Alternative models of cardiac rehabilitation : a systematic review

The traditional hospital-based model of cardiac rehabilitation faces substantial challenges, such as cost and accessibility. These challenges have led to the development of alternative models of cardiac rehabilitation in recent years. The aim of this study was to identify and critique evidence for the effectiveness of these alternative models. A total of 22 databases were searched to identify quantitative studies or systematic reviews of quantitative studies regarding the effectiveness of alternative models of cardiac rehabilitation. Included studies were appraised using a Critical Appraisal Skills Programme tool and the National Health and Medical Research Council's designations for Level of Evidence. The 83 included articles described interventions in the following broad categories of alternative models of care: multifactorial individualized telehealth, internet based, telehealth focused on exercise, telehealth focused on recovery, community- or home-based, and complementary therapies. Multifactorial individualized telehealth and community- or home-based cardiac rehabilitation are effective alternative models of cardiac rehabilitation, as they have produced similar reductions in cardiovascular disease risk factors compared with hospital-based programmes. While further research is required to address the paucity of data available regarding the effectiveness of alternative models of cardiac rehabilitation in rural, remote, and culturally and linguistically diverse populations, our review indicates there is no need to rely on hospital-based strategies alone to deliver effective cardiac rehabilitation. Local healthcare systems should strive to integrate alternative models of cardiac rehabilitation, such as brief telehealth interventions tailored to individual's risk factor profiles as well as community- or home-based programmes, in order to ensure there are choices available for patients that best fit their needs, risk factor profile, and preferences.

The Music Industry : Music in the Cloud, 1st edition

"The music industry is going through a period of immense change brought about in part by the digital revolution. What is the role of music in the age of computers and the internet? How has the music industry been transformed by the economic and technological upheavals of recent years, and how is it likely to change in the future? This is the first major study of the music industry in the new millennium. Wikström provides an international overview of the music industry and its future prospects in the world of global entertainment. He illuminates the workings of the music industry, and captures the dynamics at work in the production of musical culture between the transnational media conglomerates, the independent music companies and the public." -- back cover Table of Contents Introduction: Music in the Cloud Chapter 1: A Copyright Industry. Chapter 2: Inside the Music Industry Chapter 3: Music and the Media Chapter 4: Making Music - An Industrial or Creative Process Chapter 5: The Social and Creative Music Fan Chapter 6: Future Sounds

CPAP apparatus : an inexpensive alternative

Objective: To describe an effective and inexpensive CPAP-mask apparatus for use in the emergency department. Conclusion: CPAP is an effective tool in the treatment of acute pulmonary oedema in the emergency department. The mask apparatus described is an inexpensive alternative to the commercially produced machines.

Patients with terminal cancer who use alternative therapies: their beliefs and practices

This paper examines the extent to which patients who have been diagnosed as having terminal cancer choose to use non-medical therapies. In particular it is concerned with the illness behaviour of patients who are receiving conventional cytotoxic drug and radiation treatments, who also decide to use a wide range of ‘alternative’ medications and therapies. The paper discusses the findings of a study of 152 patients with metastatic cancer that examined the extent to which they used alternative cancer therapies, as well as the beliefs and attitudes they have about their cancer, its treatment, and the practitioners providing that treatment. Four groups of users of alternative therapies, who differ according to their commitment to and the type of therapies they use, were identified. Results of logistic regression analyses indicate that those using alternative therapies were different in range of social attitudes. These differences were primarily their greater reported ‘will to live’ and desire for control over treatment decisions, and the differing beliefs they hold about their disease.

Dreams and nightmares of alternative powers' futures

This chapter argues the importance of the role and nature of other powers to world order. The author suggests that, if the US are not prepared to take a lead in creating a rules-based legal order, they should and can do so – and it is in their interests to do so. America should be a natural leader in this process, taking part in a global dialogue just as they did in the transatlantic dialogue during the late eighteenth century.

Review : alternative splicing (AS) of genes as an approach for generating protein complexity

Prior to the completion of the human genome project, the human genome was thought to have a greater number of genes as it seemed structurally and functionally more complex than other simpler organisms. This along with the belief of “one gene, one protein”, were demonstrated to be incorrect. The inequality in the ratio of gene to protein formation gave rise to the theory of alternative splicing (AS). AS is a mechanism by which one gene gives rise to multiple protein products. Numerous databases and online bioinformatic tools are available for the detection and analysis of AS. Bioinformatics provides an important approach to study mRNA and protein diversity by various tools such as expressed sequence tag (EST) sequences obtained from completely processed mRNA. Microarrays and deep sequencing approaches also aid in the detection of splicing events. Initially it was postulated that AS occurred only in about 5%; of all genes but was later found to be more abundant. Using bioinformatic approaches, the level of AS in human genes was found to be fairly high with 35-59%; of genes having at least one AS form. Our ability to determine and predict AS is important as disorders in splicing patterns may lead to abnormal splice variants resulting in genetic diseases. In addition, the diversity of proteins produced by AS poses a challenge for successful drug discovery and therefore a greater understanding of AS would be beneficial.

Unpacking ‘lessons learned’ : investigating failures and considering alternative solutions

One of the most common ways to share project knowledge is to capture the positive and negative aspects of projects in the form of lessons learned (LL). If effectively used, this process can assist project managers in reusing project knowledge and preventing future projects from repeating mistakes. Nevertheless, the process of capturing, storing, reviewing and reusing LL often remains suboptimal. Despite the potential for rich knowledge capture, lessons are often documented as simple, line-item statements devoid of context. Findings from an empirical investigation across four cases revealed a range of reasons related to the perceived quality, process and visibility of LL that lead to their limited use and application. Drawn from the cross-case analysis, this paper investigates an integrated approach to LL involving the use of a collaborative Web-based tool, which is easily accessible, intelligible and user-friendly, allowing more effective sharing of project knowledge and overcoming existing problems with LL.

Analysis of androgen and anti-androgen regulation of KLK-related peptidase 2, 3, and 4 alternative transcripts in prostate cancer

We assessed whether alternative transcripts (using KLK2, KLK3 and KLK4 as models) are differentially regulated by androgens and anti-androgens as an indicator of prostate cancers as they acquire treatment resistance. Using RNAseq of LNCaP cells treated with dihydrotestosterone, bicalutamide and enzalutamide, we show that the expression of variant KLK transcripts is markedly different to other variant transcripts at those loci. We also reveal that KLK variants are also over 2-fold more highly expressed in prostate cancers compared to their corresponding normal prostate. We propose that androgens and anti-androgens can activate specific variant transcripts of critical prostate cancer genes during treatment resistance

Sound Musicianship : Understanding the Crafts of Music

Sound Musicianship is a book for music educators and musicians about musicianship—about musical skills, abilities, habits, sensibilities and understandings. Musicianship is explored as a form of craftsmanship. Like most crafts, music requires a balance of theoretical knowledge and practical skills that contribute to a highly tuned ability to appreciate and express music. In particular, the book explores general trends that influence musicianship in the twenty-first century, such as an increased reliance on digital media, greater awareness of the neurological basis for musical behaviour, a renewed interest in connections between bodily movements and musical expression, and increased cultural plurality resulting from more frequent travel, increased levels of migration and ubiquitous telecommunications. The book has a deliberate focus on the developmental aspects of musicianship, which will benefit those hoping to advance their own music learning or that of others. It includes a diverse range of views and perspectives on musicianship and is organised into five sections. The first four sections explore the implications of music understood as sound, experience, motion and culture, respectively. In these sections, leading researchers and thinkers outline important issues and debates that are relevant to developing the crafts of music making and they share insights into recent trends and understandings. The final section of the book looks at educational considerations and provides a series of case studies that document innovative approaches to developing musicianship. Readers will encounter some new, interesting and thought-provoking ideas within these pages. As we move further into the twenty-first century—with all the opportunities and challenges for music making it brings—the requirement to review our concepts of musicianship training will intensify, and the definition of a “sound basis” for a contemporary musicianship will evolve. This book is intended to help stimulate and inform that evolutionary process.

Alternative modes of entrepreneurial opportunity exploitation

While entrepreneurship research has taken firm formation to be the predominant mode of opportunity exploitation, entrepreneurship can take place through many other types of organizational arrangements. In the present article, we consider one such alternative arrangement, namely the formation of inter-organizational projects (IOPs). We propose a multi-level contingency model that suggests that uncertainty both at the level of the firm and at the level of the environment makes the exploitation of opportunities through IOPs more likely. The model is tested by telephone survey data collected amongst a panel of 1725 SMEs and longitudinal industry data. Our findings provide strong support for the industry-level part of the model, but interestingly, only partial support for the firm level part of the model. This indicates that the effects of uncertainty need to be dissected into different levels of analysis to understand the conditions under which alternative modes of opportunity exploitation can be a prominent entrepreneurial alternative to new firm formation.

The adventure of the refrain : composing with improvised music

This practice-based inquiry investigates the process of composing notated scores using improvised solos by saxophonists John Butcher and Anthony Braxton. To compose with these improvised sources, I developed a new method of analysis and through this method I developed new compositional techniques in applying these materials into a score. This method of analysis and composition utilizes the conceptual language of Gilles Deleuze and Felix Guattari found in A Thousand Plateaus. The conceptual language of Deleuze and Guattari, in particular the terms assemblage, refrain and deterritorialization are discussed in depth to give a context for the philosophical origins and also to explain how the language is used in reference to improvised music and the compositional process. The project seeks to elucidate the conceptual language through the creative practice and in turn for the creative practice to clarify the use of the conceptual terminology. The outcomes of the research resulted in four notated works being composed. Firstly, Gravity, for soloist and ensemble based on the improvisational language of John Butcher and secondly a series of 3 studies titled Transbraxton Studies for solo instruments based on the improvisational-compositional language of Anthony Braxton. The implications of this research include the application of the analysis method to a number of musical contexts including: to be used in the process of composing with improvised music; in the study of style and authorship in solo improvisation; as a way of analyzing group improvisation; in the analysis of textural music including electronic music; and in the analysis of music from different cultures—particularly cultures where improvisation and per formative aspects to the music are significant to the overall meaning of the work. The compositional technique that was developed has further applications in terms of an expressive method of composing with non-metered improvised materials and one that merges well with the transcription method developed of notating pitch and sounds to a timeline. It is hoped that this research can open further lines of enquiry into the application of the conceptual ideas of Deleuze and Guattari to the analysis of more forms of music.

"Ruby's Music Festival" : developing problem solving skills using online scenarios and creating opportunities to feed forward

One of the characteristics of good teaching is giving the highest quality feedback on student work but the term “feedback” is most commonly associated with summative assessment given by a teacher after work is completed. The student can often be a passive participant in the process. This article looks at the implementation of web based scenarios completed by students prior to summative assessment with the objective of improving legal problem solving skills. It examines the design process and the implementation of the problem solving activity and the approach to teaching and learning taken in the new law unit of which it is part. We argue that such activities are effective tools to feed forward and reflect on the implications for the effective teaching of law in higher education.

Prediction and proactivity in real-time interactive music systems

We advocate for the use of predictive techniques in interactive computer music systems. We suggest that the inclusion of prediction can assist in the design of proactive rather than reactive computational performance partners. We summarize the significant role prediction plays in human musical decisions, and the only modest use of prediction in interactive music systems to date. After describing how we are working toward employing predictive processes in our own metacreation software we reflect on future extensions to these approaches.