Haemodynamic variables and functional outcome in hypothermic patients following out-of-hospital cardiac arrest

To evaluate the association between haemodynamic variables during the first 24h after intensive care unit (ICU) admission and neurological outcome in out-of-hospital cardiac arrest (OHCA) victims undergoing therapeutic hypothermia.

OUT-OF-STEP DETECTION BASED ON ZUBOV’S APPROXIMATION BOUNDARY METHOD

Disturbances in power systems may lead to electromagnetic transient oscillations due to mismatch of mechanical input power and electrical output power. Out-of-step conditions in power system are common after the disturbances where the continuous oscillations do not damp out and the system becomes unstable. Existing out-of-step detection methods are system specific as extensive off-line studies are required for setting of relays. Most of the existing algorithms also require network reduction techniques to apply in multi-machine power systems. To overcome these issues, this research applies Phasor Measurement Unit (PMU) data and Zubov’s approximation stability boundary method, which is a modification of Lyapunov’s direct method, to develop a novel out-of-step detection algorithm. The proposed out-of-step detection algorithm is tested in a Single Machine Infinite Bus system, IEEE 3-machine 9-bus, and IEEE 10-machine 39-bus systems. Simulation results show that the proposed algorithm is capable of detecting out-of-step conditions in multi-machine power systems without using network reduction techniques and a comparative study with an existing blinder method demonstrate that the decision times are faster. The simulation case studies also demonstrate that the proposed algorithm does not depend on power system parameters, hence it avoids the need of extensive off-line system studies as needed in other algorithms.

The Getting-Out-of-Bed (GoB) scale: a measure of motivation and life outlook in older adults with cancer

OBJECTIVE: To develop and evaluate the psychometric properties of a measure of motivation and life outlook (Getting-Out-of-Bed [GoB]). DESIGN: Secondary analysis of baseline and 6-month data from a longitudinal follow-up study of older breast cancer survivors. PARTICIPANTS: Women (N = 660) diagnosed with primary breast cancer stage I-IIIA disease, age >or=65 years, and permission to contact from an attending physician in four geographic regions in the United States (city-based Los Angeles, California; statewide in Minnesota, North Carolina, and Rhode Island). MEASUREMENT: Data were collected over 6-months of follow-up from consenting patients' medical records and telephone interviews with patients. Data collected included the 4-item GoB, health-related quality of life (HRQoL), breast cancer, sociodemographic, and health-related characteristics. RESULTS: Factor analysis produced, as hypothesized, one principal component with eigen values of 2.74(baseline) and 2.91(6-months) which explained 68.6%(baseline) and 72.7%(6-months) of total variance. In further psychometric analyses, GoB exhibited good construct validity (divergent: low nonstatistically significant correlations with unrelated constructs; convergent: moderate statistically significant correlations with related constructs; discriminant: distinguished high HRQoL groups with a high level of significance), excellent internal reliability (Cronbach's alpha 0.84(baseline), 0.87(6-months)), and produced stable measurements over 6-months. Women with GoB scores >or=50 at baseline were more likely at 6-months to have good HRQoL, good self-perceived health, and report regular exercise, indicating good predictive ability. CONCLUSION: GoB demonstrated overall good psychometric properties in this sample of older breast cancer survivors, suggestive of a promising tool for assessing motivation and life outlook in older adults. Nevertheless, because it was developed and initially evaluated in a select sample, using measures with similar but not exact content overlap further evaluation is needed before it can be recommended for widespread use.

Who Is Afraid of School Choice?

This study uses survey data to investigate attitudes among Swiss voters to different models offering more freedom of choice in the educational system. There is a clear opposition to the use of taxpayer money to fund private schools, while free choice between public schools seems to appeal to a majority. The opinions appear to be based on a rational calculation of personal utility. For both types of choice, approval rates are lower for middle to high-income groups and individuals with a teaching qualification. Furthermore, residents of small to medium-sized towns are opposed to more school choice. On the support side, approval rates for private school choice are higher among parents of school-age children and residents in urban areas. The results also indicate differences between the country's language regions, attributable to intercultural differences in what people consider the role of the state.

The Influence of MGA and PG600 on the Out of Season Reproductive Performance of Ewes

Seasonal lamb supply has been established as one of the major hindrances to the American sheep industry. The ability to consistently lamb ewes on an accelerated production system offers additional benefits of reduced maintenance costs, more uniform cash flow along with reduced labor and facility demands. Previous work at McNay with spring breeding indicated that light priming rams regardless of genetic base improved conception rates, however, MGA feeding postweaning gave inconsistent and sometimes depressed reproductive activity in ewes. This study was conducted to evaluate the use of MGA in late lactation and a single PG600 injection at weaning, either individually or in combination.

Dual dispatch early defibrillation in out-of-hospital cardiac arrest in a mixed urban–rural population

Aims The effects of a system based on minimally trained first responders (FR) dispatched simultaneously with the emergency medical services (EMS) of the local hospital in a mixed urban and rural area in Northwestern Switzerland were examined. Methods and results In this prospective study 500 voluntary fire fighters received a 4-h training in basic-life-support using automated-external-defibrillation (AED). FR and EMS were simultaneously dispatched in a two-tier rescue system. During the years 2001–2008, response times, resuscitation interventions and outcomes were monitored. 1334 emergencies were included. The FR reached the patients (mean age 60.4 ± 19 years; 65% male) within 6 ± 3 min after emergency calls compared to 12 ± 5 min by the EMS (p < 0.0001). Seventy-six percent of the 297 OHCAs occurred at home. Only 3 emergencies with resuscitation attempts occurred at the main railway station equipped with an on-site AED. FR were on the scene before arrival of the EMS in 1166 (87.4%) cases. Of these, the FR used AED in 611 patients for monitoring or defibrillation. CPR was initiated by the FR in 164 (68.9% of 238 resuscitated patients). 124 patients were defibrillated, of whom 93 (75.0%) were defibrillated first by the FR. Eighteen patients (of whom 13 were defibrillated by the FR) were discharged from hospital in good neurological condition. Conclusions Minimally trained fire fighters integrated in an EMS as FR contributed substantially to an increase of the survival rate of OHCAs in a mixed urban and rural area.