Perception of emotional intonation by brain-damaged adults: the influence of task processing levels

This research examined perception of moods from the tone-of-voice of semantically neutral phrases following unilateral cerebrovascular accident. It was hypothesized that right hemisphere damage (RHD) would impair even low-level discrimination and recognition of affective prosody, while left hemisphere damage (LHD) would affect performance only as associational-cognitive task demands increased. Thirty-three male subjects, 11 each in RHD, LHD, and normal groups, were given three tasks that varied in presumed amounts of processing undertaken for successful completion. Discrimination of prosodic patterns was expected to require the fewest cognitive operations. An intermediate task involved selecting from two possibilities the label that described moods conveyed prosodically. In the third task, prosodic mood selection was made from four choices, increasing the number of comparisons necessary for accurate judgment. As hypothesized, RHD subjects were inferior to normal subjects in all tasks. LHD subjects were equivalent to normal subjects for the first two tasks, but fell to the level of the RHD group for the third task. These results indicated that the right hemisphere in men was primarily involved in the reception and recognition of emotional prosodic stimuli. Increasing cognitive demands, however, brought about a shift in emphasis from the right hemisphere to both hemispheres. An implication of these findings concerns the need to examine performance levels that invoke changes from expected patterns of hemispheric specialization to advance our knowledge of functional asymmetries.     

Coronary Atherosclerosis in Valvular Heart Disease

To evaluate the usefulness of routine coronary arteriography in patients undergoing cardiac catheterization for the evaluation of valvular heart disease, we performed coronary arteriographic studies routinely in a series of 201 patients primarily catheterized for such evaluation. Coronary artery obstructive lesions in excess of 50% of the lumen were present in 45 of the 201 patients. In 18 of the 45 there was no history of chest pain. Three of the 18 had three vessels involved while 2 had two vessels involved. A total of 27 patients (13.4%) had luminal obstruction greater than 70%, and 9 of these had no pain. In 35 of the 201 patients, classic angina pectoris existed in the absence of radiographically significant disease.Severe coronary disease was found to coexist with hemodynamically severe valvular heart disease and was not predictable noninvasively.     

Code red in the OR----implementing an OR fire drill

KNOWLEDGE OF FIRE PREVENTION and fire safety is essential for every OR staff member. In the event of a surgical fire, the quick and knowledgeable response of surgical team members will affect their own safety and that of their patients. A NEW FIRE SAFETY PLAN was developed at Peninsula Regional Medical Center, Salisbury Md. To update staff members' knowledge of the facility's fire plan and special instructions for the OR, a comprehensive educational program on fire safety was presented, and an OR fire drill was conducted. THIS ARTICLE describes the facility's quest to improve knowledge of fire safety by providing multiple educational opportunities.     

An alternative approach to quantifying and addressing inequity in healthcare provision: access to surgery for lung cancer in the east of England

STUDY OBJECTIVE: Equitable access to healthcare services should be monitored routinely. This study compares provision of surgery for non-small cell lung cancer in the east of England with incidence of non-small cell lung cancer. In addition to conventional comparisons, process control charts are used to identify areas in which access seems to be significantly different from average. DESIGN: Ecological comparison of surgery rates for non-small cell lung cancer between 1998 and 2000 and incidence of non-small cell lung cancer over the same time period. SETTING: Population of Norfolk, Suffolk, Cambridgeshire. PARTICIPANTS: The denominator was the resident population. Numerators were 4092 deaths from non-small cell lung cancer and 387 surgical procedures for lung cancer. MAIN RESULTS: Incidence of non-small cell lung cancer by primary care trust (PCT) does not correlate with surgical procedure rate, in men r = 0.37 (95% confidence intervals -0.14 to 0.72), in women r = 0.07 (95% confidence intervals -0.43 to 0.53). Control charts indicate that the surgery rate is significantly different from average in three PCTs, high in one and low in two others. The optimum surgery rate is unclear but raising it from 9% to a theoretical level of 15% would mean no PCTs have above average rates while six PCTs have rates that are significantly low. CONCLUSIONS: There does not seem to be equity of access to surgery for patients with non-small cell lung cancer in the east of England. Control charts can help both to identify areas where access is particularly high or low, and also to monitor performance against a theoretical optimum surgery rate.