Effect of preoperative multimedia information on perioperative anxiety in patients undergoing procedures under regional anaesthesia.

BACKGROUND: Provision of preoperative information can alleviate patients' anxiety. However, the ideal method of delivering this information is unknown. Video information has been shown to reduce patients' anxiety, although little is known regarding the effect of preoperative multimedia information on anxiety in patients undergoing regional anaesthesia. METHODS: We randomized 110 patients undergoing upper or lower limb surgery under regional anaesthesia into the study and control groups. The study group watched a short film (created by the authors) depicting the patient's in-hospital journey including either a spinal anaesthetic or a brachial plexus block. Patients' anxiety was assessed before and after the film and 1 h before and within 8 h after their operation, using the Spielberger state trait anxiety inventory and a visual analogue scale. RESULTS: There was no difference in state and trait anxiety between the two groups at enrollment. Women had higher baseline state and trait anxiety than men (P=0.02). Patients in the control group experienced an increase in state anxiety immediately before surgery (P<0.001), and patients in the film group were less anxious before operation than those in the control group (P=0.04). After operation, there was a decrease in state anxiety from baseline in both groups, but patients in the film group were less anxious than the control group (P=0.005). CONCLUSIONS: Preoperative multimedia information reduces the anxiety of patients undergoing surgery under regional anaesthesia. This type of information is easily delivered and can benefit many patients.

Levobupivacaine-induced seizures and cardiovascular collapse treated with Intralipid.

Lipid emulsion has been used in the successful treatment of local anaesthetic-induced cardiovascular collapse in animals and in two cases of cardiac arrest in humans. Previous reports of levobupivacaine toxicity in humans have been characterised by neurological signs and symptoms, without serious cardiovascular events. We present a case in which presumed intravenous injection of levobupivacaine led to neurological and cardiovascular consequences. This was treated successfully by resuscitation that included intravenous Intralipid infusion.

Foreign body ingestion causing gastric and diaphragmatic perforation in a child.

Foreign body ingestion is a common problem in children. Most ingested foreign bodies pass through the gastrointestinal tract without difficulty once they reach the stomach. Perforation of the gastrointestinal tract very rarely occurs. This case report discusses the clinical presentation and management of a very unusual case of an eyeliner pencil ingested by a child that perforated the stomach and diaphragm, causing empyema.

Survey of respiratory sounds in infants.

BACKGROUND: Over the last decade there has been an apparent increase in childhood wheeze. We speculated that much of the reported increase may be attributed to the term wheeze being adopted by parents to describe a variety of other forms of noisy breathing. AIMS: To investigate terminology used by parents to describe their children's breath sounds. METHODS: An interview was carried out with the parents of 92 infants with noisy breathing, beginning with an open question and then directed towards a more detailed description. Finally, the parents were asked to choose from a wheeze, ruttle, and stridor on imitation by the investigator and video clips of children. RESULTS: Wheeze was the most commonly chosen word on initial questioning (59%). Only 36% were still using this term at the end of the interview, representing a decrease of one third, whereas the use of the word ruttles doubled. CONCLUSIONS: Our results reflect the degree of inaccuracy involved in the use of the term wheeze in clinical practice, which may be leading to over diagnosis. Imprecise use of this term has potentially important implications for therapy and clinical trials.

Cognitive antecedents of consumers' willingness to purchase fish rich in polyunsaturated fatty acids (PUFA).

A sample of UK consumers (N = 311) was interviewed in order to identify the attitudinal, cognitive and involvement characteristics of probable early adopters of polyunsaturated fatty acid (PUFA) fed fish. Attitude to fish significantly influenced PUFA fish, premium price PUFA fish, PUFA salmon, PUFA eel and PUFA sturgeon purchase. Involvement in healthy eating influenced PUFA fish, premium price PUFA fish and PUFA salmon purchase. Cognitive style did not influence PUFA fish and premium price PUFA fish purchase; nor, contrary to earlier research, did cognitive style and involvement interact to influence intended PUFA fish purchases.

Radical behaviorist interpretation: Generating and evaluating an account of consumer behavior.

This article considers an approach to the radical behaviorist interpretation of complex human social behavior. The chosen context is consumer psychology, a field currently dominated by cognitive models of purchase and consumption. The nature of operant interpretation is considered, and several levels of operant analysis of complex economic behavior in affluent marketing-oriented economies are developed. Empirical evidence for the interpretation is considered, and a case is made for the qualified use of the hypothetico-deductive method in the appraisal of operant interpretations of complex behaviors.

Gender differences in cognitive styles of MBA students in three countries.

Differences between the scores of male and female respondents, 115 British, 123 Australian, and 131 American midcareer MBA students, confirm propositions derived from Kirton's adaption-innovation theory to the effect that individuals who diverge most from social norms will be among the most innovative members of their group.