Secondary prevention through cardiac rehabilitation: from knowledge to implementation. A position paper from the Cardiac Rehabilitation Section of the European Association of Cardiovascular Prevention and Rehabilitation

Increasing awareness of the importance of cardiovascular prevention is not yet matched by the resources and actions within health care systems. Recent publication of the European Commission's European Heart Health Charter in 2008 prompts a review of the role of cardiac rehabilitation (CR) to cardiovascular health outcomes. Secondary prevention through exercise-based CR is the intervention with the best scientific evidence to contribute to decrease morbidity and mortality in coronary artery disease, in particular after myocardial infarction but also incorporating cardiac interventions and chronic stable heart failure. The present position paper aims to provide the practical recommendations on the core components and goals of CR intervention in different cardiovascular conditions, to assist in the design and development of the programmes, and to support healthcare providers, insurers, policy makers and consumers in the recognition of the comprehensive nature of CR. Those charged with responsibility for secondary prevention of cardiovascular disease, whether at European, national or individual centre level, need to consider where and how structured programmes of CR can be delivered to all patients eligible. Thus a novel, disease-oriented document has been generated, where all components of CR for cardiovascular conditions have been revised, presenting both well-established and controversial aspects. A general table applicable to all cardiovascular conditions and specific tables for each clinical disease have been created and commented.

Indocyanine green fluorescence-guided sentinel lymph node biopsy in dermato-oncology

Sentinel lymph node biopsy (SLNB) for cutaneous malignancies usually carried out with radioactive nanocolloids (Tc-99m). The SLNE is controversially discussed internationally. This is especially given to the high false-negative rate up to 44 %. An alternative could be the fluorescent dye indocyanine green (ICG).

Plato and Frankfurt: Two Theories of the Relations Between Love and Living Well

This thesis provides a comparison of the ideas of caring and love as they appear in the works of Plato and Frankfurt. Frankfurt, a contemporary philosopher, maintains that an individual arrives at the most meaningful life through understanding what it is that heor she cares about the most. Interestingly, the instances of eros in Plato's Symposium and Phaedrus resonate with this idea. We see throughout these erotic dialogues similarities to Frankfurt's notions of care and love.Throughout his many works, Frankfurt provides us with several distinct features of care and love. This thesis offers an in depth discussion of each of these features andalso provides commentary from other contemporary philosophers who are familiar with Frankfurt's work. In addition, this thesis applies these features of care and love to Plato's erotic dialogues, and emphasizes areas in which Plato and Frankfurt agree and those inwhich they disagree. In essence, it becomes apparent that while there are many similarities between the ideas of these two prominent thinkers, Plato and Frankfurt do not agree about what constitutes the best human life. Plato maintains that the best life is onespent dedicated to philosophy and in pursuit of the 'good'. Frankfurt, on the other hand,imposes no such limitations on what we should consider the best life because people are likely to have different life experiences that lead them to care about and love different things. Instead he suggests that the best or most meaningful human life is one in which a person spends his or her life caring about the things he or she does, indeed, care aboutand loving those things he or she does, indeed, love.

Can level of education, accreditation and use of databases in cardiac rehabilitation be improved? Results from the European Cardiac Rehabilitation Inventory Survey

Professional skills, education and accreditation, along with clinical outcome assessment, are considered important factors to achieve comprehensive delivery and quality of cardiac rehabilitation (CR). This study assessed professional educational programmes, accreditation and use of databases in CR across the European countries.

How Much Is Enough? an Analysis of the 5' Nontranslated Region of the Deformed Wing Virus in Honeybees

Honeybees are an essential component of today¿s agricultural system because of their role as pollinators. However, viruses, including a member of the Picornavirales order known commonly as Deformed Wing Virus (DWV), are compromising the health of honeybee colonies. Many picornaviruses, such as poliovirus, have been studied in depth because of their relation to human disease, but also because of their use of an Internal Ribosome Entry Site (IRES) to initiate translation. The primary goal of this thesis was to determine if the 5¿ Non-Translated Region (NTR) of Deformed Wing Virus (DWV) functions as an IRES. A secondary goal was to determine if there are specific parts of that 5¿ NTR that are important to IRES function. Six plasmids were constructed by inserting three different sections of the 5¿ NTR of DWV, in both sense and antisense directions, between two reporter genes. These plasmids, along with several control plasmids, were transfected into Sf9 cells, and post-transfection luciferase assays were conducted. Results were inconclusive. This could have been due to an inability of the plasmids to be expressed in Sf9 cells, an error in the construction of the plasmids, or a mechanical error in the assay procedure. At this time it appears most likely that the 5¿ NTR of DWV may be cell-type or species specific, and the next step would be to transfect the plasmids into a recently developed cultured honeybee cell line.

Panel 8: Perpetrators and “Bystanders” of the Holocaust

Panel 8: Perpetrators and “Bystanders” of the Holocaust Rachel Century, University of London, United Kingdom: "Secretaries, Secrets and Genocide: Evidence from the Post-war Investigations of the Female Secretaries of the RSHA” Download paper (login required) Istvan Pal Adam, Bristol University, United Kingdom: "Bystanders to Genocide? The Role of Building Managers in the Hungarian Holocaust" Download paper (login required) Antonio Munoz, St. John's University: “Murderers in Field Grey: Crimes of the Wehrmacht in the Region of the Army Group South, 1941-1942” Download paper (login required) David Deutsch, Ben-Gurion University, Israel: "Goebbels Close Enemies: Intimacy as an Analytic Tool for the Understanding of Genocidal Rhetoric in Goebbels Diaries" Download paper (login required) Chair:Stefan Ionescu and Hannah Schmidt Hollaender, Clark University Comment: Thomas Kühne, Clark University

Computational and Biochemical Approaches to Molecular Epidemiology

Mining activity in Butte, Montana has taken place, or continues to take place, within the urban residence of Butte itself. This has led to urban areas with high concentrations of toxic metals such as arsenic, lead, copper, zinc, mercury and cadmium. Advances in protein study and gene sequencing has opened the possibility of finding molecular biomarkers whose presence, absence or morphological changes could indicate disease processes in populations exposed to environmental toxins. While in principle, biomarkers can be any chemicals or metabolites, as well as proteins and genes that are indicative of exposure to xenobiotics, this study seeks to identify changes in cellular pathways that suggest chronic (or acute) exposure to low-levels of metals associated with historical mining activities on the Butte Hill that could cause oxidative stress or other stress to the cell.

Efficacy of psychological interventions for sexual dysfunction: a systematic review and meta-analysis

Sexual dysfunction is highly prevalent in the general population and associated with psychological distress and impaired sexual satisfaction. Psychological interventions are promising treatment options, as sexual dysfunction is frequently caused by and deteriorates because of psychological factors. However, research into the efficacy of psychological interventions is rather scarce and an up-to-date review of outcome studies is currently lacking. Therefore, we conducted a systematic review and meta-analysis of all available studies from 1980 to 2009 to examine the efficacy of psychological interventions for patients with sexual dysfunction. A total of 20 randomized controlled studies comparing a psychological intervention with a wait-list were included in the meta-analysis. The overall post-treatment effect size for symptom severity was d = 0.58 (95% CI: 0.40 to 0.77) and for sexual satisfaction d = 0.47 (95% CI: 0.27 to 0.70). Psychological interventions were shown to especially improve symptom severity for women with Hypoactive Sexual Desire Disorder and orgasmic disorder. Our systematic review of 14 studies comparing at least two active interventions head-to-head revealed that very few comparative studies are available with large variability in effect sizes across studies (d between -0.69 and 2.29 for symptom severity and -0.56 and 14.02 for sexual satisfaction). In conclusion, psychological interventions are effective treatment options for sexual dysfunction. However, evidence varies considerably across single disorders. Good evidence exists to date for female hypoactive sexual desire disorder and female orgasmic disorder. Further research is needed on psychological interventions for other sexual dysfunctions, their long-term and comparative effects.

The HeartQoL: Part II. Validation of a new core health-related quality of life questionnaire for patients with ischemic heart disease

Background: Evaluation of health-related quality of life (HRQL) is important in improving the quality of patient care. The aim of this study was to determine the psychometric properties of the HeartQoL in patients with ischemic heart disease (IHD), specifically angina, myocardial infarction (MI), or ischemic heart failure. Methods: Data for the interim validation of the HeartQoL questionnaire were collected in (a) a cross-sectional survey and (b) a prospective substudy of patients undergoing either a percutaneous coronary intervention (PCI) or referred to cardiac rehabilitation (CR) and were then analyzed to determine the reliability, validity, and responsiveness of the HeartQoL questionnaire. Results: We enrolled 6384 patients (angina, n = 2111, 33.1%; MI, n = 2351, 36.8%; heart failure, n = 1922, 30.1%) across 22 countries speaking 15 languages in the cross-sectional study and 730 patients with IHD in the prospective substudy. The HeartQoL questionnaire comprises 14-items with physical and emotional subscales and a global score (range 0–3 (poor to better HRQL). Cronbach’s α was consistently ≥0.80; convergent validity correlations between similar HeartQoL and SF-36 subscales were significant (r ≥ 0.60, p < 0.001); discriminative validity was confirmed with predictor variables: health transition, anxiety, depression, and functional status. HeartQoL score changes following either PCI or CR were significant (p < 0.001) with effect sizes ranging from 0.37–0.64. Conclusion: The HeartQoL questionnaire is reliable, valid, and responsive to change allowing clinicians and researchers to (a) assess baseline HRQL, (b) make between-diagnosis comparisons of HRQL, and (c) evaluate change in HRQL in patients with angina, MI, or heart failure with a single IHD-specific HRQL instrument.