Objective: During the past two decades, professional associations, accrediting bodies, and payors have made postsurgical pain treatment a high priority. In light of the disappointing findings in previous surveys, a survey was conducted to assess patient perceptions and characterize patient experiences/levels of satisfaction with post-surgical pain management. Research design and methods:Survey included a random sample of US adults who had undergone surgery within 5 years from the survey date. Participants were asked about their concerns before surgery, severity of perioperative pain, pain treatments, perceptions about post-surgical pain and pain medications, and satisfaction with treatments they received. Results:Of the 300 participants, 86% experienced pain after surgery; of these, 75% had moderate/extreme pain during the immediate post-surgical period, with 74% still experiencing these levels of pain after discharge. Post-surgical pain was the most prominent pre-surgical patient concern, and nearly half reported they had high/very high anxiety levels about pain before surgery. Approximately 88% received analgesic medications to manage pain; of these, 80% experienced adverse effects and 39% reported moderate/severe pain even after receiving their first dose. Study limitations:Key study limitations include the relatively small population size, potential for recall bias associated with the 14-month average time delay from surgery date to survey date, and the inability to account for influences of type of surgery and intraoperative anesthetic/analgesic use on survey results. Conclusions:Despite heightened awareness and clinical advancements in pain management, there has been little improvement in post-surgical analgesia as measured by this survey of post-surgical patients.

The benefits of all-day kindergarten are increasingly supported by educational policy groups. Rigorous, prospective empirical research is impractical for schools of limited fiscal means where education must take priority over institutional research. However, post-hoc analyses of archival and informal measures can provide invaluable information concerning educational issues of national concern. A method of university and elementary school collaboration was employed in evaluating the educational effects of a transition from half-day to full-day kindergarten in an economically challenged suburban-rural school district in Maine. A child developmental scale and educational measures were used to evaluate differences in improvement scores between children enrolled in half-day kindergarten one year and children enrolled in full-day kindergarten the following year. Additional measures addressed parent and teacher attitudes toward full-day kindergarten. Overall, children enrolled in full-day kindergarten showed greater improvement than children in half-day kindergarten. Results of teacher and parent questionnaires indicated a high degree of satisfaction with full-day kindergarten. The research effort, based on a service learning model, provided a costeffective strategy for recovering and analyzing archival data.

This qualitative study explored the impact of academically underprepared students on 14 liberal arts and sciences faculty at two open-admissions universities. In-depth interviews revealed that faculty face widespread, acute problems in teaching underprepared students. Further, they feel isolated, with little support from colleagues or administrators. To survive in an open-admission environment, many undergo a confusing, emotionally trying process of personal adaptation, role redefinition, and reassessment of college-level teaching and learning.

An automated method for coding hospital patient records is described, which uses a combination of simple computer programs and a structured dictionary. The system accepts unrestricted medical language in French as input, and generates code combinations which represent the semantic values of the original statements. The coding structure is the trial version of the Systematized Nomenclature of Medicine (SNOMED) [9], A prototype system has been developed from a 20,000 word corpus of obstetrical and gynecological data, recorded from patient records written by French-speaking Quebec physicians. Preliminary test results on a small sample show that the system generates accurate codes and code combinations for 97.9% of the data tested. The programs were written in Fortran IV and implemented on a DEC PDP-9 computer. The dictionary keys are word segments and the entries contain operators, word segments and SNOMED codes. The dictionary structure permits a single entry to generate multiple SNOMED codes and to handle the types of linguistic paraphrase found in hospital records. The SNOMED codes and code combinations constitute a metalanguage which provides the means for data compression and uniform representation of natural language medical data.

The incidence of myocardial infarction and the return to work for survivors were studied among the employees of an English car assembly plant by analysing 12 811 medical records of persons employed during the seven years between January 1966 and December 1972. The standardized morbidity ratio of myocardial infarction found in this study calculated on the basis of incidence rates reported by Kinlen )1973) for the Oxford community in which the factory was situated was 90. The standardized morbidity ratio from production line workers only was 66 and that for the monthly paid staff 272. Of the production line workers who survived the attack 22 (90%) returned to their previous jobs without undue difficulty and with two exceptions within four months of the onset of their illness; there was no relation between length of absence and age at the time of attack. These findings suggest that workers in mass production jobs such as car assembly are not special risk from myocardial infarction, and most of those who survive a heart attack are able to return to their former work. Taken with Kinlen's (1973) study and that of Armstrong et al. (1972) in Edinburgh, they also bear out mortality data by indicating that in Oxfordshire the incidence of coronary heart disease is lower than the British average.