Production of case studies of the delivery of skills for learning, skills for life and skills for work

This report summarises the main themes to emerge from a study to highlight good practice in delivering practical, applied or vocational learning provision for all pupils

An Appraisal of Developments in Surgical and Catheter-based Cardiovascular Therapy

After a few decades of limited experience in treating congenital heart defects, the introduction of cardiopulmonary bypass in 1954 provided the opportunity to advance cardiac surgery into an adult patient population. In the 1960s this resulted in the first aortic and mitral valve procedures to treat patients with valvular stenosis and/or regurgitation. Evolving from ball-caged valves to stentless porcine bioprosthetic valves, tens of millions of patients have undergone aortic, mitral, or combined valve replacements with excellent short- and long-term valve durability and survival, even with the earliest generation of mechanical valves. Ischemic heart disease was the leading cause of death in the general population (Figure 1), and the only treatment available at that time -- medical therapy -- fell short to reduce early mortality. Despite the pioneering work of Arthur M. Vineberg to induce coronary anastomosis of an internal mammary artery graft by burrowing it in the myocardium, surgical revascularization did not take off until in the mid-1960s when coronary artery bypass grafting (CABG) through surgical anastomosis was introduced. Its wide-spread adoption caused CABG to rapidly evolve as the standard of care for patients suffering from coronary artery disease

Coronary artery bypass grafting: Part 1—the evolution over the first 50 years

Surgical treatment for angina pectoris was first proposed in 1899. Decades of experimental surgery for coronary artery disease finally led to the introduction of coronary artery bypass grafting (CABG) in 1964. Now that we are approaching 50 years of CABG experience, it is appropriate to summarize the advancement of CABG into a procedure that is safe and efficient. This review provides a historical recapitulation of experimental surgery, the evolution of the surgical techniques and the utilization of CABG. Furthermore, data on contemporary clinical outcomes are discusse

Surgery in current therapy for infective endocarditis

The introduction of the Duke criteria and transesophageal echocardiography has improved early recognition of infective endocarditis but patients are still at high risk for severe morbidity or death. Whether an exclusively antibiotic regimen is superior to surgical intervention is subject to ongoing debate. Current guidelines indicate when surgery is the preferred treatment, but decisions are often based on physician preferences. Surgery has shown to decrease the risk of short-term mortality in patients who present with specific symptoms or microorganisms; nevertheless even then it often remains unclear when surgery should be performed. In this review we i) systematically reviewed the current literature comparing medical to surgical therapy to evaluate if surgery is the preferred option, ii) performed a meta-analysis of studies reporting propensity matched analyses, and iii), briefly summarized the current indications for surgery

金市場と他の金融市場との間の相互関係の実証的特徴付け

博士（経済学）神戸大

Mapping pneumonia research: a systematic analysis of UK investments and published outputs 1997–2013

BackgroundThe burden of pneumonia continues to be substantial, particularly among the poorest in global society. We describe here the trends for UK pneumonia R&D investment and published outputs, and correlate with 2013 global mortality.MethodsData related to awards to UK institutions for pneumonia research from 1997 to 2013 were systematically sourced and categorised by disease area and type of science. Investment was compared to mortality figures in 2010 and 2013 for pneumonia, tuberculosis and influenza. Investment was also compared to publication data.ResultsOf all infectious disease research between 2011 and 2013 (£917.0 million), £28.8 million (3.1%) was for pneumonia. This was an absolute and proportionate increase from previous time periods. Translational pneumonia research (33.3%) received increased funding compared with 1997–2010 where funding was almost entirely preclinical (87.5%, here 30.9%), but high-burden areas such as paediatrics, elderly care and antimicrobial resistance received little investment. Annual investment remains volatile; publication temporal trends show a consistent increase. When comparing investment to global burden with a novel ‘investment by mortality observed’ metric, tuberculosis (£48.36) and influenza (£484.21) receive relatively more funding than pneumonia (£43.08), despite investment for pneumonia greatly increasing in 2013 compared to 2010 (£7.39). Limitations include a lack of private sector data and the need for careful interpretation of the comparisons with burden, plus categorisation is subjective.ConclusionsThere has been a welcome increase for pneumonia funding awarded to UK institutions in 2011–2013 compared with 1997–2010, along with increases for more translational research. Published outputs relating to pneumonia rose steadily from 1997 to 2013. Investment relative to mortality for pneumonia has increased, but it remains low compared to other respiratory infections and clear inequities remain. Analyses that measure investments in pneumonia can provide an insight into funding trends and research gaps.Research in contextPneumonia continues to be a high-burden illness around the globe. This paper shows that although research funding is increasing in the UK (between 1997 and 2013), it remains poorly funded compared to other important respiratory infectious diseases such as tuberculosis and influenza. Publications about pneumonia have been steadily increasing over time, indicating continuing academic and clinical interest in the topic. Though global mortality of pneumonia is declining, it should still be an area of high priority for funders, policymakers and researchers