Although the response rate was low, the majority of the responders provide care to these children routinely, so it can be inferred that the results of this survey are the closest published results to the true trend.

Results showed this multilayer trauma's impact on emotional health and HRV-based measures of autonomic nervous system dysregulation. Specifically, dysregulation of depressed survivors' HRV in response to trauma reminders supports more autonomic involvement in traumatic loss/depression than in PTSD. Diagnostic criteria for PTSD include physiologic reactivity, and the present findings suggest that, in this setting, altered physiologic reactivity observed when PTSD coexists with depression.

Novel H1N1 influenza virus infected more than 43,000 people, killed 353 and spread to more than 122 countries within a few months. The World Health Organization declared a stage 6 worldwide pandemic. Healthcare workers and hospitals prepared for the worst. Federal and State regulations provided the legal framework to allow for the preparation and planning for a pandemic. One State had mandated both seasonal and Novel H1N1 vaccination of all healthcare workers in an effort to reduce transmission of influenza in healthcare facilities.The US Supreme Court decided in 1905 that the police power of the State permitted a State Department of Health the leeway to mandate vaccination in the face of a contagious disease. Law suits were filed, and a temporary injunction barring mandatory vaccination was entered by the court.While awaiting a court hearing, the mandatory vaccination regulation was rescinded because of the shortage of both seasonal and H1N1 vaccine. Based on the current state of the pandemic and the shortage of vaccination, it is possible that the US Supreme Court would uphold mandatory vaccination in a pandemic.

N2O decreased both BIS and SE when added to sevoflurane, but not propofol. The observed changes in the sevoflurane group were not clinically significant. Decreases in BIS and SE in the sevoflurane group could result from a true additive effect and second-gas effect of N2O that was unaccounted for despite a meticulous titration of sevoflurane using end-tidal gas monitoring.

Recent studies investigating the relationship between depth of anesthesia and implicit memory have conflicting results. Limitations of these studies include lack of standardization in surgical procedures and failure to control depth of anesthesia prospectively. We assessed implicit memory function at two different (BIS-guided and prospectively controlled) anesthetic depths during surgical stimulus. A list of words was played via headphones to 37 patients during orthopedic surgery under general anesthesia. The Bispectral (BIS) Index was monitored and patients were randomized to remain in a deeper (BIS 40-45) or lighter (BIS 55-60) plane of surgical anesthesia during word presentation. Postoperatively, implicit memory performance was tested using a simple auditory word-stem completion test for presented as well as non-presented words. Absence of explicit memory was evaluated by asking four standard questions regarding intraoperative awareness. All patients received sevoflurane and fentanyl for general anesthesia. There was no evidence of implicit memory in either study group. Hit rates for presented and non-presented words were 0.23 ± 0.14 and 0.25 ± 0.09, respectively. No explicit memory was reported by any patient. Depth of anesthesia did not affect implicit memory formation in anesthetized patients undergoing surgery. General anesthesia, even at a higher BIS range, appears to abolish implicit memory as assessed by a simple word-stem completion test.