Management of ST-elevation myocardial infarction according to European and American guidelines.

AIMS To highlight differences between the most recent guidelines of the European Society of Cardiology (ESC) and the American College of Cardiology Foundation/American Heart Association (ACCF/AHA) on the management of ST-elevation myocardial infarction (STEMI). METHODS AND RESULTS ESC 2012 and ACCF/AHA 2013 guidelines on the management of STEMI were systematically reviewed for consistency. Recommendations were matched, directly compared in terms of class of recommendation and level of evidence, and classified as "identical", "overlapping", or "different". Out of 32 recommendations compared, 26 recommendations (81%) were classified as identical or overlapping, and six recommendations (19%) were classified as different. Most diverging recommendations were related to minor differences in class of recommendation between the two documents. This applies to recommendations for reperfusion therapy >12 hours after symptom onset, immediate transfer of all patients after fibrinolytic therapy, rescue PCI for patients with failed fibrinolysis, and intra-aortic balloon pump use in patients with cardiogenic shock. More substantial differences were observed with respect to the type of P2Y12 inhibitor and duration of dual antiplatelet therapy. CONCLUSIONS The majority of recommendations for the management of STEMI according to ESC and ACCF/AHA guidelines were identical or overlapping. Differences were explained by gaps in available evidence, in which case expert consensus differed between European and American guidelines due to divergence in interpretation, perception, and culture of medical practice. Systematic comparisons of European and American guidelines are valuable and indicate that interpretation of available evidence leads to agreement in the vast majority of topics. The latter is indirect support for the process of review and guideline preparation on both sides of the Atlantic.

The Beach in Anglophone Literatures and Cultures: Reading Littoral Space

From early colonial encounters to the ecological disasters of the twenty-first century, the performativity of contact has been a crucial element in the political significance of the beach. Conceptualising the beach as a creative trope and as a socio-cultural site, as well as an aesthetically productive topography, this collection examines its multiplicity of meanings and functions as a natural environment engendering both desire and fear in the human imagination from the Victorian period to the present. The contributors examine literature, film, and art, in addition to moments of encounter and environmental crisis, to highlight the beach as a social space inspiring particular codes of behaviour and specific discourses, as a geographical frontier between land and water, as an historical site of contact and conflict, and as a vacationscape promising regeneration and withdrawal from everyday life. The diversity of the beach is reflected in the geographical range, with essays on locales and texts from Britain, Ireland, the Caribbean, South Africa, the United States, Polynesia, and New Zealand. Focusing on the changed function of the beach as a result of processes of industrialisation and the rise of a modern leisure and health culture, this interdisciplinary volume theorises the beach as a demarcater of the precarious boundary between land and the sea, as well as between nature and culture.

The roles of religiosity and affluence for adolescents' family orientation: Multilevel analyses of 18 cultures

Recent sociological and psychological debates concern the nature of the relation between changing religious beliefs and changing significance of the family. The current study analyzes multilevel relations between religiosity (personal and culture-level) and several aspects of family orientation for n = 4902 adolescents from 18 nations/areas from diverse cultural contexts covering a number of religious denominations with data from the Value-of-Children-Study (Trommsdorff & Nauck, 2005). In addition, cultural values from the World Values Survey representing religious versus secular values as well as survival versus self- expression values are examined at the cultural level of analysis as a joint effect with nation-level economic development. Results showed that religiosity/religious values were positively related to all aspects of adolescents’ family orientation at the individual as well as the cultural level, while societal affluence was only related to a loss of importance of the traditional and hierarchical aspects of family orientation. Postmaterialist self-expression values were unrelated to adolescents’ family orientation.

Modularity and Integrity Issues in Instructional Engineering

Course materials for e-learning are a special type of information system (IS). Thus, in the development of educational material one may learn from principles, methods, and tools that originated in the Software Engineering (SE) discipline and that are relevant in similar ways in "Instructional Engineering". An important SE principle is mo dularization, which supports properties like reusability and adaptability of code. To foster the adaptability of courseware we present a concept in which learning material is organized as a library of modular course objects. A certain lecturer may customize the courseware according to his specific course requirements. He must consider logical dependencies of and relationship integrity between selected course objects. We discuss integrity issues that have to be regarded for the composition of consistent course materials.

Regulation and transcript analysis of the ceroperon responsible for quorum sensing in Rhodobacter sphaeroides 2.4.1

Rhodobacter sphaeroides 2.4.1 is a Gram negative facultative photoheterotrophic bacterium that has been shown to have an N-acyl homoserine lactone-based quorum sensing system called cer for c&barbelow;ommunity e&barbelow;scape r&barbelow;esponse. The cer ORFs are cerR, the transcriptional regulator, cerI, the autoinducer synthase and cerA , whose function is unknown. The autoinducer molecule, 7,8- cis-N-(tetradecenoyl) homoserine lactone, has been characterized. The objective of this study was to identify an environmental stimulus that influences the regulation of cerRAI and, to characterize transcription of the cer operon. ^ A cerR::lacZ transcriptional fusion was made and β-Galactosidase assays were performed in R. sphaeroides 2.4.1 strains, wild type, AP3 (CerI−) and AP4 (CerR−). The cerR::lacZ β-Galactosidase assays were used as an initial survey of the mode of regulation of the Cer system. A cerA::lacZ translational fusion was created and was used to show that cerA can be translated. The presence of 7,8-cis-N-(tetradecenoyl) homoserine lactone was detected from R. sphaeroides strains wild type and AP4 (CerR−) using a lasR::lacZ translational fusion autoinducer bioassay. The cerR::lacZ transcriptional fusion in R. sphaeroides 2.4.1 wild type was tested under different environmental stimuli, such as various carbon sources, oxygen tensions, light intensities and culture media to determine if they influence transcription of the cer ORFs. Although lacZ assay data implicated high light intensity at 100 W/m2 to stimulate cer transcription, quantitative Northern RNA data of the cerR transcript showed that low light intensity at 3 W/m2 is at least one environmental stimulus that induces cer transcription. This finding was supported by DNA microarray analysis. Northern analysis of the cerRAI transcript provided evidence that the cer ORFs are co-transcribed, and that the cer operon contains two additional genes. Bioinformatics was used to identify genes that may be regulated by the Cer system by identifying putative lux box homologue sequences in the presumed promoter region of these genes. Genes that were identified were fliQ, celB and calsymin, all implicated in interacting with plants. Primer extension was used to help localize cis-elements in the promoter region. The cerR::lacZ transcriptional fusion was monitored in a subset of different global DNA binding transcriptional regulator mutant strains of R. sphaeroides 2.4.1. Those regulators involved in maintaining an anaerobic photosynthetic lifestyle appeared to have an effect. Collectively, the data imply that R. sphaeroides 2.4.1 activates the Cer system when grown anaerobic photosynthetically at low light intensity, 3 W/m2, and it may be involved in an interaction with plants. ^

Perceived gender relations and sexual relations among undergraduate female students in the Mekong Delta of Vietnam

Background. Literature worldwide has documented associations between gender-based relationship inequity, sexual communication self-efficacy, and actual use of condoms and contraceptives among young women. However studies that have rigorously tested these associations in southern Vietnam are extremely rare. This study aimed to examine these associations and other current sexual practices among undergraduate female students in the Mekong Delta. Method. A qualitative study was conducted to examine the operationalization of the Theory of Gender and Power and to obtain salient and culture-relevant dimensions of perceived gender relations in the Mekong Delta of Vietnam. Sixty-four undergraduate female students from two universities participated in eight group discussions focusing on their viewpoints regarding national and local gender equity issues. A subsequent cross-sectional survey consisting of 1181 third-year female students from Can Tho University and An Giang University was conducted. Latent variable modeling and logistic regression were employed to examine the hypothesized associations. Results. Dimensions of perceived gender relations were attributable to theoretical structures of labor, power, and cathexis. Perceptions about gender inequities were comparable to findings from several reports, in which women were still viewed as inferior and subordinate to men. Among students who had ever had a boyfriend(s) (72.4%), 44.8% indicated that their boyfriend had ever asked for sex, 13% had ever had penile-vaginal sex, and 10.3% had ever had oral sex. For those who had ever had penile-vaginal sex, 33% did not use any contraceptive method at first sex. The greater a student’s perception that women were subordinate to men, the lower her self-efficacy for sexual communication and the lower her actual frequencies of asking for contraceptive or condom use. Sexual communication self-efficacy was marginally associated with actual contraceptive use (p=.039) and condom use (p=.092) at first sex. Conclusion. Sexual health promotion strategies should address the influence of perceived unequal gender relations on young women’s sexual communication self-efficacy and the subsequent impact on actual contraceptive and condom use.^

Lengua y Literatura : Disciplina escolar. Hacia una metodología circunstanciada de su enseñanza

La metodología circunstanciada de la enseñanza de la lengua y la literatura desarrollada y argumentada a lo largo de esta investigación se presenta como un modo de renegociar los encastres de perspectivas de las didácticas de la lengua o la literatura que hoy muestran en la Argentina su historia de entramados y superposiciones de diversos estatutos de saberes. Estas reconfiguraciones, estudiadas en las últimas cuatro décadas, no son ajenas a las coyunturas políticas, ni a los mecanismos de reproducción y producción de la cultura escolar y del sistema educativo, expresados en las particularidades de la disciplina escolar. Por ello, esta metodología se articula en tres fundamentos que no sobreimprimen nuevas prerrogativas didácticas a las reconfiguraciones de la enseñanza de la lengua y la literatura que actualmente encarnan la disciplina escolar y el sistema educativo en tres de sus niveles [primario, pero con especial atención al secundario e ingresos a la educación superior]. Básicamente, y más allá de sus matices, se trata de reconfiguraciones que develan la reificación de la lectura y la escritura como contenidos de enseñanza en nombre de criterios de utilidad y realidad para los docentes y alumnos. Así, se explica que los efectos de este estado de situación van consolidando un vacío metodológico revelado a través de relatos que permiten recuperar una historia reciente de la enseñanza de la lengua y la literatura en la Argentina, de los devenires de cada una de sus perspectivas, que, en apariencia, no se cruzarían. Sin embargo, puestos en relación, muestran los hechos en los que esas perspectivas se conjugaron, acaso conjuraron, e iniciaron sus complejas, y, a veces, no tan nítidas, alianzas. No obstante, ninguna perspectiva se impone por completo. Mirados sus efectos desde el trabajo docente, se encuentra un encastre entre el textualismo cognitivista, la psicogénesis y la más reciente perspectiva sociocultural e histórica, que abonan a una argamasa de saberes desestabilizadores de la enseñanza de la lengua y la literatura como rito de institución. Por el contrario, con sus prerrogativas siempre articuladas en retóricas de "cómo debe ser la mejor enseñanza" de la lengua y la literatura, de la lectura y la escritura, suman categorías, conceptos, recortes de líneas teóricas, investigaciones, por lo general, todos disímiles, para remodelarlos en orientaciones por demás distantes y ajenas a las realizaciones cotidianas del trabajo docente.Los fundamentos aquí planteados, entonces, se circunstancian en los modos en que docentes y alumnos dicen que se realiza la enseña de la lengua y la literatura. Asimismo, se expone que una idea de cambio radical no es pertinente para la comprensión de prácticas/acciones sociales como las educativas institucionales, y que, en realidad, es necesario recuperar en sentido estricto, y de las teorías sociales, la noción de cambio como variación de la reproducción y producción social. Por lo tanto, los postulados desarrollados para una metodología circunstanciada de la enseñanza de la lengua y la literatura están pensados en ese orden de la variación y no del aplastamiento de los sentidos que, histórica y culturalmente, la constituyen e instituyen

Navegar en la tormenta : El anticomunismo en la historiografía de los Estados Unidos durante la Guerra Fría

Este artículo indaga la gravitación del anticomunismo en la historiografía norteamericana durante la guerra fría. Comienza con una reconstrucción histórica de tal actitud política en la sociedad americana; luego analiza la expansión, características y perdurabilidad del macartismo y, finalmente, describe sus consecuencias sobre la investigación, enseñanza y divulgación de la historia. Analiza como fuentes principales a las obras historiográficas y a los historiadores que sufrieron las ráfagas del anticomunismo; así como a las resoluciones e interpretaciones que desde el propio campo de la disciplina y de las agencias gubernamentales legitimaron la necesidad de prohibir y expurgar la influencia marxista sobre el campo de la cultura, de la educación y del saber histórico. El artículo explica la manera en que las prácticas persecutorias afectaron la carrera de historiadores izquierdistas o progresistas y cómo impactaron sobre las interpretaciones de procesos y acontecimientos significativos del pasado de la gran nación americana.