A COMPARISON OF OUTCOMES OF A HOME-BASED CARDIAC REHABILITATION PROGRAM AS AN ALTERNATIVE TO TRADITIONAL OUTPATIENT PHASE II CARDIAC REHABILITATION

Phase II outpatient cardiac rehabilitation (CR) is an intervention offered to patients that have been diagnosed with heart disease, undergone various procedures such as stenting or valve replacement, or to those with claudication diseases. Home-based cardiac rehabilitation (HBCR) is an alternative approach to traditional outpatient phase II CR, that is an emergent area of study with preliminary evidence showing in some outcomes that it approximates traditional CR. As there is current interest in the study of HBCR, this paper examines outcomes of mortality, risk factor modification, exercise capacity, and cardiac function to determine the extent to which this intervention may be a suitable alternative to traditional phase II outpatient CR. In this review, outcomes in HBCR are compared to usual care control groups (participants who are non-participants or non-referrals to CR) to identify outcomes that change following a HBCR intervention. Following comparisons of HBCR and usual care controls, the former is then compared to traditional phase II outpatient CR to present areas of significant improvement between the interventions. After examining the various outcomes in the most relevant 28 manuscripts from a large literary search, preliminary evidence indicates HBCR is, in many respects (e.g. Peak VO2, 6MWD, METs, resting SBP, RHR, LVEF, TC, HDL, LDL, and mortality), equivalent to traditional outpatient phase II CR in eliciting an exercise response. Traditional phase II outpatient CR has an advantage in adherence and safety due to direct patient monitoring, coverage and reimbursement of health care, and standardized guidelines in terms of outcomes. HBCR is advantageous in situations with barriers to adherence or participation such as travel, frailty due to advancing age, and additional comorbidities or health issues

Metadiscourse repertoire of L1 Mandarin undergraduates writing in English : a cross-contextual, cross-disciplinary study

This article presents a qualitative, comparative study of metadiscourse in the academic writing of two groups of undergraduate students working in two different disciplines. The groups of students were: 1) Native speakers of Mandarin studying in China through the medium of English; 2) Native speakers of Mandarin studying in the UK through the medium of English. For each group of students, we examined writing undertaken in two undergraduate disciplinary courses: Literary Criticism and Translation Studies. Our aim was to extend research into English writing by L1 Mandarin speakers, and to identify patterns of difference and similarity both between educational contexts and between disciplines. Results suggest that patterns of metadiscourse use in our corpus are associated with both disciplinary and contextual factors, but that contextual factors may have a stronger effect than disciplinary factors. For our data, local institutional culture seems to have a noticeable influence on student writers' use of metadiscourse

“In this paper we suggest”: Changing patterns of disciplinary metadiscourse

Metadiscourse is the commentary on a text made by its producer in the course of speaking or writing. Here we take an interpersonal perspective, focusing on metadiscourse as a repertoire of resources available for writers to organise a discourse or their stance towards its content or the reader. In this paper we explore whether, and to what extent, metadiscourse has changed in professional writing in different disciplines over the past 50 years. Extending our diachronic work analysing a corpus of 2.2 million words from articles in the top journals in four disciplines, we show there has been a significant increase in interactive features and a significant decrease in interactional types. Surprisingly, interactional metadiscourse shows a marked decline in the discursive soft knowledge fields and a substantial increase in the science subjects

Decreased Autocrine EGFR Signaling in Metastatic Breast Cancer Cells Inhibits Tumor Growth in Bone and Mammary Fat Pad

Breast cancer metastasis to bone triggers a vicious cycle of tumor growth linked to osteolysis. Breast cancer cells and osteoblasts express the epidermal growth factor receptor (EGFR) and produce ErbB family ligands, suggesting participation of these growth factors in autocrine and paracrine signaling within the bone microenvironment. EGFR ligand expression was profiled in the bone metastatic MDA-MB-231 cells (MDA-231), and agonist-induced signaling was examined in both breast cancer and osteoblast-like cells. Both paracrine and autocrine EGFR signaling were inhibited with a neutralizing amphiregulin antibody, PAR34, whereas shRNA to the EGFR was used to specifically block autocrine signaling in MDA-231 cells. The impact of these was evaluated with proliferation, migration and gene expression assays. Breast cancer metastasis to bone was modeled in female athymic nude mice with intratibial inoculation of MDA-231 cells, and cancer cell-bone marrow co-cultures. EGFR knockdown, but not PAR34 treatment, decreased osteoclasts formed in vitro (p<0.01), reduced osteolytic lesion tumor volume (p<0.01), increased survivorship in vivo (p<0.001), and resulted in decreased MDA-231 growth in the fat pad (p<0.01). Fat pad shEGFR-MDA-231 tumors produced in nude mice had increased necrotic areas and decreased CD31-positive vasculature. shEGFR-MDA-231 cells also produced decreased levels of the proangiogenic molecules macrophage colony stimulating factor-1 (MCSF-1) and matrix metalloproteinase 9 (MMP9), both of which were decreased by EGFR inhibitors in a panel of EGFR-positive breast cancer cells. Thus, inhibiting autocrine EGFR signaling in breast cancer cells may provide a means for reducing paracrine factor production that facilitates microenvironment support in the bone and mammary gland

Metadiscourse in social studies texts

Running title: MetadiscourseIncludes bibliographical references (leaves 50-52)Performed pursuant to contract no. 400-81-0030 of the National Institute of Educatio

The use of author roles in improving textbooks and learning

Running title: Improving textbooks and learningIncludes bibliographical references (leaves 33-36)Performed pursuant to contract no. 400-81-0030 of the National Institute of Educatio

Metadiscourse : what it is and how it is used in school and non-school social science texts

Includes bibliographiesSupported in part by the National Institute of Education under contract no. NIE-400-81-003

The interaction of metadiscourse and anxiety in determining children's learning of social studies textbook materials

The role of attitudinal, voice, and informational metadiscourse characteristics and level of student anxiety were studied as they affect learning from social studies textbooks for 120 sixth-graders. Analyses of covariance, controlling for reading ability, revealed significant interaction effects involving metadiscourse and anxi-ety. As expected, high anxious students showed their best performance with first person voice and no attitudinal metadiscourse while low anxious students showed the opposite effect. The importance of studying the joint effects of metadiscourse and anxiety as determinants of textbook reading is discussed. The present study examines the effects of adding metadiscourse characteristics to a text on children&apos;s understanding of social studies textbook materials as a function of their level of test anxiety. To the authors &apos; knowledge, this is the first experimental investigation systematically studying metadiscourse variables in a fully crossed orthogonal design. It is also the first attempt to relate evaluation anxiety to metadiscourse characteristics and social studies textbook learning and retention

The case for a rhetorical perspective on learning from texts : exploring metadiscourse

Includes bibliographical references (columns 27-31)The work upon which this publication is based was performed pursuant to contract no. 400-81-0030 of the National Institute of Educatio