Exploring performance of, and attitudes to, Stop- and Mock-Before-You-Block in preventing wrong-side blocks.

We conducted an online survey to assess the career experiences of wrong side blocks, the practice of Stop-Before-You-Block, the recently described method of Mock-Before-You-Block and attitudes to these. Respondents were 208 anaesthetists across nine hospitals (173 consultants or Staff and Associate Specialist doctors'), representing 3623 years of collective anaesthetic practice. There had been a total of 62 wrong side blocks (by 51 anaesthetists and one current trainee). Predisposing factors for this were commonly ascribed to distractions (35 (69%), for example due to rushing or teaching), patient positioning (9 (18%)) or miscommunication (6 (12%)). Two (4%) respondents felt they had performed Stop-Before-You-Block too early; 62 (41%) of all respondents stated they performed Stop-Before-You-Block as early as preparing the skin or on arrival of the patient in the anaesthetic room, and not any later. Twenty (10%) respondents admitted to not performing Stop-Before-You-Block at all or only occasionally (including 5 (2%) who had performed a wrong side block). Mock-Before-You-Block was easily understood (by 169 out of 197 (86%)) and 14 out of 61 (23%) respondents felt it would have prevented the wrong side error in their case. However, free-text comments indicated that many anaesthetists were reluctant to use a method that interrupted their performance of the block. We conclude that considerable work is needed to achieve full compliance with Stop-Before-You-Block at the correct time.

DNA dodecaploid plants detected among somaclones of Actinidia deliciosa var. deliciosa cv. Hayward.

Ninety two adventitious shoots (somaclones) were regenerated from leaf-derived callus of Actinidia deliciosa var. deliciosa cv. Hayward. Each somaclone was multiplied in vitro through axillary bud culture to produce several individual clonal shoots. A total of 671 shoots were exflasked but only 223 (33%) resulted in rooted plants. These represented 46 of the original 92 somaclones. Shoot apices from representative plants of each of the 46 somaclones were analysed by flow cytometry to detect changes in their DNA ploidy. Two somaclones had twice the DNA ploidy of hexaploid Hayward (6C) indicating that they were DNA dodecaploids (12C). Seven clonal derivatives of these two somaclones were also DNA dodecaploid. The mean length of their stomatal guard cells was significantly greater than those from hexaploid somaclones. This is the first description of a method to produce DNA dodecaploid kiwifruit plants.

Psychiatric symptoms and cerebellar pathology.

The authors describe three patients hospitalized for psychiatric disorders, all of whom had cerebellar lesions. Referring to recent research on nonmotor cerebellar functions, the authors suggest that patients with cerebellar lesions may develop an organic brain syndrome that closely resembles the organic brain syndrome associated with cerebral cortical lesions.