Reflecting on the Development of British Ocean Cruise Tourism: Keeping the Romance Afloat

This study reflects on the development of the British ocean cruise industry. In taking a historical perspective this provides an opportunity to discover if, despite changes in social expectation and technological advance, an element of the value cruise passengers place on their experience has been lost. Equating the ocean cruise experience to passenger cumulative value, the study utilises a thematic approach to reviewing literature and relates this to philosophical perspectives in developing a research strategy. The research data collected provides an insight to cruise tourist expectation and their perception of cumulative value in providing conclusions of value to cruise planners and offering a foundation for further research

Preoperative Intravenous Fluid Therapy Decreases Postoperative Nausea and Pain in High Risk Patients

The potential for preoperative IV rehydration to reduce postoperative nausea and vomiting (PONV) and pain in patients undergoing ambulatory surgery remains unclear, with conflicting results reported. We sought to determine whether preoperative IV rehydration with a balanced salt solution would decrease the incidence of PONV in patients at increased risk for these symptoms. Eighty ASA grade I-III patients presenting for gynecologic laparoscopy were randomized to receive large (2 mL/kg per hour fasting) or small (3 mL/kg) volume infusions of compound sodium lactate solution over 20 min preoperatively. A standardized balanced anesthetic was used. The incidence and severity of PONV and pain, and need for supplemental antiemetic and analgesic therapy, were assessed by a blinded investigator at 0.5, 1, and 4 h postoperatively, and on the first and third postoperafive days. The incidence (control 87% versus large volume 59%) and severity of PONV were significantly reduced in the large volume infusion group at all time intervals. The large volume inffision group also had decreased postoperative pain scores and required less supplemental analgesia. Preoperative correction of intravascular volume deficits effectively reduces PONV and postoperative pain in high risk patients presenting for ambt flatory surgery. We recommend the preoperative administration of 2 mL/kg of compound sodium lactate for every hour of fasting to patients with an increased PONV risk presenting for ambulatory surgery