Quality of Life in Patients with Implantable Cardioverter Defibrillators

Background: The implantable cardioverter defibrillator (ICD) is a life saving device for individuals with life threatening ventricular arrhythmias. There is no doubt that it is a cost effective therapy in various congenital and acquired arrhythmogenic disorders. Nevertheless, shock delivery may be painful and frightening which causes psychological distress and deterioration of perceived quality of life. Methods: A systematic meta-analysis on studies reporting quality of life in patients implanted with ICDs was done using professional databases. Related articles and references of the relevant articles were also searched for suitable studies. Results: Thirty studies with a total of 3412 patients on implantable defibrillators were identified. Five of them were large randomised studies with a total of 1680 patients, while 25 were non-randomised studies. Medical Outcome Study 36-item Short Form health survey (SF - 36) was the most common instrument used for assessment of quality of life. Only one of the 5 major randomised trial reported worsening of quality of life after implantation of a defibrillator. In the subgroup of patients receiving shocks, three out of the five trials reported worsening of quality of life. Summary: Most of the randomised studies showed either neutral or better quality of life in patients on implantable defibrillators. In the subset of patients receiving shocks, worsening of quality of life was found in most randomised studies. Therefore, activation of antitachycardia pacing should be performed in every ICD-patient in order to miminze painful shocks and consequent deterioration of quality of life

Mergers and Acquisitions in the Indian Pharmaceutical Industry: Nature, Structure and Performance

This paper tries to address the extent, nature and impact of the recent surge in consolidation strategies especially in the form of mergers and acquisitions followed by the firms in the Indian pharmaceutical industry. The study found that many of the firms are implementing these strategies in the new context of globalisation mainly to overcome the acute competition arising out of the pro-market reforms and to strengthen their market portfolio. The study reaches the conclusion that the consolidation strategies followed by the firms enabled them to cut down the wasteful expenses to a greater extent and which resulted in better performance of the merging firms compared to the non-merging firms in this industry.mergers; acquisitions; consolidation; pharmaceutical industry; performance

The role of attention in motion extrapolation: Are moving objects 'corrected' or flashed objects attentionally delayed?

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Students' Impressions on the Effectiveness of Online Discussion Forums

Purpose: The study has evaluated the effectiveness of online discussion forums among the students of Abu Dhabi University, UAE. Results: The results have shown strong association between positive learning experience and frequency of student participation in discussion forums. However, no statistical significance (p-value=0.306) has been observed among online forums and age of the participants for developing critical thinking skills. Moreover, a significant difference has been identified in students' participation on the effectiveness of online discussion (p-value=0.000). Conclusion: It is concluded that online discussion forums serve as an efficient and effective tool for interaction among the participants

The use of prepositions among malay adult ESL learners

One predicament facing an educationist is whether grammar should be taught formally, or allowed to be naturally acquired. This question is pertinent in the face of the fact that there has generally been a deterioration of students‟ grammar skills among English as a second language (ESL) learners in Malaysia, especially in the use of syntactical categories such as prepositions and articles.In order to get to the depth of the issue, a protracted study using a case study research design was carried out. This study was carried out on seven Malay students from the International Islamic University Malaysia. The study sought to determine the extent to which students acquired English prepositions in the naturalistic setting in the oral and written modes, the different types of errors in students‟ use of prepositions, in the use of alternative locative frames, and whether there was a specific pattern in acquisition of prepositions. Data from students‟ written samples, interviews and presentations were collected. The baseline data was collected initially, and subsequent data collected at six monthly intervals over three years. The progress of the students was monitored over this period. An analysis of students‟ use of prepositions in the various speaking and writing tasks was carried out. Although errors persist, most subjects showed improvements in their use of prepositions for both speaking and writing tasks. The errors they committed were of two kinds: errors of commission and errors of omission. They had more errors of commission than errors of omission. In the use of alternative locative frames, one of the most common errors was the unnecessary use of the phrase involving a preposition, „for me‟. Persistent errors could arise due to incomplete linguistic rule formation. It also cannot be denied that there could be transfer from the students‟ first language (L1). There were also instances of other words like adverbs being used instead of prepositions. With respect to the performances of students in the most commonly used prepositions, and in certain clusters of prepositions, in the speaking tasks, the best improvement was seen in the prepositions „for‟, „in‟ and „about‟, while in the writing tasks, the prepositions „to, „of‟ and „in‟ were among those where the students had the best results. These findings imply that grammar should be taught in a way that is compatible with the natural processes of acquisition. The subjects‟ overall competency was not of a very high level, not having gained native use of the various prepositions. Consequently, language instructors should also be equipped with special skills to be able to teach prepositions; they should be provided with suitable, accurate teaching materials. Learners should also be developmentally ready to acquire prepositions, and changes have to be made in the curriculum for instruction of prepositions that pose greater problems to second language (L2) learners

Effects of fluctuating daily surface fluxes on the time-mean oceanic circulation

The effect of fluctuating daily surface fluxes on the time-mean oceanic circulation is studied using an empirical flux model. The model produces fluctuating fluxes resulting from atmospheric variability and includes oceanic feedbacks on the fluxes. Numerical experiments were carried out by driving an ocean general circulation model with three different versions of the empirical model. It is found that fluctuating daily fluxes lead to an increase in the meridional overturning circulation (MOC) of the Atlantic of about 1 Sv and a decrease in the Antarctic circumpolar current (ACC) of about 32 Sv. The changes are approximately 7% of the MOC and 16% of the ACC obtained without fluctuating daily fluxes. The fluctuating fluxes change the intensity and the depth of vertical mixing. This, in turn, changes the density field and thus the circulation. Fluctuating buoyancy fluxes change the vertical mixing in a non-linear way: they tend to increase the convective mixing in mostly stable regions and to decrease the convective mixing in mostly unstable regions. The ACC changes are related to the enhanced mixing in the subtropical and the mid-latitude Southern Ocean and reduced mixing in the high-latitude Southern Ocean. The enhanced mixing is related to an increase in the frequency and the depth of convective events. As these events bring more dense water downward, the mixing changes lead to a reduction in meridional gradient of the depth-integrated density in the Southern Ocean and hence the strength of the ACC. The MOC changes are related to more subtle density changes. It is found that the vertical mixing in a latitudinal strip in the northern North Atlantic is more strongly enhanced due to fluctuating fluxes than the mixing in a latitudinal strip in the South Atlantic. This leads to an increase in the density difference between the two strips, which can be responsible for the increase in the Atlantic MOC

Meissner response of a bulk superconductor with an embedded sheet of reduced penetration depth

We calculate the change in susceptibility resulting from a thin sheet with reduced penetration depth embedded perpendicular to the surface of an isotropic superconductor, in a geometry applicable to scanning Superconducting QUantum Interference Device (SQUID) microscopy, by numerically solving Maxwell's and London's equations using the finite element method. The predicted stripes in susceptibility agree well in shape with the observations of Kalisky et al. of enhanced susceptibility above twin planes in the underdoped pnictide superconductor Ba(Fe1-xCox)2As2 (Ba-122). By comparing the predicted stripe amplitudes with experiment and using the London relation between penetration depth and superfluid density, we estimate the enhanced Cooper pair density on the twin planes, and the barrier force for a vortex to cross a twin plane. Fits to the observed temperature dependence of the stripe amplitude suggest that the twin planes have a higher critical temperature than the bulk, although stripes are not observed above the bulk critical temperature.Comment: 16 pages, 9 figure

Virtual Socializing: Its Motives and Spread

Virtual communities constitute an important attribute through which social dialogues are mediated. The emergence of online communities is the outcome of the prevalence of web based technologies. In the world of inter and intra connectedness individuals have the prerogative to get connected to the community of their choice. The present study examines the magnitude and motivations of online social networking through field survey method.virtual socializing, online communities, social networking, virtual platforms, virtual communities