Secondary prevention in the clinical management of patients with cardiovascular diseases. Core components, standards and outcome measures for referral and delivery.

Despite major improvements in diagnostics and interventional therapies, cardiovascular diseases remain a major health care and socio-economic burden both in western and developing countries, in which this burden is increasing in close correlation to economic growth. Health authorities and the general population have started to recognize that the fight against these diseases can only be won if their burden is faced by increasing our investment on interventions in lifestyle changes and prevention. There is an overwhelming evidence of the efficacy of secondary prevention initiatives including cardiac rehabilitation in terms of reduction in morbidity and mortality. However, secondary prevention is still too poorly implemented in clinical practice, often only on selected populations and over a limited period of time. The development of systematic and full comprehensive preventive programmes is warranted, integrated in the organization of national health systems. Furthermore, systematic monitoring of the process of delivery and outcomes is a necessity. Cardiology and secondary prevention, including cardiac rehabilitation, have evolved almost independently of each other and although each makes a unique contribution it is now time to join forces under the banner of preventive cardiology and create a comprehensive model that optimizes long term outcomes for patients and reduces the future burden on health care services. These are the aims that the Cardiac Rehabilitation Section of the European Association for Cardiovascular Prevention & Rehabilitation has foreseen to promote secondary preventive cardiology in clinical practice.

Hidden Contradictions and Conditionality: Conceptualisations of Inclusive Education in International Law

The nature of education that children with disabilities should receive has been subject to much debate. This article critically assesses the ways in which the international human rights framework has conceptualised ‘inclusive education’. It argues that the right to education for children with disabilities in international law is constitutive of hidden contradictions and conditionality. This is most evident with respect to conceptualisations of ‘inclusion’ and ‘support’, and their respective emphases upon the extent of individual impairment or ‘deficit’ rather than upon the extent of institutional or structural deficit. It is vital that the new Committee on the Rights of Persons with Disabilities pays close attention to the utilisation of these concepts lest the Convention on the Rights of Persons with Disabilities further legitimises the ‘special needs’ educational discourse to which children with disabilities have been subject.

Secondary Outcomes in a Clinical Trial of Carotenoids with Coantioxidants versus Placebo in Early Age-Related Macular Degeneration

Purpose: To report the secondary outcomes in the Carotenoids with Coantioxidants in Age-Related Maculopathy trial.

Design: Randomized double-masked placebo-controlled clinical trial (registered as ISRCTN 94557601).

Participants: Participants included 433 adults 55 years of age or older with early age-related macular degeneration (AMD) in 1 eye and late-stage disease in the fellow eye (group 1) or early AMD in both eyes (group 2).

Intervention: An oral preparation containing lutein (L), zeaxanthin (Z), vitamin C, vitamin E, copper, and zinc or placebo. Best-corrected visual acuity (BCVA), contrast sensitivity (CS), Raman spectroscopy, stereoscopic colour fundus photography, and serum sampling were performed every 6 months with a minimum follow-up time of 12 months.

Main Outcome Measures: Secondary outcomes included differences in BCVA (at 24 and 36 months), CS, Raman counts, serum antioxidant levels, and progression along the AMD severity scale (at 12, 24, and 36 months).

Results: The differential between active and placebo groups increased steadily, with average BCVA in the former being approximately 4.8 letters better than the latter for those who had 36 months of follow-up, and this difference was statistically significant (P = 0.04). In the longitudinal analysis, for a 1-log-unit increase in serum L, visual acuity was better by 1.4 letters (95% confidence interval, 0.3-2.5; P = 0.01), and a slower progression along a morphologic severity scale (P = 0.014) was observed.

Conclusions: Functional and morphologic benefits were observed in key secondary outcomes after supplementation with L, Z, and coantioxidants in persons with early AMD.

Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article. © 2012 American Academy of Ophthalmology.

A study of secondary instabilities in postbuckling composite aerostructures

A number of experimental studies have shown that postbuckling stiffened composite panels, loaded in uniaxial compression, may undergo secondary instabilities, characterised by an abrupt change in the buckled mode-shape of the skin between the supporting stiffeners. In this study high-speed digital speckle photogrammetry is used to gain further insight into an I-stiffened panel's response during this transient phase. This energy-dissipating phenomenon will be shown to be able to cause catastrophic structural failure in vulnerable structures. It is therefore imperative that an accurate and reliable methodology is available to predict this phenomenon. The shortcomings of current non-linear implicit solution schemes, found in most commercially-available finite element codes, are discussed. A robust and efficient strategy, which utilises an automated quasi-, static/pseudo-transient hybrid scheme, is presented in this paper and validated using a number of experimental tests. This approach is shown to be able to predict mode-jumping with good accuracy.

Introduction to Special Section on Education in Archaeology

Malone, C.A.T. Introduction (with Stone and Baxter) to Special Section Education and Archaeology (19 papers).

Higher education in flight:a new direction for international assignments research

This paper draws attention to the significant internationalisation of the higher education sector and role of international assignments in supporting and driving this. The paper then proceeds to identify the similarities and unique features of the sector in the context of international assignments which we argue, primarily revolve around alternative forms, namely international frequent flyers and short-term assignments. Finally, a model is proposed that may facilitate higher education institutes in more effective international assignment utilisation. © 2012 Copyright Taylor and Francis Group, LLC.

Language Teacher Education in Ireland, North and South

The European Union considers modern languages among the basic skills or key competencies required by all its citizens and is concerned to promote excellence in the teaching and learning of languages as well as greater diversity in the range of languages available to learners in the Member States, as witnessed by the recent European Commission Action Plan, Promoting Language Learning and Linguistic Diversity: An Action Plan 2004-2006. This consideration, the changing socio-cultural demography of Ireland, the need for more joined-up thinking in the context of language teaching in schools, and in the context of language teacher education in particular, form the back-drop to the paper. Among the challenges facing modern/world languages’ education in Ireland identified in the paper are, lack of a languages’ policy, lack of a languages’ strategy, and lack of an integrated language curriculum and by implication, a whole school approach to language teaching and learning. The paper refers to positive signs that are occurring in this context as well, e.g. official recognition to Irish as a working language in the European Union and in the Official Languages Act in Ireland (2003). The paper reports on the recent first ever all Ireland cross-border conference in the context of language teacher education. It outlines the background, aims, and content of the conference that includes findings from a study about the impact of autonomous language teaching and learning supported by the European Language Portfolio in the context of post-primary language teacher education in Ireland. The paper shows data from the first ever survey on language teacher education provision, policy and practice across colleges in Ireland, North and South. Initial teacher education is on the cusp of change. This paper highlights several key issues facing language teacher education. This paper has implications for Irish as well as international readers, and is aimed at supporting all those who want to bring about improvement in this important area.

Roche Tomography of the Secondary Stars in CVS

The secondary stars in cataclysmic variables (CVs) are key to our understanding of the origin evolution and behaviour of this class of interacting binary. In seeking a fuller understanding of these objects the challenge for observers is to obtain images of the secondary star. This goal can be achieved through Roche tomography an indirect imaging technique that can be used to map the Roche-lobe-filling secondary star. The review begins with a description of the basic principles that underpin Roche tomography including methods for determining the binary system parameters. Noise propagation onto Roche tomograms is also covered. Finally the review concludes with a look at the main scientific highlights to date and the future prospects for Roche tomography