ECMO Biocompatibility: Surface Coatings, Anticoagulation, and Coagulation Monitoring

The interaction between the patient and the ECMO (extracorporeal membrane oxygenation) circuit initiates a significant coagulation and inflammatory response due to the large surface area of foreign material contained within the circuit. This response can be blunted with the appropriate mix of biocompatible materials and anticoagulation therapy. The use of anticoagulants, in turn, requires appropriate laboratory testing to determine whether the patient is appropriately anticoagulated. Physicians must balance the risks of bleeding with the risks of thrombosis; the proper interpretation of these tests is often shrouded in mystery. It is the purpose of this chapter to help demystify the coagulation system, anticoagulants, biocompatible surfaces, and coagulation testing so that ECMO practitioners can make informed decisions about their patients and to spur coordinated efforts for future research to improve our understanding of these complex processes

The differential recruitment of executive functions during time, number and length perception: An individual differences approach.

Developmental, behavioural and neurological similarities in the processing of different magnitudes (time, number, space) support the existence of a common magnitude processing system (e.g. ATOM; Bueti & Walsh, 2009; Walsh, 2003). It is however unclear whether the recruitment of wider cognitive resources (STM and executive function) during magnitude processing is similar across magnitude domains or domain specific. The current study used an individual differences approach to examine the relationship between STM, executive function and magnitude processing. In two experiments, participants completed number, length and duration bisection tasks to assess magnitude processing and tasks which have been shown to assess STM span and the four key executive component processes identified by Miyake et al. (2000) and Fisk and Sharp (2004) (shifting, inhibition, updating and access). The results suggest that the recruitment of STM and executive resources differed for the different magnitude domains. Duration perception was associated with access, inhibition and STM span. Length processing was associated with updating and number processing was associated with access to semantic memory. For duration and length, greater difficulty in the magnitude judgement task resulted in more relationships to STM and executive function. It is suggested that duration perception may be more demanding of STM and executive resources because it is represented sequentially, unlike length and number which can be represented non-sequentially

Paracorporeal Lung Devices: Thinking Outside the Box

Extracorporeal Membrane Oxygenation (ECMO) is a resource intensive, life-preserving support system that has seen ever-expanding clinical indications as technology and collective experience has matured. Clinicians caring for patients who develop pulmonary failure secondary to cardiac failure can find themselves in unique situations where traditional ECMO may not be the ideal clinical solution. Existing paracorporeal ventricular assist device (VAD) technology or unique patient physiologies offer the opportunity for thinking “outside the box.” Hybrid ECMO approaches include splicing oxygenators into paracorporeal VAD systems and alternative cannulation strategies to provide a staged approach to transition a patient from ECMO to a VAD. Alternative technologies include the adaptation of ECMO and extracorporeal CO2 removal systems for specific physiologies and pediatric aged patients. This chapter will focus on: (1) hybrid and alternative approaches to extracorporeal support for pulmonary failure, (2) patient selection and, (3) technical considerations of these therapies. By examining the successes and challenges of the relatively select patients treated with these approaches, we hope to spur appropriate research and development to expand the clinical armamentarium of extracorporeal technology

Time crawls when you’re not having fun: Feeling entitled makes dull tasks drag on

All people have to complete dull tasks, but individuals who feel entitled may be more inclined to perceive them as a waste of their "precious" time, resulting in the perception that time drags.This hypothesis was confirmed in three studies.In Study 1, participants with higher trait entitlement (controlling for related variables) thought dull tasks took longer to complete; no link was found for fun tasks.In Study 2, participants exposed to entitled messages thought taking a dull survey was a greater waste of time and took longer to complete.In Study 3, participants subliminally exposed to entitled words thought dull tasks were less interesting, thought they took longer to complete, and walked away faster when leaving the laboratory.Like most resources, time is a resource valued more by entitled individuals.A time-entitlement link provides novel insight into mechanisms underlying self-focus and prosocial dynamics. © 2011 by the Society for Personality and Social Psychology, Inc

Associations of intention to undertake physical activity among community dwelling British South Asian adults aged 60 and over: a cross sectional study.

OBJECTIVE: High prevalence of sedentary behaviour is seen in most immigrant groups in Western countries, particularly in those from the Indian subcontinent. The primary objective of this study was to determine the socio-cognitive associations with intention to undertake physical activity (PA) among separate groups of Indian, Pakistani and Bangladeshi older adults aged ≥60 in the North West of England, UK. STUDY DESIGN: Cross-sectional survey. METHODS: Using a cross-sectional survey, informed by the Theory of Planned Behaviour (TPB), 138/964 South Asian (SA) older adults completed a mailed questionnaire that assessed self-reported PA and TPB variables. RESULTS: Associations were seen in beliefs about PA and the amount of PA undertaken (rho=0.18, p=0.04). Attitude was correlated with intention (rho = 0.29, p = 0.01) and amount of PA undertaken (rho=0.21, p=0.02). Subjective norm was correlated with intention to undertake PA (rho=0.21, p=0.02). Between-group differences were seen between: (1) Indian and Pakistani group’s in subjective norm (2) all ethnicities in intention to undertake PA and (3) in the amount and attitude to undertaking PA between men and women. Co-morbidity was associated with beliefs about PA uptake. CONCLUSIONS: Subgroup differences between Indian, Pakistani and Bangladeshi older adults in subjective norm and intention to undertaking PA highlight the importance of tailoring interventions to accommodate for subgroup differences when developing culturally appropriate PA interventions aimed at increasing uptake and adherence

Unifying prospective and retrospective interval-time estimation: a fading-gaussian activation-based model of interval-timing

Hass and Hermann (2012) have shown that only variance-based processes will lead to the scalar growth of error that is characteristic of human time judgments. Secondly, a major meta-review of over one hundred studies (Block et al., 2010) reveals a striking interaction between the way in which temporal judgments are queried and cognitive load on participants’ judgments of interval duration. For retrospective time judgments, estimates under high cognitive load are longer than under low cognitive load. For prospective judgments, the reverse pattern holds, with increased cognitive load leading to shorter estimates. We describe GAMIT, a Gaussian spreading-activation model, in which the sampling rate of an activation trace is differentially affected by cognitive load. The model unifies prospective and retrospective time estimation, normally considered separately, by relating them to the same underlying process. The scalar property of time estimation arises naturally from the model dynamics and the model shows the appropriate interaction between mode of query and cognitive load

China and the crisis : global power, domestic caution and local initiative

Even though the global crisis had a quick and dramatic impact on Chinese exports, the Chinese government responded with a range of policy responses that have helped maintain high rates of growth. This success has helped propel China to the centre of global politics, accelerating what many perceive to be a power shift from the West to China. But these gains were achieved by reversing policy in previous years designed to make a fundamental shift in China‟s mode of development, and have highlighted the problems associated with making such a transition. At the moment that many are looking at the Chinese "model" as a potential alternative to the Washington Consensus, one of the consequences of the crisis is to further question the long term efficacy of this "model" in China itself