The Experts below are selected from a list of 60 Experts worldwide ranked by ideXlab platform
Paul Fulbrook - One of the best experts on this subject based on the ideXlab platform.
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core body Temperature measurement a comparison of Axilla tympanic membrane and pulmonary artery blood Temperature
Intensive and Critical Care Nursing, 1997Co-Authors: Paul FulbrookAbstract:This research study was undertaken to examine the relationship between pulmonary artery blood Temperature (regarded as the ‘gold standard’ measurement for core body Temperature), Axilla Temperature using the Tempa.DOT Ax chemical thermometer and tympanic membrane Temperature using the Diatek 9000 Insta Temp thermometer. Sixty adult intensive care patients had their Temperatures monitored. A single set of five simultaneous Temperatures, i.e. left and right Axilla, left and right tympanic membrane (TM), and pulmonary artery (PA) blood were recorded. The mean difference between left and right TM Temperatures was 0.58°C, and although both were moderately well correlated with PA Temperature ( r = 0.63 and 0.78, respectively) the mean differences between the two sites were clinically significant (0.85°C and 0.94°C, respectively). The range of differences between the sites was significant. Plotting limits of agreement showed that both left and right TM Temperatures may be up to 1.2°C above or 1.3°C below PA blood Temperature: a clinically unacceptable range. In particular, large Temperature differences were recorded when patients were lying with one side of their head to a pillow. Fan therapy directed to the head was not found to affect these differences significantly. The mean difference between left and right Axilla Temperatures was 0.36°C, and although both were modestly correlated with PA Temperature ( r = 0.48 and 0.53, respectively) the mean differences between the two sites were clinically significant (0.47°C and 0.50°C, respectively). The range of differences between the sites was particularly significant. Plotting limits of agreement showed that both left and right Axilla Temperatures may be up to 1.2°C above or 1.6°C below PA blood Temperature: a clinically unacceptable range. Because the range of Temperature differences found between PA blood and the other sites was so great, it is concluded that neither the chemical Axilla thermometer nor the tympanic membrane thermometer used in this study are clinically reliable tools for adult intensive care patients.
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Core body Temperature measurement: a comparison of Axilla, tympanic membrane and pulmonary artery blood Temperature.
Intensive & critical care nursing, 1997Co-Authors: Paul FulbrookAbstract:This research study was undertaken to examine the relationship between pulmonary artery blood Temperature (regarded as the 'gold standard' measurement for core body Temperature), Axilla Temperature using the Tempa.DOT Ax chemical thermometer and tympanic membrane Temperature using the Diatek 9000 InstaTemp thermometer. Sixty adult intensive care patients had their Temperatures monitored. A single set of five simultaneous Temperatures, i.e. left and right Axilla, left and right tympanic membrane (TM), and pulmonary artery (PA) blood were recorded. The mean difference between left and right TM Temperatures was 0.58 degree C, and although both were moderately well correlated with PA Temperature (r = 0.63 and 0.78, respectively) the mean differences between the two sites were clinically significant (0.85 degree C and 0.94 degree C, respectively). The range of differences between the sites was significant. Plotting limits of agreement showed that both left and right TM Temperatures may be up to 1.2 degrees C above or 1.3 degrees C below PA blood Temperature: a clinically unacceptable range. In particular, large Temperature differences were recorded when patients were lying with one side of their head to a pillow. Fan therapy directed to the head was not found to affect these differences significantly. The mean difference between left and right Axilla Temperatures was 0.36 degree C, and although both were modestly correlated with PA Temperature (r = 0.48 and 0.53, respectively) the mean differences between the two sites were clinically significant (0.47 degree C and 0.50 degree C, respectively). The range of differences between the sites was particularly significant. Plotting limits of agreement showed that both left and right Axilla Temperatures may be up to 1.2 degrees C above or 1.6 degrees C below PA blood Temperature: a clinically unacceptable range. Because the range of Temperature differences found between PA blood and the other sites was so great, it is concluded that neither the chemical Axilla thermometer nor the tympanic membrane thermometer used in this study are clinically reliable tools for adult intensive care patients.
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Core Temperature measurement: A comparison of rectal, Axillary and pulmonary artery blood Temperature
Intensive & critical care nursing, 1993Co-Authors: Paul FulbrookAbstract:This research study was undertaken to determine the relationship between pulmonary artery (PA) blood Temperature, rectal Temperature and Axillary Temperature for adult patients admitted to an intensive care unit (ICU). 31 adults had their Temperatures monitored. Simultaneous recordings of PA blood Temperature, rectal Temperature and Axillary Temperature were taken every 4h for up to 7 days. The mean difference between rectal and Axillary Temperature for all 31 patients was 0.32°C. Of the 16 patients who had their PA blood Temperature monitored mean rectal Temperature was 0.1°C above PA blood Temperature and mean Axillary Temperature was 0.19°C below PA blood Temperature. Very high statistical correlations were obtained which demonstrate the strength of the relationships between the three sites (rectal-Axillary Temperature difference R = 0.97; PA blood-rectal Temperature difference R = 0.99; PA blood-Axilla Temperature difference R = 0.97). The linear relationship between the three sites studied was not found to be affected by age, gender, number of Temperature samples taken, post/non-operative admission or peripheral Temperature.
M Ellis - One of the best experts on this subject based on the ideXlab platform.
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Postnatal hypothermia and cold stress among newborn infants in Nepal monitored by continuous ambulatory recording.
Archives of disease in childhood. Fetal and neonatal edition, 1996Co-Authors: M Ellis, N Manandhar, U Shakya, D S Manandhar, A Fawdry, A M CostelloAbstract:To describe the pattern of hypothermia and cold stress after delivery among a normal neonatal population in Nepal; to provide practical advice for improving thermal care in a resource limited maternity hospital. The principal government funded maternity hospital in Kathmandu, Nepal, with an annual delivery rate of 15,000 (constituting 40% of all Kathmandu Valley deliveries), severe resource limitations (annual budget Pounds 250,000), and a cold winter climate provided the setting. Thirty five healthy term neonates not requiring special care were enrolled for study within 90 minutes of birth. Continuous ambulatory Temperature monitoring, using microthermistor skin probes for forehead and Axilla, a flexible rectal probe, and a black ball probe placed next to the infant for ambient Temperature, was carried out. All probes were connected to a compact battery powered Squirrel Memory Logger, giving a Temperature reading to 0.2 degree C at five minute intervals for 24 hours. Severity and duration of hypothermia, using cutoff values of core Temperature less than 36 degrees C, 34 degrees C, and 32 degrees C; and cold stress, using cutoff values of skin-core (forehead-Axilla) Temperature difference greater than 3 degrees C and 4 degrees C were the main outcome measures. Twenty four hour mean ambient Temperatures were generally lower than the WHO recommended level of 25 degrees C (median 22.3 degrees C, range 15.1-27.5 degrees C). Postnatal hypothermia was prolonged, with Axillary core Temperatures only reaching 36 degrees C after a mean of 6.4 hours (range 0-21.1; SD 4.6). There was persistent and increasing cold stress over the first 24 hours with the core-skin (Axillary-forehead) Temperature gap exceeding 3 degrees C for more than half of the first 24 hours. Continuous ambulatory recording identifies weak links in the "warm chain" for neonates. The severity and duration of thermal problems was greater than expected even in a hospital setting where some of the WHO recommendations had already been implemented.
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Postnatal hypothermia and cold stress among newborn infants in Nepal monitored by continuous ambulatory recording.
Archives of Disease in Childhood-fetal and Neonatal Edition, 1996Co-Authors: M Ellis, N Manandhar, U Shakya, D S Manandhar, A Fawdry, Amdel CostelloAbstract:AIMS: To describe the pattern of hypothermia and cold stress after delivery among a normal neonatal population in Nepal; to provide practical advice for improving thermal care in a resource limited maternity hospital. METHODS: The principal government funded maternity hospital in Kathmandu, Nepal, with an annual delivery rate of 15,000 (constituting 40% of all Kathmandu Valley deliveries), severe resource limitations (annual budget Pounds 250,000), and a cold winter climate provided the setting. Thirty five healthy term neonates not requiring special care were enrolled for study within 90 minutes of birth. Continuous ambulatory Temperature monitoring, using microthermistor skin probes for forehead and Axilla, a flexible rectal probe, and a black ball probe placed next to the infant for ambient Temperature, was carried out. All probes were connected to a compact battery powered Squirrel Memory Logger, giving a Temperature reading to 0.2 degree C at five minute intervals for 24 hours. Severity and duration of hypothermia, using cutoff values of core Temperature less than 36 degrees C, 34 degrees C, and 32 degrees C; and cold stress, using cutoff values of skin-core (forehead-Axilla) Temperature difference greater than 3 degrees C and 4 degrees C were the main outcome measures. RESULTS: Twenty four hour mean ambient Temperatures were generally lower than the WHO recommended level of 25 degrees C (median 22.3 degrees C, range 15.1-27.5 degrees C). Postnatal hypothermia was prolonged, with Axillary core Temperatures only reaching 36 degrees C after a mean of 6.4 hours (range 0-21.1; SD 4.6). There was persistent and increasing cold stress over the first 24 hours with the core-skin (Axillary-forehead) Temperature gap exceeding 3 degrees C for more than half of the first 24 hours. CONCLUSIONS: Continuous ambulatory recording identifies weak links in the "warm chain" for neonates. The severity and duration of thermal problems was greater than expected even in a hospital setting where some of the WHO recommendations had already been implemented.
Thomas Reilly - One of the best experts on this subject based on the ideXlab platform.
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The circadian rhythm of core Temperature: origin and some implications for exercise performance.
Chronobiology international, 2005Co-Authors: Jim Waterhouse, Greg Atkinson, Benjamin Edwards, Barry Drust, Dietmar Weinert, Warren Gregson, Shaoyuan Kao, Seika Aizawa, Thomas ReillyAbstract:This review first examines reliable and convenient ways of measuring core Temperature for studying the circadian rhythm, concluding that measurements of rectal and gut Temperature fulfil these requirements, but that insulated Axilla Temperature does not. The origin of the circadian rhythm of core Temperature is mainly due to circadian changes in the rate of loss of heat through the extremities, mediated by vasodilatation of the cutaneous vasculature. Difficulties arise when the rhythm of core Temperature is used as a marker of the body clock, since it is also affected by the sleep-wake cycle. This masking effect can be overcome directly by constant routines and indirectly by "purification" methods, several of which are described. Evidence supports the value of purification methods to act as a substitute when constant routines cannot be performed. Since many of the mechanisms that rise to the circadian rhythm of core Temperature are the same as those that occur during thermoregulation in exercise, there is an interaction between the two. This interaction is manifest in the initial response to spontaneous activity and to mild exercise, body Temperature rising more quickly and thermoregulatory reflexes being recruited less quickly around the trough and rising phase of the resting Temperature rhythm, in comparison with the peak and falling phase. There are also implications for athletes, who need to exercise maximally and with minimal risk of muscle injury or heat exhaustion in a variety of ambient Temperatures and at different times of the day. Understanding the circadian rhythm of core Temperature may reduce potential hazards due to the time of day when exercise is performed.
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A comparison of the suitabilities of rectal, gut, and insulated Axilla Temperatures for measurement of the circadian rhythm of core Temperature in field studies.
Chronobiology international, 2002Co-Authors: Ben Edwards, James Waterhouse, Thomas Reilly, Greg AtkinsonAbstract:Eight healthy males were studied for a total of 13 subject-days to assess if gut (from an ingested pill) and Axilla (from a thermally insulated skin probe) Temperatures would act as a substitute for rectal Temperature in field studies of the circadian rhythm of core Temperature. Subjects slept and went about their activities, indoors and outdoors, normally. Regular recordings (at 6 min intervals) were made of Temperatures from the three sites. In addition, activity was measured (by a sensor on the nondominant wrist) so that the raw Temperature data could be "purified," that is, corrected for the direct effects of sleep and activity. Inspection of the raw data indicated that there was a close parallelism between rectal and gut Temperatures, but that the parallelism between rectal and insulated Axilla Temperatures was less reliable. This parallelism was supported by initial calculations of the correlations between rectal and gut Temperatures (high and positive) and between rectal and insulated Axilla (lower, though still positive) Temperatures. Calculation of the limits of agreement between the parameters of the cosine curves fitted to the raw data confirmed that the rectal and gut Temperatures were far closer with regard to acrophase and amplitude than were rectal and insulated Axilla Temperatures (-0.31 +/- 0.89 vs. +0.75 +/- 6.03 h and +0.002 +/- 0.116 vs. +0.083 +/- 0.625 degrees C, respectively). After purification of the Temperature data, the limits of agreement for the cosine parameters acrophase and amplitude still indicated that there was a closer agreement between rectal and gut Temperatures than between rectal and insulated Axilla Temperatures (-0.30 +/- 1.12 vs. +0.58 +/- 6.69 h, and +0.007 +/- 0.116 vs. +0.104 +/- 0.620 degrees C, respectively). Part of the explanation of this difference was the unreliable relationships between Temperature changes in insulated Axilla Temperature and bursts of activity and going to bed. It is concluded that, whereas gut Temperature is a viable alternativ to rectal Temperature (from the viewpoints of both user acceptability and the reliability of data obtained), insulated Axilla Temperature, though acceptable to subjects, is unreliable from an experimental viewpoint.
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Circadian rhythms, jet lag, and shift work, with particular reference to athletes
European Journal of Sport Science, 2002Co-Authors: James Waterhouse, Benjamin Edwards, Sandra Carvalho-bos, Paul Buckley, Thomas ReillyAbstract:Changes in individuals’ sleep-wake cycles lead to negative side effects. This review considers how side effects can be reduced, the recommendations being based largely on work performed at our institute. Subjects journeying to Aus-tralia had symptoms of jet lag that did not adjust synchronously, and the best predictors of jet lag were their travel arrangements. The value of melatonin in reducing jet lag was not confirmed but, in a laboratory-based study, evening administration of melatonin did not result in worse performance the next morn-ing. The effects of exercise upon the phase of the body clock were insubstantial. Gut Temperature, unlike insulated Axilla Temperature, was an acceptable substi-tute for rectal Temperature. Ascertaining by questionnaire why people ate or did not eat at a particular time indicated that night work exerted a considerable disruptive influence, one of the main factors being time pressure. Compared with day workers, night workers had less appetite, ate cold rather than hot mea...
Greg Atkinson - One of the best experts on this subject based on the ideXlab platform.
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The circadian rhythm of core Temperature: origin and some implications for exercise performance.
Chronobiology international, 2005Co-Authors: Jim Waterhouse, Greg Atkinson, Benjamin Edwards, Barry Drust, Dietmar Weinert, Warren Gregson, Shaoyuan Kao, Seika Aizawa, Thomas ReillyAbstract:This review first examines reliable and convenient ways of measuring core Temperature for studying the circadian rhythm, concluding that measurements of rectal and gut Temperature fulfil these requirements, but that insulated Axilla Temperature does not. The origin of the circadian rhythm of core Temperature is mainly due to circadian changes in the rate of loss of heat through the extremities, mediated by vasodilatation of the cutaneous vasculature. Difficulties arise when the rhythm of core Temperature is used as a marker of the body clock, since it is also affected by the sleep-wake cycle. This masking effect can be overcome directly by constant routines and indirectly by "purification" methods, several of which are described. Evidence supports the value of purification methods to act as a substitute when constant routines cannot be performed. Since many of the mechanisms that rise to the circadian rhythm of core Temperature are the same as those that occur during thermoregulation in exercise, there is an interaction between the two. This interaction is manifest in the initial response to spontaneous activity and to mild exercise, body Temperature rising more quickly and thermoregulatory reflexes being recruited less quickly around the trough and rising phase of the resting Temperature rhythm, in comparison with the peak and falling phase. There are also implications for athletes, who need to exercise maximally and with minimal risk of muscle injury or heat exhaustion in a variety of ambient Temperatures and at different times of the day. Understanding the circadian rhythm of core Temperature may reduce potential hazards due to the time of day when exercise is performed.
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A comparison of the suitabilities of rectal, gut, and insulated Axilla Temperatures for measurement of the circadian rhythm of core Temperature in field studies.
Chronobiology international, 2002Co-Authors: Ben Edwards, James Waterhouse, Thomas Reilly, Greg AtkinsonAbstract:Eight healthy males were studied for a total of 13 subject-days to assess if gut (from an ingested pill) and Axilla (from a thermally insulated skin probe) Temperatures would act as a substitute for rectal Temperature in field studies of the circadian rhythm of core Temperature. Subjects slept and went about their activities, indoors and outdoors, normally. Regular recordings (at 6 min intervals) were made of Temperatures from the three sites. In addition, activity was measured (by a sensor on the nondominant wrist) so that the raw Temperature data could be "purified," that is, corrected for the direct effects of sleep and activity. Inspection of the raw data indicated that there was a close parallelism between rectal and gut Temperatures, but that the parallelism between rectal and insulated Axilla Temperatures was less reliable. This parallelism was supported by initial calculations of the correlations between rectal and gut Temperatures (high and positive) and between rectal and insulated Axilla (lower, though still positive) Temperatures. Calculation of the limits of agreement between the parameters of the cosine curves fitted to the raw data confirmed that the rectal and gut Temperatures were far closer with regard to acrophase and amplitude than were rectal and insulated Axilla Temperatures (-0.31 +/- 0.89 vs. +0.75 +/- 6.03 h and +0.002 +/- 0.116 vs. +0.083 +/- 0.625 degrees C, respectively). After purification of the Temperature data, the limits of agreement for the cosine parameters acrophase and amplitude still indicated that there was a closer agreement between rectal and gut Temperatures than between rectal and insulated Axilla Temperatures (-0.30 +/- 1.12 vs. +0.58 +/- 6.69 h, and +0.007 +/- 0.116 vs. +0.104 +/- 0.620 degrees C, respectively). Part of the explanation of this difference was the unreliable relationships between Temperature changes in insulated Axilla Temperature and bursts of activity and going to bed. It is concluded that, whereas gut Temperature is a viable alternativ to rectal Temperature (from the viewpoints of both user acceptability and the reliability of data obtained), insulated Axilla Temperature, though acceptable to subjects, is unreliable from an experimental viewpoint.
A M Costello - One of the best experts on this subject based on the ideXlab platform.
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Postnatal hypothermia and cold stress among newborn infants in Nepal monitored by continuous ambulatory recording.
Archives of disease in childhood. Fetal and neonatal edition, 1996Co-Authors: M Ellis, N Manandhar, U Shakya, D S Manandhar, A Fawdry, A M CostelloAbstract:To describe the pattern of hypothermia and cold stress after delivery among a normal neonatal population in Nepal; to provide practical advice for improving thermal care in a resource limited maternity hospital. The principal government funded maternity hospital in Kathmandu, Nepal, with an annual delivery rate of 15,000 (constituting 40% of all Kathmandu Valley deliveries), severe resource limitations (annual budget Pounds 250,000), and a cold winter climate provided the setting. Thirty five healthy term neonates not requiring special care were enrolled for study within 90 minutes of birth. Continuous ambulatory Temperature monitoring, using microthermistor skin probes for forehead and Axilla, a flexible rectal probe, and a black ball probe placed next to the infant for ambient Temperature, was carried out. All probes were connected to a compact battery powered Squirrel Memory Logger, giving a Temperature reading to 0.2 degree C at five minute intervals for 24 hours. Severity and duration of hypothermia, using cutoff values of core Temperature less than 36 degrees C, 34 degrees C, and 32 degrees C; and cold stress, using cutoff values of skin-core (forehead-Axilla) Temperature difference greater than 3 degrees C and 4 degrees C were the main outcome measures. Twenty four hour mean ambient Temperatures were generally lower than the WHO recommended level of 25 degrees C (median 22.3 degrees C, range 15.1-27.5 degrees C). Postnatal hypothermia was prolonged, with Axillary core Temperatures only reaching 36 degrees C after a mean of 6.4 hours (range 0-21.1; SD 4.6). There was persistent and increasing cold stress over the first 24 hours with the core-skin (Axillary-forehead) Temperature gap exceeding 3 degrees C for more than half of the first 24 hours. Continuous ambulatory recording identifies weak links in the "warm chain" for neonates. The severity and duration of thermal problems was greater than expected even in a hospital setting where some of the WHO recommendations had already been implemented.