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The prophylactic use of granisetron 40 microg/kg is as effective as meperidine (0.4 mg/kg) and tramadol (0.1 mg/kg) in preventing postanesthetic shivering without prolonging the emergence time from anesthesia.

National criteria for assessing Indonesian cultural heritage properties are mentioned in Article five under the Law 11/2010 on Cultural Property. In general, the four criteria are not much different from the previous legislation, the Law 5/1992. National criteria serve as a guide in determining the criteria for provincial and municipal level. This paper aims to review the national criteria based on opinions of 33 respondents (local people from various professions), who have an interest in heritage conservation, through semi-structured interviews and nominal group technique (NGT). The results of the study highlighted the crucial need of involving community in reviewing current national criteria, to improve assessment criteria for cultural heritage values. Besides, it would support national, provincial and municipal governments in drafting new regulations as a guideline for practice of heritage conservation regarding the Law 11/2010, which until today most have not been published.

IntroductionThis study was designed to compare the effects of intranasal (IN) and intravenous (IV) administration of naloxone in patients who had overdosed on opioids.Material and methodsThis randomized clinical trial study was conducted in the Department of Poisoning Emergencies at Noor and Ali Asghar (PBUH) University Hospital. One hundred opioid overdose patients were assigned by random allocation software into two study groups (n = 50). Both groups received 0.4 mg naloxone: one group IN and the other IV. Outcomes included change in the level of consciousness (measured using a descriptive scale and the Glasgow Coma Scale (GCS)), time to response, vital signs (blood pressure, heart rate and respiratory rate), arterial blood O2 saturation before and after naloxone administration, side-effects (agitation) and length of hospital stay.ResultsPatients who had been administered IN naloxone demonstrated significantly higher levels of consciousness than those in the IV group using both descriptive and GCS scales (p < 0.001). There was a significant difference in the heart rate between IN and IV groups (p = 0.003). However, blood pressure, respiratory rate and arterial O2 saturation were not significantly different between the two groups after naloxone administration (p = 0.18, p = 0.17, p = 0.32). There was also no significant difference in the length of hospital stay between the two groups (p = 0.14).ConclusionsIntranasal naloxone is as effective as IV naloxone in reversing both respiratory depression and depressive effects on the central nervous system caused by opioid overdose.

Over the past few decades, Quality Management System (QMS) and High Performance Work System (HPWS) have emerged as key concepts to enhance organizational effectiveness. All over the globe, majority of contemporary manufacturing and services organizations have applied at least one of these development strategies or even both. This study proposes an integrated framework of QMS and HPWS and empirically investigates the relationship between QMS and HPWS practices and their direct and indirect effects on organizational effectiveness using structural equation modelling (SEM). This research makes a number of significant contributions: (1) The black box of the conjoint implementation is opened up for better appreciation of the interplay of QMS and HPWS practices and their influence on organizational effectiveness (2) The key QMS practices recognized as contributing factor of performance have been classified and examined at two distinct levels i.e. QMS Top Level practices and QMS Core practices (3) The mediating and interaction effects of QMS Core practices and HPWS practices on the relationship of QMS-Top Level practices and organizational effectiveness have been thoroughly investigated. The proposed framework is tested through cross-sectional data from 90 Technical Services Organizations (TSO) operating in Pakistan. The research hypotheses are supported by the test results of the SEM. The findings and implications are discussed along with limitations and future research guidelines.