A comparison of third-generation semi-invasive arterial waveform analysis with thermodilution in patients undergoing coronary surgery

Uncalibrated semi-invasive continous monitoring of cardiac index (CI) has recently gained increasing interest. The aim of the present study was to compare the accuracy of CI determination based on arterial waveform analysis with transpulmonary thermodilution. Fifty patients scheduled for elective coronary surgery were studied after induction of anaesthesia and before and after cardiopulmonary bypass (CPB), respectively. Each patient was monitored with a central venous line, the PiCCO system, and the FloTrac/Vigileo-system. Measurements included CI derived by transpulmonary thermodilution and uncalibrated semi-invasive pulse contour analysis. Percentage changes of CI were calculated. There was a moderate, but significant correlation between pulse contour CI and thermodilution CI both before (r(2) = 0.72, P < 0.0001) and after (r(2) = 0.62, P < 0.0001) CPB, with a percentage error of 31% and 25%, respectively. Changes in pulse contour CI showed a significant correlation with changes in thermodilution CI both before (r(2) = 0.52, P < 0.0001) and after (r(2) = 0.67, P < 0.0001) CPB. Our findings demonstrated that uncalibrated semi-invasive monitoring system was able to reliably measure CI compared with transpulmonary thermodilution in patients undergoing elective coronary surgery. Furthermore, the semi-invasive monitoring device was able to track haemodynamic changes and trends

Functional Skills Support Programme: Developing functional skills in personal, social, health and economic education

This booklet is part of "... a series of 11 booklets which helps schools to implement functional skills across the curriculum. The booklets illustrate how functional skills can be applied and developed in different subjects and contexts, supporting achievement at Key Stage 3 and Key Stage 4. Each booklet contains an introduction to functional skills for subject teachers, three practical planning examples with links to related websites and resources, a process for planning and a list of additional resources to support the teaching and learning of functional skills." - The National Strategies website

Creating jobs and boosting our economy

In 2009, Washington's legislature slashed billions from the state budget, adding to the misery of recession by cutting services, jobs, and incomes of public servants. Virtually every area of state government was affected, including K-12 education, higher education, health care, the social safety net, and public safety.Directly and indirectly, those state budget cuts are costing Washington an estimated 44,000 jobs.With the economy only tentatively recovering from the deep hole of this long recession, the state now faces an additional budget gap of $2.6 billion. If the legislature were to cut that entire amount from state services, our state would lose another 33,600 private and public sector jobs. Even a$1 billion reduction in state spending would trigger losses of 13,000 more jobs.In contrast, maintaining state services through a combination of $1.6 billion in new state taxes, plus$1 billion in enhanced federal aid and transfers from other funds would result in a net savings of 18,600 to 29,000 jobs for the working people of Washington

Iowa Public Television’s Planning Targets 2011-2014

Agency Performance Plan, Iowa Public Televisio

Reproducibility of the dynamics of facial expressions in unilateral facial palsy

The aim of this study was to assess the reproducibility of non-verbal facial expressions in unilateral facial paralysis using dynamic four-dimensional (4D) imaging. The Di4D system was used to record five facial expressions of 20 adult patients. The system captured 60 three-dimensional (3D) images per second; each facial expression took 3–4 seconds which was recorded in real time. Thus a set of 180 3D facial images was generated for each expression. The procedure was repeated after 30 min to assess the reproducibility of the expressions. A mathematical facial mesh consisting of thousands of quasi-point ‘vertices’ was conformed to the face in order to determine the morphological characteristics in a comprehensive manner. The vertices were tracked throughout the sequence of the 180 images. Five key 3D facial frames from each sequence of images were analyzed. Comparisons were made between the first and second capture of each facial expression to assess the reproducibility of facial movements. Corresponding images were aligned using partial Procrustes analysis, and the root mean square distance between them was calculated and analyzed statistically (paired Student ttest, P &lt; 0.05). Facial expressions of lip purse, cheek puff, and raising of eyebrows were reproducible. Facial expressions of maximum smile and forceful eye closure were not reproducible. The limited coordination of various groups of facial muscles contributed to the lack of reproducibility of these facial expressions. 4D imaging is a useful clinical tool for the assessment of facial expressions

Healthy aims: developing new medical implants and diagnostic equipment

Healthy Aims is a €23-million, four-year project, funded under the EU’s Information Society Technology Sixth Framework program to develop intelligent medical implants and diagnostic systems (www.healthyaims.org). The project has 25 partners from 10 countries, including commercial, clinical, and research groups. This consortium represents a combination of disciplines to design and fabricate new medical devices and components as well as to test them in laboratories and subsequent clinical trials. The project focuses on medical implants for nerve stimulation and diagnostic equipment based on straingauge technology

Taxing food: implications for public health nutrition

AIM: To set out a policy analysis of food taxes as a way of influencing food consumption and behaviour. DESIGN: The study draws on examples of food taxes from the developed world imposed at national and local levels. Studies were identified from a systemised search in six databases with criteria designed to identity articles of policy relevance. RESULTS: The dominant approach identified from the literature was the imposition of food taxes on food to raise general revenue, such as Value Added Tax in the European Union. Food taxes can be applied in various ways, ranging from attempts to directly influence behaviour to those which collect taxes for identified campaigns on healthy eating through to those applied within closed settings such as schools. There is a case for combining taxes of unhealthy foods with subsidies of healthy foods. The evidence from the literature concerning the use and impact of food taxes on food behaviour is not clear and those cases identified are mainly retrospective descriptions of the process. Many food taxes have been withdrawn after short periods of time due to industry lobbying. CONCLUSIONS FOR POLICY: Small taxes with the clear purpose of promoting the health of key groups, e.g. children, are more likely to receive public support. The focus of many tax initiatives is unclear; although they are generally aimed at consumers, another focus could be food manufacturers, using taxes and subsidies to encourage the production of healthier foods, which could have an effect at a population level. Further consideration needs to be given to this aspect of food taxes. Taxing food (and subsidies) can influence food behaviour within closed systems such as schools and the workplace