Paul J. Johnson

DENSITY‐DEPENDENT REGULATION OF BODY MASS AND CONDITION IN BADGERS (MELES MELES) FROM WYTHAM WOODS

Body mass and an index of condition for badgers (Meles meles) in a high-density population (Wytham Woods, UK) were examined between 1990 and 1997 and compared with the size of the groups with which individuals were associated. Both body mass and condition decreased as centered group size increased. Fecundity also declined with increasing centered group size. Female badgers exhibited the greatest effects of density-dependent constraints on body mass and condition in autumn, whereas for males the effect was most pronounced in spring.

Manipulating the abundance of Lepthyphantes tenuis (Araneae: Linyphiidae) by field margin management

Populations of the linyphiid spider Lepthyphantes tenuis were sampled in field margins in May, July and September in 1990–1991 and 1995–1996. Field margins were subjected to 10 grassland management regimes, which included the effects of spraying the herbicide glyphosate, cutting, leaving vegetation in situ after the cut, sowing and a control. These treatments were randomised within six complete blocks at the University of Oxford’s farm at Wytham. Cutting vegetation had an immediate effect on number of L. tenuis in both spring and summer. Cutting margins in summer had a more persistent effect on populations of L. tenuis than did cutting margins in spring. The effect of cutting was not mitigated by leaving cut vegetation in situ, but no cutting ensured higher number of L. tenuis in margins, an indication that height and structural complexity of grassland vegetation were important in determining population size. Significantly fewer spiders were found in July and September plots which had been sprayed with herbicide in late June/early July. However, spider numbers were not affected by glyphosate application when samples were taken nearly a year later. Sowing a wildflower seed mixture had no significant effects on number of this generalist predator although other invertebrate groups did benefit. Field margins provided an excellent source habitat for L. tenuis. Habitats that border crop fields acted as a refugia for many other beneficial invertebrates and should be retained as an important component of the agricultural landscape.

Home telemonitoring of chronic heart failure patients: novel system architecture of the home or hospital in heart failure study

The HHH (home or hospital in heart failure) study is a European Community multicenter trial aimed at assessing in a population of chronic heart failure patients 3 incremental home telemonitoring strategies against usual clinical practice. End points are rehospitalization, quality of life, mortality and cost-efficacy. Easy accessibility by the patient and low management costs are the two basic criteria that have guided the design of the architecture of the HHH telemonitoring system. Voice messages, vital signs and long-term cardiorespiratory data are periodically transmitted by the patients at home to a centralized interactive voice response system shared by several hospitals. From there, relevant data are automatically routed to the pertaining medical staff. The HHH technical infrastructure has been completed and tested in the 3 countries involved in the study and enrolment is in progress. Preliminary results on the feasibility of the HHH telemonitoring model are available.

Home telemonitoring of respiratory activity and heart rate variability in chronic heart failure patients: the challenge of the home or hospital in heart failure project

Nocturnal respiratory disorders and depressed heart rate variability are known predictors of poor prognosis in chronic heart failure (CHF) patients. Intermittent monitoring of cardiorespiratory signals while the patient is at home might thus allow early identification of clinical deterioration and prompt optimization of treatment, leading to reduced hospitalizations and mortality and improved quality of life. Within the European Community multicenter trial HHH (Home or Hospital in Heart Failure), we are testing a novel low-cost system for 24-hour recording of cardiorespiratory signals, suitable to be self-managed by the patient at home, with transmission of acquired data through standard telephone lines to the medical/nursing staff. Preliminary results from 24 CHF patients enrolled so far indicate that monthly home telemonitoring is feasible and the compliance is high.

The clinical and economic advantages of remote, community-based physiological assessment.

A prospective study documented the nutritional intakes of a large cohort of pregnant women living in Portsmouth and investigated the independent relationships of smoking, dietary intake and other maternal socio-economic factors on outcome and cardiorespiratory function of the child during sleep at home at three weeks and three months of age. Unattended overnight cardiorespiratory recording was performed and the data stored in local memory before transmission on demand via modem to Oxford next morning. The telemetry of the physiological data, entirely managed by part-time community nurses in Portsmouth, was very successful. Despite some losses, which included transmission failures, electrode or lead disconnection, and monitor malfunction, 92% of the physiological data were analysed at Oxford. Personalized physiological monitoring in the community provides an opportunity for new evidence bases that will enable a new level of individualized care.

A Comparative Study of a New Wireless Continuous Cardiorespiratory Monitor for the Diagnosis and Management of Patients with Congestive Heart Failure at Home

Congestive heart failure (CHF) is a major and increasing chronic disease in Western society, with a high mortality, morbidity and cost for unplanned hospital admissions. Continuous cardiorespiratory monitoring is required to detect Cheyne–Stokes respiration (CSR). We have tested a new wireless monitoring system and compared it with polysomnography (PSG) and respiratory inductance plethysmography (RIP) in six CHF patients with CSR in a sleep laboratory. The wireless system compared well with RIP for the detection of CSR but less well with PSG, which had unexpected but significant respiratory sensing errors that led to misclassification of the respiratory disorder present. The wireless system could be used to select CHF patients for better-customized treatment at home as part of a specialist-supported community telemedicine programme.