the present time.
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