Recent reformulations of the societal reaction theory argue that the thesis is a perspective rather than a theory, and that the perspective is meant to provide a set of sensitizing concepts to those researching deviance. This research examines the degree of congruence between hypotheses deduced from those assertions and a set of real world occurrences. Data for a sample of male defendants charged with felony offenses are examined to estimate the effects of (I) deviants' social attributes, (2) the specific societal reactors, (3) the values placed on certain offenses and (4) the organizational imperatives of the deviance-controlling organization, controlling for the alleged offense, on the probability of being labeled and sanctioned for deviant behavior. Our analyses indicate that characteristics associated with the alleged offense account for more of the explained variance in the labeling decision examined here (full prosecution) than in the sanctioning (sentence severity) decision. Moreover, while we find the deviants'

Purpose Hypotension is common after spinal anesthesia for cesarean delivery. It is associated with nausea, vomiting and fetal acidosis. Previous research on phenylephrine excluded obese subjects. We compared the incidence of intraoperative nausea and vomiting (IONV) in obese patients who received a prophylactic phenylephrine infusion versus those who received phenylephrine boluses for the treatment of spinal-induced hypotension. Methods In this multi-centre, double-blinded randomized controlled trial, 160 obese women undergoing elective cesarean delivery under spinal anesthesia were randomized to receive a prophylactic phenylephrine infusion initiated at 50 μg/min and titrated according to a predefined algorithm or 100 μg phenylephrine boluses to treat hypotension. Maternal systolic blood pressure was maintained within 20% of baseline. The primary study outcome was the incidence of IONV. Results IONV was significantly reduced in the infusion group compared to the bolus group, 46% vs 75%; relative risk 0.61 (95% CI 0.47 to 0.80); P < 0.001. This was associated with significantly reduced need for intraoperative rescue antiemetics, 26% vs 42%; relative risk 0.62 (95% CI 0.40 to 0.97); P = 0.04, but no difference in the incidence of vomiting. Postoperative vomiting at 2h was reduced in the infusion group, 11% vs 25%; relative risk 0.44 (95% CI 0.21 to 0.90); P = 0.02, however there were no differences in the incidence or severity of postoperative nausea, need for rescue antiemetics at 2h and 24h or the incidence of postoperative vomiting at 24h. The infusion group had a significantly lower incidence of hypotension but greater incidence of reactive hypertension. Conclusion In obese women undergoing cesarean delivery with spinal anesthesia, prophylactic phenylephrine infusion was associated with less intraoperative nausea, less need for rescue antiemetics and reduced early postoperative vomiting. Trial Registry Number NCT01481740 https://clinicaltrials.gov/ct2/show/NCT01481740?term=NCT01481740&rank=1

(Can J Anesth. 2018;65(3):254–262) Hypotension is a common complication of cesarean delivery with spinal anesthesia and can cause intraoperative nausea and/or vomiting (IONV). Bolus dosing of phenylephrine has been shown to be an effective treatment for hypotension, but it does not treat or prevent IONV. Prophylactic phenylephrine infusion, however, has been shown to reduce the incidence of hypotension as well as maternal nausea and vomiting. However, previous studies excluded obese women. This multicenter, randomized, double-blinded study compared phenylephrine infusion to phenylephrine boluses, hypothesizing that IONV incidence would be lower with prophylactic phenylephrine infusion.