Changes in the 2017 Pediatric Hypertension Clinical Guidelines.

The clinical practice guidelines on diagnosis and management of high blood pressure in children and adolescents have been periodically modified and updated since the original publication in 1977.1 Since the last pediatric blood pressure guideline was published in 2004, known as the Fourth Report,2 the literature on child BP and hypertension has expanded considerably. There has been a recognized need to update the Fourth Report for several years. However, the National Heart, Lung, and Blood Institute (NHLBI) who sponsored previous pediatric BP guidelines announced that NHLBI would no longer sponsor development of new clinical guidelines.3 Subsequently, in 2014 the American Academy of Pediatrics (AAP) agreed to sponsor development of a new pediatric BP clinical practice guideline (CPG). The new CPG for screening and management of high BP in children and adolescents was recently published in Pediatrics.4 This CPG was developed using the rigorous evidence-based approach recommended by the Institute of Medicine in 2011.5 This methodology was consistent with recent NHLBI recommendations on development of CPGs for cardiovascular disease.3 The new pediatric hypertension CPG contains several modifications from the previous guideline to guide clinicians in diagnosis and management of elevated BP and hypertension in children and adolescents. This summary describes those changes made since the 2004 Fourth Report

The Childhood Role in Development of Primary Hypertension.

Primary hypertension is not just an adult disorder. Current US population data on children and adolescents demonstrate a prevalence of elevated blood pressure (BP) and hypertension combined of over 10%. Recent reports from prospective cohort studies describe an association of high BP in childhood with hypertension in young adulthood. Excess adiposity is strongly associated with higher BP in childhood and increases risk for hypertension in adulthood. In addition to overweight/obesity, other exposures that raise the risk for high BP include low birthweight, dietary sodium, and stress. Using intermediate markers of cardiovascular injury, studies on hypertensive children report findings of cardiac hypertrophy, vascular stiffness, and early atherosclerotic changes. Impaired cognitive function has also been demonstrated in hypertensive children. Recent advances in clinical and translational research support the concept that the evolution of primary hypertension begins in childhood

The manned maneuvering unit flight controller arm

The Manned Maneuvering Unit (MMU) and its support equipment provide an extravehicular astronaut mobility, and the ability to work outside the confines of the Shuttle Orbiter payload bay. The MMU design requirements are based on the highly successful Skylab M-509 maneuvering unit. Design of the MMU was started as an R&D effort in April 1975 and Flight Hardware design was started in August 1979 to support a possible requirement for in-space inspection and repair of Orbiter thermal protection tiles. Subsequently, the qualification test and production activities were slowed, and the current projected earliest first flight is now STS-11 in January, 1984. The MMU propulsion subsystem provides complete redundancy with two identical "system". Each system contains a high pressure gaseous nitrogen tank, an isolation valve, a regulator, and twelve 1.7 lbf (7.5 N) thrusters. The thrusters are packaged to provide the crew member six-degree-of-freedom control in response to commands from translational and rotational hand controllers. This paper discusses the MMU control arm requirements, design, and developmental history

Interest Groups in a Multi-level Polity: The Impact of European Integration on National Systems

institutionalisation; Europeanization; multilevel governance; Nation-state

The First EU Social Partner Agreement in Practice: Parental Leave in the 15 Member States. IHS Political Science Series: 2004, No. 96

In this paper, we analyze the impact of one specific EU social policy measure, the Parental Leave Directive. This Directive is based on the first Euro-collective agreement, concluded in November 1995 by the ETUC, UNICE and CEEP. Contrary to the rather sceptical assessments presented by many observers at the time of its adoption, our in-depth analysis of the Directive's implementation in all 15 member states reveals rather far-reaching effects. The Directive induced significant policy reforms in the majority of member states and thus facilitated the reconciliation of work and family life for many working parents. These effects were not only brought about by compliance with the compulsory minimum standards of the Directive, but also by a considerable number of voluntary reforms. We argue that domestic party politics and processes of policy learning may explain the occurrence of these "unforced" changes, which have hitherto received little attention by Europeanisation scholars

Finite-Size Corrections for Ground States of Edwards-Anderson Spin Glasses

Extensive computations of ground state energies of the Edwards-Anderson spin glass on bond-diluted, hypercubic lattices are conducted in dimensions d=3,..,7. Results are presented for bond-densities exactly at the percolation threshold, p=p_c, and deep within the glassy regime, p>p_c, where finding ground-states becomes a hard combinatorial problem. Finite-size corrections of the form 1/N^w are shown to be consistent throughout with the prediction w=1-y/d, where y refers to the "stiffness" exponent that controls the formation of domain wall excitations at low temperatures. At p=p_c, an extrapolation for $d\to\infty$ appears to match our mean-field results for these corrections. In the glassy phase, w does not approach the value of 2/3 for large d predicted from simulations of the Sherrington-Kirkpatrick spin glass. However, the value of w reached at the upper critical dimension does match certain mean-field spin glass models on sparse random networks of regular degree called Bethe lattices.Comment: 6 pages, RevTex4, all ps figures included, corrected and final version with extended analysis and more data, such as for case d=3. Find additional information at http://www.physics.emory.edu/faculty/boettcher

Is comprehension or application the more important skill for first-year computer science students?

Time and performance data was collected on a class of 147 Computer Science 1B students, where students carried out a design and programming task based on one that had been seen in a previous examination. Given that students had previously worked through the task, we assessed their comprehension of that material in this assignment. We were then able to collect the performance data and correlate this with the examination marks for the student to determine if there was a relationship between performance in the examination and performance in this practical. We were also able to correlate the performance in this practical with the time taken to complete the practical, and with the student’s statement as to whether they remembered how they had solved it in their previous attempt. By doing this, we discovered that the students who remembered having solved it previously had a significantly higher mean examination mark than those students who claimed not to remember it. Unsurprisingly, students also performed better in this assignment if they had performed better in the examination. The mean time to complete the task was significantly less for those students who claimed to remember the task. In this task, the comprehension of the original material and the ability to recall it was of more importance than the ability to apply knowledge to an unseen problem.Nickolas J. G. Falkne