Patriotic selections for supplementary reading,

"Intended primarily for use as readings and declamations ... in our schools."--Pref.

Introductory Syriac method and manual

Readings and word lists in Syriac and English; manual in English.

Insurance; principles and practices,

"Readings" and "Problems" at end of each chapter.

The Pilgrim hymnal with responsive readings.

Preface -- Contents -- Order of Subjects -- The hymns -- Sentences and canticles -- Canticles -- Responsive readings and other aids to worship -- Editorial notes -- Acknowledgements -- Indexes of tunes -- Indexes of hymns -- Index of sentences and canticles.

Studies of antihypertensive drug persistence and adherence in the Glasgow Blood Pressure Clinic

Hypertension (HTN) is a major risk factor for cardiovascular diseases including stroke, coronary heart disease (CHD), chronic renal failure, peripheral vascular disease, myocardial infarction, congestive heart failure and premature death. The prevalence of HTN in Scotland is very high and although a high proportion of the patients receive antihypertensive medications, blood pressure (BP) control is very low. Recommendations for starting a specific antihypertensive class have been debated between various guidelines over the years. Some guidelines and HTN studies have preferred to start with a combination of an antihypertensive class instead of using a single therapy, and they have found greater BP reductions with combination therapies than with monotherapy. However, it has been shown in several clinical trials that 20% to 35% of hypertensive patients could not achieve the target BP, even though they received more than three antihypertensive medications. Several factors were found to affect BP control. Adherence and persistence were considered as the factors contributing the most to uncontrolled hypertension. Other factors such as age, sex, body mass index (BMI), alcohol intake, baseline systolic BP (SBP), and the communication between physicians and patients have been shown to be associated with uncontrolled BP and resistant hypertension. Persistence, adherence and compliance are interchangeable terms and have been used in the literature to describe a patient’s behaviour with their antihypertensive drugs and prescriptions. The methods used to determine persistence and adherence, as well as the inclusion and exclusion criteria, vary between persistence and adherence studies. The prevalence of persistence and adherence have varied between these studies, and were determined to be high in some studies and low in others. The initiation of a specific antihypertensive class has frequently been associated with an increase or decrease in adherence and persistence. The tolerability and efficacy of the initial antihypertensive class have been the most common methods of explaining this association. There are also many factors that suggest a relationship with adherence and persistence. Some factors in previous studies, such as age, were frequently associated with adherence and persistence. On the other hand, relationships with certain factors have varied between the studies. The associations of age, sex, alcohol use, smoking, baseline systolic blood pressure (SBP) and diastolic BP (DBP), the presence of comorbidities, an increase in the number of pills and the relationship between patients and physicians with adherence and persistence have been the most commonly investigated factors. Most studies have defined persistence in terms of a patient still taking medication after a period of time. A medication possession ratio (MPR) ≥ 80 has been used to define compliance. Either of these terminologies, or both, have been used to estimate adherence. In this study, I used the same definition for persistence to identify patients who have continued with their initial treatment, and used persistence and MPR to define patients who adhered to their initial treatment. The aim of this study was to estimate the prevalence of persistence and adherence in Scotland. Also, factors that could have had an effect on persistence and adherence were studied. The number of antihypertensive drugs taken by patients during the study and factors that led to an increase in patients being on a combination therapy were also evaluated. The prevalence of resistance and BP control were determined by taking the BP after the last drug had been taken by persistent patients during five follow-up studies. The relationship of factors such as age, sex, BMI, alcohol use, smoking, estimated glomerular filtration rate (eGFR), and albumin levels with BP reductions for each antihypertensive class were determined. Information Services Division (ISD) data, which includes all antihypertensive drugs, were collected from pharmacies in Scotland and linked to the Glasgow Blood Pressure Clinic (GBPC) database. This database also includes demographic characteristics, BP readings and clinical results for all patients attending the GBPC. The case notes for patients who attended the GBPC were reviewed and all new antihypertensive drugs that were prescribed between visits, BP before and after taking drugs, and any changes in the hypertensive drugs were recorded. A total of 4,232 hypertensive patients were included in the first study. The first study showed that angiotensin converting enzyme inhibitor (ACEI) and beta-blockers (BB) were the most prescribed antihypertensive classes between 2004 and 2013. Calcium channel blockers (CCB), thiazide diuretics and angiotensin receptor blockers (ARB) followed ACEI and BB as the most prescribed drugs during the same period. The prescription trend of the antihypertensive class has changed over the years with an increase in prescriptions for ACEI and ARB and a decrease in prescriptions for BB and diuretics. I observed a difference in antihypertensive class prescriptions by age, sex, SBP and BMI. For example, CCB, thiazide diuretics and alpha-blockers were more likely to be prescribed to older patients, while ACEI, ARB or BB were more commonly prescribed for younger patients. In a second study, 4,232 and 3,149 hypertensive patients were included to investigate the prevalence of persistence in the Scottish population in 1- and 5-year studies, respectively. The prevalence of persistence in the 1-year study was 72.9%, while it was only 62.8% in the 5-year study. Those patients taking ARB and ACEI showed high rates of persistence and those taking diuretics and alpha blockers had low rates of persistence. The association of persistence with clinical characteristics was also investigated. Younger patients were more likely to totally stop their treatment before restarting their treatment with other antihypertensive drugs. Furthermore, patients who had high SBP tended to be non-persistent. In a third study, 3,085 and 1,979 patients who persisted with their treatment were included. In the first part of the study, MPR was calculated, and patients with an MPR ≥ 80 were considered as adherent. Adherence rates were 29.9% and 23.4% in the 1- and 5-year studies, respectively. Patients who initiated the study with ACEI were more likely to adhere to their treatments. However, patients who initiated the study with thiazide diuretics were less likely to adhere to their treatments. Sex, age and BMI were different between the adherence and non-adherence groups. Age was an independent factor affecting adherence rates during both the 1- and 5-year studies with older patients being more likely to be adherent. In the second part of the study, pharmacy databases were checked with patients' case notes to compare antihypertensive drugs that were collected from the pharmacy with the antihypertensive prescription given during the patient’s clinical visit. While 78.6% of the antihypertensive drugs were collected between clinical visits, 21.4% were not collected. Patients who had more days to see the doctor in the subsequent visit were more likely to not collect their prescriptions. In a fourth study, 3,085 and 1,979 persistent patients were included to calculate the number of antihypertensive classes that were added to the initial drug during the 1-year and 5-year studies, respectively. Patients who continued with treatment as a monotherapy and who needed a combination therapy were investigated during the 1- and 5-year studies. In all, 55.8% used antihypertensive drugs as a monotherapy and 44.2% used them as a combination therapy during the 1-year study. While 28.2% of patients continued with treatment without the required additional therapy, 71.8% of the patients needed additional therapy. In all, 20.8% and 46.5% of patients required three different antihypertensive classes or more during the 1-year and 5-year studies, respectively. Patients who started with ACEI, ARB and BB were more likely to continue as monotherapy and less likely to need two more antihypertensive drugs compared with those who started with alpha-blockers, non-thiazide diuretics and CCB. Older ages, high BMI levels, high SBP and high alcohol intake were independent factors that led to an increase in the probability of patients taking combination therapies. In the first part of the final study, BPs were recorded after the last drug had been taken during the 5 year study. There were 815 persistent patients who were assigned for this purpose. Of these, 39% had taken one, two or three antihypertensive classes and had controlled BP (controlled hypertension [HTN]), 29% of them took one or two antihypertensive classes and had uncontrolled BP (uncontrolled HTN), and 32% of the patients took three antihypertensive classes or more and had uncontrolled BP (resistant HTN). The initiation of an antihypertensive drug and the factors affecting BP pressure were compared between the resistant and controlled HTN groups. Patients who initiated the study with ACEI were less likely to be resistant compared with those who started with alpha blockers and non-thiazide diuretics. Older patients, and high BMI tended to result in resistant HTN. In the second part of study, BP responses for patients who initiated the study with ACEI, ARB, BB, CCB and thiazide diuretics were compared. After adjusting for risk factors, patients who initiated the study with ACEI and ARB were more respondent than those who took CCB and thiazide diuretics. In the last part of this study, the association between BP reductions and factors affecting BP were tested for each antihypertensive drug. Older patients responded better to alpha blockers. Younger patients responded better to ACEI and ARB. An increase in BMI led to a decreased reduction in patients on ACEI and diuretics (thiazide and non-thiazide). An increase in albumin levels and a decrease in eGFR led to decreases in BP reductions in patients on thiazide diuretics. An increase in eGFR decreased the BP response with ACEI. In conclusion, although a high percentage of hypertensive patients in Scotland persisted with their initial drug prescription, low adherence rates were found with these patients. Approximately half of these patients required three different antihypertensive classes during the 5 years, and 32% of them had resistant HTN. Although this study was observational in nature, the large sample size in this study represented a real HTN population, and the large pharmacy data represented a real antihypertensive population, which were collected through the support of prescription data from the GBPC database. My findings suggest that ACEI, ARB and BB are less likely to require additional therapy. However, ACEI and ARB were better tolerated than BB in that they were more likely to be persistent than BB. In addition, users of ACEI, and ARB have good BP response and low resistant HTN. Linkage patients who participated in these studies with their morbidity and mortality will provide valuable information concerning the effect of adherence on morbidity and mortality and the potential benefits of using ACEI or ARB over other drugs.

Reading fictions

Each of the six chapters, which offer a cumulative course of study, begins with a concise overview of the concepts to be explored through the students’ reading of selected stories. The first chapter, 'Texts and readings', tries to make reading seem 'strange' through a series of de-familiarising activities that ask students to consider not only what particular stories might mean, but also how they are made to mean in different, and often quite contradictory, ways. This is explored further in the second chapter which introduces the idea of 'reading positions' and investigates the idea that in some senses, stories are always 'already read'. The next two chapters, called 'Intertextuality' and 'Re-readings?', invite students to consider how they produce particular readings and how they might choose among quite different readings or interpretations of the same story. The fifth chapter explores ideas about texts and their relationship to 'reality' through readings of racism, while the final chapter, 'Real people?' asks students to consider how they produce often rich and detailed readings of characters from minimal textual information. Terms and concepts which may be new to some students are highlighted in the text and indexed for easy reference. The short stories in this collection are by writers from different parts of the world and will appeal to students. They range from 'expressive realist' texts to less conventional narrative forms. Those teachers who have enjoyed using Reading Stories with their students will have a lot to look forward to in this collection of surefire 'winners' - by writers as varied as Bessie Head, Kristin Hunter, Tim Winton, Joyce Carol Oates, John Wain and Patricia Grace - each of which is accompanied by imaginative, enjoyable and thought-provoking activities.

Reading stories

What expectations do readers have of stories? Where do readers’ expectations come from? Do certain kinds of readings serve to support particular beliefs and assumptions? These and other questions are raised in Reading Stories, a collection of eleven short stories that have been very popular with Year 10 classes and above, accompanied by activities for talk and writing that encourage students to reflect on stories and their reading of them. Reading Stories aims to make recent literary theory accessible to students through a range of practical activities that work well in the classroom. Each story’s accompanying activities are designed to give students not only the opportunity but also the support they might need to construct and analyse possible readings of the text. There are five chapters - offering a cumulative learning experience - that consider such areas as readers’ expectations, how and why readings change, what is at stake in the disagreements between readings, and reading for gender, race and class. The approaches used begin with students’ familiarity with stories and then work to make available for analysis aspects of reading and ‘interpretation’ that are often taken for granted. While the concepts addressed are complex, the book aims to encourage participation from all students.

Changing user behaviour using a digital repository system

Griffith University is developing a digital repository system using HarvestRoad Hive software to better meet the needs of academics and students using institutional learning and teaching, course readings, and institutional intellectual capital systems. Issues with current operations and systems are discussed in terms of user behaviour. New repository systems are being designed in such a way that they address current service and user behaviour issues by closely aligning systems with user needs. By developing attractive online services, Griffith is working to change current user behaviour to achieve strategic priorities in the sharing and reuse of learning objects, improved selection and use of digitised course readings, the development of ePrint and eScience services, and the management of a research portfolio service.

(Mis)Using Pulse Oximetry : A Review of Pulse Oximetry use in Acute Care Medical Wards

Background: Nurses routinely use pulse oximetry (SpO2) monitoring equipment in acute care. Interpretation of the reading involves physical assessment and awareness of parameters including temperature, haemoglobin, and peripheral perfusion. However, there is little information on whether these clinical signs are routinely measured or used in pulse oximetry interpretation by nurses. Aim: The aim of this study was to review current practice of SpO2 measurement and the associated documentation of the physiological data that is required for accurate interpretation of the readings. The study reviewed the documentation practices relevant to SpO2 in five medical wards of a tertiary level metropolitan hospital. Method: A prospective casenote audit was conducted on random days over a three-month period. The audit tool had been validated in a previous study. Results: One hundred and seventy seven episodes of oxygen saturation monitoring were reviewed. Our study revealed a lack of parameters to validate the SpO2 readings. Only 10% of the casenotes reviewed had sufficient physiological data to meaningfully interpret the SpO2 reading and only 38% had an arterial blood gas as a comparator. Nursing notes rarely documented clinical interpretation of the results. Conclusion: The audits suggest that medical and nursing staff are not interpreting the pulse oximetry results in context and that the majority of the results were normal with no clinical indication for performing this observation. This reduces the usefulness of such readings and questions the appropriateness of performing “routine” SpO2 in this context.

Ammonia emissions from a representative in-use fleet of vehicles in Guangzhou

Emission rates of ammonia (NH3) are reported for a fleet of 130 light-, medium-, and heavy-duty vehicles recruited in Guangzhou, China. NH3 measurements were performed using Nessler's Reagents spectrophotometry and nationwide standard chassis dynamometer test cycles required by Chinese EPA. Emissions of CO and NOx were also measured during these test cycles. Emission factors of NH3 were calculated for each type of vehicle and used to estimate the total emissions of NH3 from motor vehicles in Guangzhou (GZ) in 2009. Emission factors of NH3 show large variations among different categories of vehicles, with a range from 4 to 138 mg km-1. The average emissions of NH3 in Guangzhou in 2009 were estimated to be 983 t, with a range from 373 to 2136 t. In addition, it was found that vehicles with the highest NH3 emission rates possess the following characteristics: mediumand heavy-duty vehicles, certified with out-of-date emission standards, mid-range odometer readings, and higher CO and NOx emission rates. The results of this study will be useful for developing NH3 emissions inventories in Guangzhou and other urban areas in China.

A methodological approach to reporting corrected small field relative outputs

Purpose The goal of this work was to set out a methodology for measuring and reporting small field relative output and to assess the application of published correction factors across a population of linear accelerators. Methods and materials Measurements were made at 6 MV on five Varian iX accelerators using two PTW T60017 unshielded diodes. Relative output readings and profile measurements were made for nominal square field sizes of side 0.5 to 1.0 cm. The actual in-plane (A) and cross-plane (B) field widths were taken to be the FWHM at the 50% isodose level. An effective field size, defined as FSeff=A·B, was calculated and is presented as a field size metric. FSeffFSeff was used to linearly interpolate between published Monte Carlo (MC) calculated kQclin,Qmsrfclin,fmsr values to correct for the diode over-response in small fields. Results The relative output data reported as a function of the nominal field size were different across the accelerator population by up to nearly 10%. However, using the effective field size for reporting showed that the actual output ratios were consistent across the accelerator population to within the experimental uncertainty of ±1.0%. Correcting the measured relative output using kQclin,Qmsrfclin,fmsr at both the nominal and effective field sizes produce output factors that were not identical but differ by much less than the reported experimental and/or MC statistical uncertainties. Conclusions In general, the proposed methodology removes much of the ambiguity in reporting and interpreting small field dosimetric quantities and facilitates a clear dosimetric comparison across a population of linacs

Quick, Decentralized, Energy-Efficient One-Shot Max Function Computation Using Timer-Based Selection

In several wireless sensor networks, it is of interest to determine the maximum of the sensor readings and identify the sensor responsible for it. We propose a novel, decentralized, scalable, energy-efficient, timer-based, one-shot max function computation (TMC) algorithm. In it, the sensor nodes do not transmit their readings in a centrally pre-defined sequence. Instead, the nodes are grouped into clusters, and computation occurs over two contention stages. First, the nodes in each cluster contend with each other using the timer scheme to transmit their reading to their cluster-heads. Thereafter, the cluster-heads use the timer scheme to transmit the highest sensor reading in their cluster to the fusion node. One new challenge is that the use of the timer scheme leads to collisions, which can make the algorithm fail. We optimize the algorithm to minimize the average time required to determine the maximum subject to a constraint on the probability that it fails to find the maximum. TMC significantly lowers average function computation time, average number of transmissions, and average energy consumption compared to approaches proposed in the literature.

PPs without Disguises: Reply to Bruening

[EN]Bresnan and Nikitina (2009) and Rappaport Hovav and Levin (2008) show that, contrary to standard assumptions, fixed-theme idioms may appear in to-constructions under certain pragmatic circumstances. Bruening (2010a) contends that the cases they present are in fact R(ightward)-dative shifts, double object constructions with the object projected to the right. In this article, we argue that Bruening’s proposed theoretical apparatus is unnecessarily complex and ad hoc and falls short of explaining the main facts it is supposed to deal with, massively overgenerating. A regular PP structure is argued to be empirically more adequate and conceptually simpler, avoiding the main problems of the R-dative shift analysis. New empirical evidence concerning pairlist readings and scope freezing also suggests that the empirical facts about idioms should be reconsidered in completely different terms.

Precision of age determination of northern offshore spotted dolphins.

We investigated within- and between-reader precision in estimating age for northern offshore spotted dolphins and possible effects on precision from the sex and age-class of specimens. Age was estimated from patterns of growth layer groups i n the dentine and cementum of the dolphins' teeth. Each specimen was aged at least three times by each of two persons. Two data samples were studied. The first comprised 800 of each sex from animals collected during 1973-78. The second included 45 females collected during 1981. There were significant, generally downward trends through time in the estimates from multiple readings of the 1973-78 data. These trends were slight, and age distributions from last readings and mean estimates per specimen appeared to be homogeneous. The largest factor affecting precision in the 1973-78 data set was between-reader variation. In light of the relatively high within-reader precision (trends considered), the consistent between-reader differences suggest a problem of accuracy rather than precision for this series. Within-reader coefficients of variation averaged approximately 7% and 11%. Pooling the data resulted i n an average coefficient of variation near 16%. Within- and between-reader precision were higher for the 1981 sample, and the data homogeneous over both factors. CVs averaged near 5% and 6% for the two readers. These results point to further refinements in reading the 1981 series. Properties of the 1981 sample may be partly responsible for greater precision: by chance there were proportionately fewer older dolphins included, and preparation and selection criteria were probably more stringent. (PDF contains 35 pages.)

Bewertung von Frische- und Verderbsindikatoren bei der Eislagerung von Schollen (Pleuronectes platessa)

An iced storage experiment with plaice was conducted during the 1l5th cruise of FRV "Walther Herwig II" in the North Sea. Iced stored plaice were rated by sensory methods as saleable until day 18 of iced storage and as edible until day 20. In addition to the sensory tests the Fischtester VI readings and the pH-value measured in muscle homogenate proved to be useful freshness indicators, while TVB-N is a typical spoilage indicator.