Use of Statin Therapy to Reduce Cardiovascular Risk in Older Patients

Background. Cardiovascular disease is the principal cause of mortality in older individuals, and more than 80% of deaths due to coronary heart disease or stroke occur in patients over 65 years of age. Hyperlipidemia is one of the main modifiable risk factors for cardiovascular disease. Current guidelines recommend the use of statins to reduce low-density lipoprotein cholesterol to appropriate targets based on an individual's cardiovascular risk, and clearly state that older age should not be a barrier to treatment. Despite extensive evidence demonstrating clear benefit with statin therapy in older individuals, this population remains chronically undertreated. Scope. This paper provides an overview of the current evidence available regarding the efficacy and safety of statin therapy to reduce cardiovascular risk in older patients. We use hypothetical case studies to address some of the questions frequently posed by physicians responsible for the cardiovascular health of older patients. Conclusions. Various factors may account for the failure to provide appropriate treatment, including a lack of awareness of clinical benefits and perceived safety issues. However, if current guidelines are followed and older patients treated to appropriate LDL-C goals, the likelihood of cardiovascular events will be reduced in this high-risk population. Employing an evidence-based approach to the management of cardiovascular risk in older patients is likely to yield benefits in terms of overall cardiovascular burden

‘I understood the words but I didn’t know what they meant’: Japanese online MBA students’ experiences of British assessment practices

We report on a case study of high Japanese student failure rates in an online MBA programme. Drawing on interviews, and reviews of exam and assignment scripts we frame the problems faced by these students in terms of a ‘language as social practice’ approach and highlight the students’ failure to understand the specific language games that underpin the course assessment approach. We note the way in which the distance learning and online context can make the challenges faced by international students less immediately visible to both students and institution

Reliability of quantitative multiparameter maps is high for magnetization transfer and proton density but attenuated for R1 and R2* in healthy young adults

We investigate the reliability of individual differences of four quantities measured by magnetic resonance imaging-based multiparameter mapping (MPM): magnetization transfer saturation (MT), proton density (PD), longitudinal relaxation rate (R1 ), and effective transverse relaxation rate (R2 *). Four MPM datasets, two on each of two consecutive days, were acquired in healthy young adults. On Day 1, no repositioning occurred and on Day 2, participants were repositioned between MPM datasets. Using intraclass correlation effect decomposition (ICED), we assessed the contributions of session-specific, day-specific, and residual sources of measurement error. For whole-brain gray and white matter, all four MPM parameters showed high reproducibility and high reliability, as indexed by the coefficient of variation (CoV) and the intraclass correlation (ICC). However, MT, PD, R1 , and R2 * differed markedly in the extent to which reliability varied across brain regions. MT and PD showed high reliability in almost all regions. In contrast, R1 and R2 * showed low reliability in some regions outside the basal ganglia, such that the sum of the measurement error estimates in our structural equation model was higher than estimates of between-person differences. In addition, in this sample of healthy young adults, the four MPM parameters showed very little variability over four measurements but differed in how well they could assess between-person differences. We conclude that R1 and R2 * might carry only limited person-specific information in some regions of the brain in healthy young adults, and, by implication, might be of restricted utility for studying associations to between-person differences in behavior in those regions

Making judgements about students making work : lecturers’ assessment practices in art and design.

This research study explores the assessment practices in two higher education art and design departments. The key aim of this research was to explore art and design studio assessment practices as lived by and experienced by art and design lecturers. This work draws on two bodies of pre existing research. Firstly this study adopted innovative methodological approaches that have been employed to good effect to explore assessment in text based subjects (think aloud) and moderation mark agreement (observation). Secondly the study builds on existing research into the assessment of creative practice. By applying thinking aloud methodologies into a creative practice assessment context the authors seek to illuminate the ‘in practice’ rather than espoused assessment approaches adopted. The analysis suggests that lecturers in the study employed three macro conceptions of quality to support the judgement process. These were; the demonstration of significant learning over time, the demonstration of effective studentship and the presentation of meaningful art/design work

Outlaw Community Innovations

Recent studies of outlaw communities provide qualitative evidence of their existence and the organisation of the underlying innovation processes. We provide descriptive results from a large scale survey of two online outlaw communities focussing on Microsoft's XBox. In line with previous findings, we identify two types of participants in outlaw communities - user innovators and adopters. Based on 2,256 responses, we find that users modify their XBox mainly to be able to increase the set of available functions of their XBox. Users are also motivated to modify their XBox for the sake of having fun and to conduct pirate behaviour. Finally, the results from our survey suggest that user innovators are largely intrinsically motivated by fun and the intellectual stimulation of writing code for homebrew software

Filtered overlap: speedup, locality, kernel non-normality and Z_A~1

We investigate the overlap operator with a UV filtered Wilson kernel. The filtering leads to a better localization of the operator even on coarse lattices and with the untuned choice $\rho=1$. Furthermore, the axial-vector renormalization constant $Z_A$ is much closer to 1, reducing the mismatch with perturbation theory. We show that all these features persist over a wide range of couplings and that the details of filtering prove immaterial. We investigate the properties of the kernel spectrum and find that the kernel non-normality is reduced. As a side effect we observe that for certain applications of the filtered overlap a speed-up factor of 2-4 can be achieved.Comment: 30 pp, 23 fig

Evaluation of Etiquette Strategies to Adapt Feedback In Affect-Aware Tutoring

The purpose of this research is to investigate how to mitigate user frustration and improve task performancein the context of human-computer interaction (HCI). Even though user frustration plays a role in manyaspects of HCI and studies have looked into the consequences of frustration in various fields, the ways tomitigate frustration are less deeply examined. Once the system has the ability to understand and includeuser emotions as factors in HCI, the interaction between the user and the computer system could be adaptedif the computers are able to modify its behavior with users in appropriate ways to further joint performance.Specifically, a preliminary study was conducted to explore the task performance, motivation, andconfidence implications of changing the interaction between the human and the computer via differentetiquette strategies. Participants solved a total of twenty mathematics problems under different frustrationcondition with feedback given in different styles of etiquette. Changing etiquette strategies in tutoring ledto changes in performance, motivation, and confidence. The most effective etiquette strategies changedwhen users were frustrated. This work provides the foundation for the design of adaptive intelligenttutoring system based on etiquette strategies.Copyright Human Factors and Ergonomics Society 2016. Posted with permission.</div

Coloring translates and homothets of a convex body

We obtain improved upper bounds and new lower bounds on the chromatic number as a linear function of the clique number, for the intersection graphs (and their complements) of finite families of translates and homothets of a convex body in \RR^n.Comment: 11 pages, 2 figure

A national clinician–educator program: a model of an effective community of practice

Background: The increasing complexity of medical training often requires faculty members with educational expertise to address issues of curriculum design, instructional methods, assessment, program evaluation, faculty development, and educational scholarship, among others. Discussion: In 2007, The Royal College of Physicians &amp; Surgeons of Canada responded to this need by establishing the first national clinician&#x2013;educator program. We define a clinician&#x2013;educator and describe the development of the program. Adopting a construct from the business community, we use a community of practice framework to describe the benefits (with examples) of this program and challenges in developing it. The benefits of the clinician&#x2013;educator program include: improved educational problem solving, recognition of educational needs and development of new projects, enhanced personal educational expertise, maintenance of professional satisfaction and retention of group members, a positive influence within the Royal College, and a positive influence within other Canadian academic institutions. Summary: Our described experience of a social reorganization &#x2013; a community of practice &#x2013; suggests that the organizational and educational benefits of a national clinician&#x2013;educator program are not theoretical, but real

Entanglement of two-mode Gaussian states: characterization and experimental production and manipulation

A powerful theoretical structure has emerged in recent years on the characterization and quantification of entanglement in continuous-variable systems. After reviewing this framework, we will illustrate it with an original set-up based on a type-II OPO with adjustable mode coupling. Experimental results allow a direct verification of many theoretical predictions and provide a sharp insight into the general properties of two-mode Gaussian states and entanglement resource manipulation