Hypothermia: a Problem for North Sea Industries

The North Sea is a thermally inhospitable environment for thoseworking above or below the water, and for any unfortunate enoughto be accidentally immersed in it. The low air temperaturescoupled with high wind speeds make working conditions abovethe surface both unpleasant and hazardous, while the low watertemperatures throughout the year make hypothermia and subsequentdrowning inevitable to those immersed in the sea for any butshort periods of time. The threat of hypothermia commences whenpersonnel board the service helicopter to be transported toan off-shore rig or barge, and remains until they step ashoreagain at the end of their duty period. This paper reviews some of the relevant applied physiologicalfacts concerning this potential problem, and offers some guidelineson the management of immersion victims who may be sufferingfrom hypothermia. ⁰Requests for reprints should be addressed to: Surg. Cdr F. St C. Golden, RN, Institute of Naval Medicine, Gosport, Hants.     

Recruitment of the elderly into a pharmacologic prevention trial: the Ginkgo Evaluation of Memory Study experience

The difficulty involved in recruiting healthy older adults into clinical trials, especially those involving pharmacologic agents, is an important issue in research. The Ginkgo Evaluation of Memory (GEM) Study, a double-blind, placebo-controlled randomized clinical trial evaluating Ginkgo biloba to prevent dementia, successfully recruited 3072 participants age 75 years and older at four U.S. sites from September 2000 through June 2002. Using targeted mailing lists, an estimated 243,400 study brochures were mailed out to potential participants. Subsequent attempts were made to reach 14,603 households by telephone, from which 12,186 (83.4%) successful contacts were made. Overall, telephone or in-person evaluations identified 2149 (17.6%) ineligible persons for cognitive (20.6%), medical (49.4%), or other (30.0%) reasons. A total of 6944 (57.0%) refused participation resulting in 3072 enrolled into the study, a recruitment rate of 25.2% based on telephone contacts made or 1.3% of all mailed brochures. Recruitment rates were stable over the 21-month enrollment period but were higher for the two urban centers than the two rural ones. Recruitment was dependent most on mailing lists available, density of older adults in the catchment areas, and Institutional Review Board restrictions. Men and persons under age 85 were more likely to enroll. Primary reason for refusals involved lack of interest (48.4%) or self-perceived poor health (16.2%). Over 9% were unwilling to give up current Ginkgo supplementation or would not accept assignment to placebo. An additional 7% did not want another medication and almost 4% had care-giving responsibilities which prevented involvement. Mass mailings were the most successful approach for recruitment at all four sites and the method through which the vast majority of interviewees had learned about the study. Information on the experience of the GEM Study recruitment may be helpful to other clinical trials attempting to randomize older adults into prevention trials.