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.

Getting to the bottom of arsenic standards and guidelines

Public health policy for arsenic needs to better reflect the ability to detect the risk(s).

Assessing Lifetime Homes Standards and Part M Building Regulations for Housing Design in the UK

The aims of this article are to examine Lifetime Home Standards (LTHS) and Part M of the UK Building Regulations and to discuss how relevant and successful they are. The UK government expects all new homes to be built to LTHS by 2013. This is increasingly important with an ageing population. The home environment can enable independence and provide a therapeutic place for everyone. As Part M of the building regulations are compulsory in all housing and LTHS are mandatory for public sector housing, a review of research articles was undertaken on these standards. The paper begins with a brief background on accessibility regulations, followed by a critical review of the standards that takes the body of literature that has been written around them into account. This review suggests that the standards should be improved and that designers and architects face challenges to creatively incorporate them into housing design.

University Competition, Grading Standards, and Grade Inflation

We develop a model of strategic grade determination by universities distinguished by their distributions of student academic abilities. Universities choose grading standards to maximize the total wages of graduates, taking into account how the grading standards affect firms' productivity assessment and job placement. We identify conditions under which better universities set lower grading standards, exploiting the fact that firms cannot distinguish between good and badA''s. In contrast, a social planner sets stricter standards at better universities. We show how increases in skilled jobs drive grade inflation, and determine when grading standards fall faster at better schools. (JEL I21)

Is it time for standards and a common data exchange format for digital image analysis?

Digital image analysis is at a crossroads. While the technology has made great strides over the past few decades, there is an urgent need for image analysis to inform the next wave of large scale tissue biomarker discovery studies in cancer. Drawing parallels from the growth of next generation sequencing, this presentation will consider the case for a common language or standard format for storing and communicating digital image analysis data. In this context, image analysis data comprises more than simply an image with markups and attached key-value pair metrics. The desire to objectively benchmark competing platforms or a push for data to be deposited to public repositories much like genomics data may drive the need for a standard that also encompasses granular, cell-by-cell data.

Addressing the theory practice gap in nurse education: evaluating teaching through audit against NMC standards and final management placement

Introduction
This paper outlines an innovative approach to auditing and evaluating the content of a management and leadership module for undergraduate nursing students after their final management clinical placement. Normally evaluations of teaching in a module take place at the end of a teaching module and therefore do not properly reflect the value of the teaching in relation to practical clinical experience.
Aim
This audit and evaluation sought to explore both the practical value of the teaching and learning, and also the degree to which it the teaching reflected against the NMC Standards of Education and Learning (2010 domain 3).
Methods
Having piloted the evaluative tool with an earlier cohort of nursing students, this evaluation explored both a quantitative assessment employing a Personal Response System (n =172), together with a qualitative dimension (n=116), thus delivering paper-based comments and reflections from students on the value and practicality of the module teaching theory to their final clinical management experience. The quantitative audit data were analysed for frequencies and cross tabulation and the qualitative audit data were thematically analysed.
Results
Results suggest a significant proportion of the students, appreciated the quality of the standard of teaching, but more importantly, ‘valued or highly valued’ the teaching and learning in relation to how it helped to significantly inform their management placement experience. A smaller proportion of the students underlined limitations and areas in which further improvement can be made in teaching and learning to the module.
Conclusion
Significantly positive evaluation by the students of the practical value of teaching and learning, to the theoretical management module. This has proved a useful auditing approach in assessing the theoretical teaching to student’s Level 3 clinical experience, and facilitated significant recommendations as far as developing the teaching and learning to better reflect the practice needs of nursing students

Choice and use of standards for dynamic headspace trapping and application to the analysis of the volatiles of baked potato

When attempting to quantify the volatile components of a food isolated by dynamic headspace trapping onto an adsorbent, the analyst has to select the most appropriate compounds to use as standards and at which stage of the analysis to add them. Factors to be borne in mind include the volatility of the standard, the response of the GC detector, and whether to add the standard to the sample or to the adsorbent trap. This chapter considers the issues and describes the application of one chosen method to the quantitation of the volatile components of baked potato.

Cigarette Smoke, Airway Epithelial Cells and Host Defence

In COPD inflammation driven by exposure to tobacco smoke results in impaired innate immunity in the airway and ultimately to lung injury and remodeling. To understand the biological processes involved in host interactions with cigarette derived toxins submerged epithelial cell culture is widely accepted as a model for primary human airway epithelial cell culture research. Primary nasal and bronchial epithelial cells can also be cultured in air-liquid interface (ALI) models. ALI and submerged culture models have their individual merits, and the decision to use either technique should primarily be determined primarily by the research hypothesis.

Cigarette smoke has gaseous and particulate matter, the latter constituent primarily represented in cigarette smoke extract (CSE). Although not ideal in order to facilitate our understanding of the responses of epithelial cells to cigarette smoke, CSE still has scientific merit in airway cell biology research. Using this model, it has been possible to demonstrate differences in levels of tight junction disruption after CSE exposure along with varied vulnerability to the toxic effects of CSE in cell cultures derived from COPD and control study groups.

Primary nasal epithelial cells (PNECs) have been used as an alternative to bronchial epithelial cells (PBECs). However, at least in subjects with COPD, PNECs cannot consistently substitute for PBECs. Although airway epithelial cells from patients with COPD exhibit a constitutional pro-inflammatory phenotype, these cells have a diminished inflammatory response to CSE exposure. COPD epithelial cells have an increased susceptibility to undergo apoptosis, and have reduced levels of Toll-like receptor-4 expression after CSE exposure, both of which may account for the reduced inflammatory response observed in this group.

The use of CSE in both submerged and ALI epithelial cultures has extended our understanding of the cellular mechanisms that are important in COPD, and helped to unravel important pathways which may be of relevance in its pathogenesis.

Freedom of Expression and Hate Speech

This is a study of free speech and hate speech with reference to the international standards and to the United States jurisprudence. The study, in a comparative and critical fashion, depicts the historical evolution and the application of the concept of ‘free speech,’ within the context of ‘hate speech.’ The main question of this article is how free speech can be discerned from hate speech, and whether the latter should be restricted. To this end, it examines the regulation of free speech under the First Amendment to the United States Constitution, and in light of the international standards, particularly under the International Convention on the Elimination of All Forms of Racial Discrimination, International Covenant on Civil and Political Rights, and the European Convention on Human Rights and Fundamental Freedoms. The study not only illustrates how elusive the endeavour of striking a balance between free speech and other vital interests could be, but also discusses whether and how hate speech should be eliminated within the ‘marketplace of ideas.’

Procurement and Fairness in the Workplace

Public procurement is a potential lever for ensuring greater attention is given to ensuring minimum standards and effective employment rights in the workplace. Public sector purchasers may encourage or require private sector employers from whom they buy to adopt a proactive approach to ensuring fairness at work, focusing on organisational changes that the employer could make. This chapter explores whether and how far public procurement does, or could, influence whether – and how much – employment rights have an impact on employer policy and practice. It considers what public procurement offers as a strategy and what factors help to determine its effectiveness.

Automated object identification and position estimation for airport lighting quality assessment

The development of an automated system for the quality assessment of aerodrome ground lighting (AGL), in accordance with associated standards and recommendations, is presented. The system is composed of an image sensor, placed inside the cockpit of an aircraft to record images of the AGL during a normal descent to an aerodrome. A model-based methodology is used to ascertain the optimum match between a template of the AGL and the actual image data in order to calculate the position and orientation of the camera at the instant the image was acquired. The camera position and orientation data are used along with the pixel grey level for each imaged luminaire, to estimate a value for the luminous intensity of a given luminaire. This can then be compared with the expected brightness for that luminaire to ensure it is operating to the required standards. As such, a metric for the quality of the AGL pattern is determined. Experiments on real image data is presented to demonstrate the application and effectiveness of the system.

Voltage Dip Benchmarking in Power Quality and Disturbance Monitoring

This paper examines power quality benchmarks in the electricity supply industry (ESI) and impact of standards for the reduction of voltage dip incidents. The paper considers adherence to particular standards and is supported by several case studies from incidents where voltage dips have been detected and assessed by the power systems division of Scottish Power and where improvements have been implemented to help militate against subsequent incidents.

Science and Literacy? That’s NEWS to Us!

Evaluating claims in media reports, as NGSS requires, is a challenge, demanding science knowledge and literacy skill. Workshop exploring how to “use the news” to develop your students’ critical abilities.