Differential effects of anti-hypertensive treatment on the retinal microcirculation: an Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT) sub- study

Changes in the retinal microcirculation are associated with hypertension and predict cardiovascular mortality. There are few data describing the impact of antihypertensive therapy on retinal vascular changes. This substudy of the Anglo-Scandinavian Cardiac Outcomes Trial compared the effects of an amlodipine-based regimen (373 patients) with an atenolol-based regimen (347 patients) on retinal microvascular measurements made from fundus photographs. The retinal photographs were taken at a stage in the trial when treatments were stable and blood pressure was well controlled. Amlodipine-based treatment was associated with a smaller arteriolar length:diameter ratio than atenolol-based treatment (13.32 [10.75 to 16.04] versus 14.12 [11.27 to 17.81], median [interquartile range]; P<0.01). The association remained significant after adjustment for age, sex, cholesterol, systolic and diastolic blood pressures, body mass index, smoking, and statin treatment. This effect appeared to be largely attributable to shorter retinal arteriolar segment lengths in the amlodipine-treated group and is best explained by the vasodilator effects of amlodipine causing the visible emergence of branching side vessels. Photographic assessment of the retinal vascular network may be a useful approach to evaluating microvascular structural responses in clinical trials of antihypertensive therapy.

La ricerca sulla montagna nel Settecento sotto nuove prospettive: il network anglo-elvetico-alpino

ZusammenfassungDie Erforschung der Alpen im 18. Jahrhundert unter neuen Perspektiven.Das anglo-schweizerisch-alpine Netzwerk. Der Beitrag beschäftigt sich mit Johann Jakob Scheuchzers Korrespondenten-netz. Zwei grosse Bereiche seiner Korrespondenz wurden berücksichtigt: einer-seits die Kontakte mit verschiedenen englischen Mitgliedern der Royal Society,besonders mit dem Arzt und Fossilienforscher John Woodward, anderseits dasschweizerisch-alpine Informantennetz. Scheuchzer wurde ein wichtiger Spre-cher von Woodwards Diluvialtheorie in Europa und war für die Engländer derbedeutende Informant in allen Fragen, was die Alpen und die Naturgeschichteder Schweiz betraf. Diese Rolle als Vermittler von Wissen über die Berge und die Schweiz wurde durch das schweizweit gut organisierte Netz von Informantenermöglicht. Besonders wichtig waren Scheuchzers Kontakte mit den alpinen Eliten. Der Aufsatz zeigt, wie wichtig die zwei grossen Teile seiner Korrespon-denz für Scheuchzers Forschungstätigkeit waren und welche Rolle besondersdie alpinen Informanten gespielt haben.

[Swiss Research Agenda for Nursing (SRAN): the development of an agenda for clinical nursing research in Switzerland]

In many Anglo-Saxon and North European countries nursing research agendas have been developed to address priorities in nursing research in accordance with a nationally defined health policy. In Switzerland, due to lack of a nationwide governmental health policy, co-ordination of nursing research so far was scarce. The "Swiss Research Agenda for Nursing (SRAN)" project developed an agenda for clinical nursing research between 2005 and 2007. Based on literature reviews, expert panels and a national survey a project team formulated an agenda which passed a consensus conference. The agenda recommends aspects that should lead research and defines seven research priorities for nursing in Switzerland for the time between 2007 and 2017. Nursing research should prioritize to investigate 1) the effectiveness of nursing interventions; 2) the influences of service adaptations in a changing health care system; 3) the phenomena in patients requiring nursing care; 4) the influence of the work environment on the quality of nursing care; 5) the functioning of family and social systems; 6) varieties of life circumstances and their integration; and 7) the implementation of ethical principles in nursing. Written in German and French, the Swiss Research Agenda for Nursing for the first time formulates priorities for nursing research in Switzerland and can be used for strategic discussions. As a next step, the development of an action plan to enhance nursing research will take place in Switzerland.