Activity

In 30 years, adults 65 and older will represent 20% of the US population, with increased medical comorbidities leading to higher rates of critical illness and mortality. Despite significant acute illness, presenting symptoms and vital sign abnormalities may be subtle. Resuscitative guidelines are a helpful starting point but appropriate diagnostics, bedside ultrasound, and frequent reassessments are needed to avoid procrustean care that may worsen outcomes. Baseline functional status is as important as underlying comorbid conditions when prognosticating, and the patient’s personal wishes should be sought early and throughout care with clear communication regarding prospects for immediate survival and overall recovery.Geriatric trauma patients will continue to increase in prevalence as the population ages, and many specific considerations need to be made to provide appropriate care to these patients. This article outlines common presentations of trauma in geriatric patients, with consideration to baseline physiologic function and patterns of injury that may be more prevalent in geriatric populations. Additionally, the article explores specific evidence-based management practices, the significance of trauma team and geriatrician involvement, and disposition decisions.Geriatric emergency medicine has emerged as a subspecialty of emergency medicine over the past 25 years. This emergence has seen the development of increases in training opportunities, care delivery strategies, collaborative best practice guidelines, and formal geriatric emergency department accreditation. This multidisciplinary field remains ripe for continued development in the coming decades as the aging US population parallels a call from patients, health care providers, and health systems to improve the delivery of high-value care. This article educates emergency medicine practitioners and highlights high-value care practice trends to inform and prioritize decision-making for this unique patient population.Foot temperature during activities of daily living affects the human performance and well-being. Footwear thermal characteristics affect the foot temperature inside the shoe during activities of daily living. The temperate at the sole of the foot (plantar temperature) is influenced by different thermal properties such as heat capacity, heat diffusivity, and thermal conductivity of the shoe sole in addition to its mechanical properties. Hence the purpose of this study was to propose a method to allow investigating the effect of footwear thermal characteristics on the foot temperature during activities of daily living, like walking or jogging. The transient heat transfer between the foot and the ground was studied to drive the governing equation for heat transfer modelling in footwear and to predict foot sole temperature during walking, and jogging. Different thermo-mechanical properties of shoe sole, as well as geometrical parameters, were investigated. The proposed model showed to be able to adequately predict the plantar temperature at the ball of the foot when compared to the results from experimental measurements. Finally, using the proposed method, the thermal behaviour of two different shoes with two different sole materials EVA08 and EVA12 were compared. It was shown that heat capacity as compared to the thermal conductivity of the shoe sole is more effective in reducing the plantar temperature increase in short term. Selleck SC79 The proposed method proved to be able to accurately predict the thermal behaviour of shoes and can provide a tool to predict footwear thermal comfort.

We compared the accuracy and design of two thermoregulatory models, the US Army’s empirically designed Heat Strain Decision Aid (HSDA) and the rationally based Health Risk Prediction (HRP) for predicting human thermal responses during exercise in hot and humid conditions and wearing chemical protective clothing.

Accuracy of the HSDA and HRP model predictions of core body and skin temperature (Tc, Ts) were compared to each other and relative to measured outcomes from eight male volunteers (age 24±6 years; height 178±5cm; body mass 76.6±8.4kg) during intermittent treadmill marching in an environmental chamber (air temperature 29.3±0.1°C; relative humidity 56±1%; wind speed 0.4±0.1m∙s

) wearing three separate chemical protective ensembles. Model accuracies and precisions were evaluated by the bias, mean absolute error (MAE), and root mean square error (RMSE) compared to observed data mean±SD and the calculated limits of agreement (LoA).

Average predictions of Tc were comparable and acceptable for each method, HSDA (Bias 0.02°C; MAE 0.18°C; RMSE 0.21°C) and HRP (Bias 0.10°C; MAE 0.25°C; RMSE 0.34°C). The HRP averaged predictions for Ts were within an acceptable agreement to observed values (Bias 1.01°C; MAE 1.01°C; RMSE 1.11°C).

Both HSDA and HRP acceptably predict Tc and HRP acceptably predicts Ts when wearing chemical protective clothing during exercise in hot and humid conditions.

Both HSDA and HRP acceptably predict Tc and HRP acceptably predicts Ts when wearing chemical protective clothing during exercise in hot and humid conditions.Partial Body Cryostimulation (PBC) consists of exposing minimally dressed participants to very cold air, in a specially designed cabin (cryo-cabin), for a short period of time. In recent years, cryo-cabins have been launched with a coverage to limit thermo-dispersion, however a validation study is lacking. The aim of this study was to compare thermal responses after a PBC protocol in an open cryo-cabin or into a cryo-cabin closed at the top with a polyurethane-made lid. Eighteen young male adults completed the two 150 s PBC sessions in a cross-over fashion. Temperature of the inner cabin and thermal responses were measured prior and 1, 5, 10, 20 min after completing each PBC session. When covered, cryo-cabins maintained a lower temperature in the front with respect to the back. There was a significant interaction regarding coverage*time*position with a main effect of coverage. Body surfaces were significantly colder under covered condition compared to open PBC. Subjects perceived a greater thermal discomfort during a covered PBC rather than during an open condition.