Resistive polymer versus forced-air warming: comparable heat transfer and core rewarming rates in volunteers

BACKGROUND: Mild perioperative hypothermia increases the risk of several severe complications. Perioperative patient warming to preserve normothermia has thus become routine, with forced-air warming being used most often. In previous studies, various resistive warming systems have shown mixed results in comparison with forced-air. Recently, a polymer-based resistive patient warming system has been developed. We compared the efficacy of a standard forced-air warming system with the resistive polymer system in volunteers. METHODS: Eight healthy volunteers participated, each on two separate study days. Unanesthetized volunteers were cooled to a core temperature (tympanic membrane) of 34 degrees C by application of forced-air at 10 degrees C and a circulating-water mattress at 4 degrees C. Meperidine and buspirone were administered to prevent shivering. In a randomly designated order, volunteers were then rewarmed (until their core temperatures reached 36 degrees C) with one of the following active warming systems: (1) forced-air warming (Bair Hugger warming cover #300, blower #750, Arizant, Eden Prairie, MN); or (2) polymer fiber resistive warming (HotDog whole body blanket, HotDog standard controller, Augustine Biomedical, Eden Prairie, MN). The alternate system was used on the second study day. Metabolic heat production, cutaneous heat loss, and core temperature were measured. RESULTS: Metabolic heat production and cutaneous heat loss were similar with each system. After a 30-min delay, core temperature increased nearly linearly by 0.98 (95% confidence interval 0.91-1.04) degrees C/h with forced-air and by 0.92 (0.85-1.00) degrees C/h with resistive heating (P = 0.4). CONCLUSIONS: Heating efficacy and core rewarming rates were similar with full-body forced-air and full-body resistive polymer heating in healthy volunteers.

Species mobility and frequency dynamics in a Swiss limestone grassland

Community dynamics in a calcareous grassland (Mesobrometum) in Egerkingen (Jura mountains, Switzerland) were investigated for 53 non-woody species in 25 1-m2 plots over 6 years. 50 0.0 1-m2 subplots per plot were recorded. The derived variables were spatial frequency, temporal frequency, frequency fluctuation, turnover, and cumulative frequency (each species), and cumulative species richness (all species). Spectra for 53 species of all variables were different for the two investigated spatial scales (0.0 1 m2, 1 m2). The comparison with other investigations of similar grass lands showed that the behaviour of some species is specific for this type of vegetation in general (e.g. Achillea millefolium, Arrhenatherum elatius, Bromus erectus ), but most species behaved in a stand-specific way, i.e. they may play another (similar or completely different) role in another grassland stand. Six spatio-temporal patterns were defined across species. To understand community dynamics, not only the dynamics of mobility but also of frequency fluctuations and spatial distribution of the species are fundamental. In addition, the understanding of temporal behaviour of all species present should be included. Averages always hide important information of vegetation dynamics, as was shown by the present investigation.

Forced oscillation technique in infants and young children

Due to its non-invasive character, the forced oscillation technique has gained importance in clinical research in infants and young children. Standardisation has enabled systematic and comparable measurements to be made in different laboratories throughout the world. The theoretical conditions are now fulfilled for use of these techniques in the clinical environment. This review discusses the principles, usefulness and pitfalls of various forced oscillation techniques in a research and clinical environment and the present and future clinical applications in children. It will focus particularly on the role of infant and preschool lung function as forced oscillation only requires minimal cooperation.

Social Work, Mobility and Membership

Social work is more involved in the collective life of its clientele than are other human service activities, because it is directly concerned with the bonds and conflicts between individuals, and the co-operative and competitive aspects of groups and communities. Hence it relies on being sited in organisations relevant to service users' lives, and on being able to influence these collectivities. This article argues that the 'organisational landscape' is being transformed, as commercial enterprises (more mobile and adaptable than either state or non-government organisations) take over important aspects of collective provision. The implications of this transformation for practice are analysed, by reference to examples from the United Kingdom in particular.

Context-aware Opportunistic Routing in Mobile Ad-hoc Networks Incorporating Node Mobility

Opportunistic routing (OR) employs a list of candi- dates to improve reliability of wireless transmission. However, list-based OR features restrict the freedom of opportunism, since only the listed nodes can compete for packet forwarding. Additionally, the list is statically generated based on a single metric prior to data transmission, which is not appropriate for mobile ad-hoc networks. This paper provides a thorough perfor- mance evaluation of a new protocol - Context-aware Opportunistic Routing (COR). The contributions of COR are threefold. First, it uses various types of context information simultaneously such as link quality, geographic progress, and residual energy of nodes to make routing decisions. Second, it allows all qualified nodes to participate in packet forwarding. Third, it exploits the relative mobility of nodes to further improve performance. Simulation results show that COR can provide efficient routing in mobile environments, and it outperforms existing solutions that solely rely on a single metric by nearly 20 - 40 %.

The lower quality of preventive care among forced migrants in a country with universal healthcare coverage

OBJECTIVE To assess the association between socio-demographic factors and the quality of preventive care and chronic care of cardiovascular (CV) risk factors in a country with universal health care coverage. METHODS Our retrospective cohort assessed a random sample of 966 patients aged 50-80years followed over 2years (2005-2006) in 4 Swiss university primary care settings (Basel/Geneva/Lausanne/Zürich). We used RAND's Quality Assessment Tools indicators and examined recommended preventive care among different socio-demographic subgroups. RESULTS Overall patients received 69.6% of recommended preventive care. Preventive care indicators were more likely to be met among men (72.8% vs. 65.4%; p<0.001), younger patients (from 71.0% at 50-59years to 66.7% at 70-80years, p for trend=0.03) and Swiss patients (71.1% vs. 62.7% in forced migrants; p=0.001). This latter difference remained in multivariate analysis adjusted for gender, age, civil status and occupation (OR 0.68; 95% CI 0.54-0.86). Forced migrants had lower scores for physical examination and breast and colon cancer screening (all p≤0.02). No major differences were seen for chronic care of CV risk factors. CONCLUSION Despite universal healthcare coverage, forced migrants receive less preventive care than Swiss patients in university primary care settings. Greater attention should be paid to forced migrants for preventive care.