Hypertension Guideline 2003 Update

Outcomes. Extensive data from many randomised controlled trials have shown the benefit of treating hypertension. The target blood pressure (BP) for antihypertensive management should be systolic BP < 140 mmHg, diastolic < 90 mmHg, with minimal or no drug side-effects. However, a lesser reduction will elicit benefit although this is not optimal. The reduction of BP in the elderly and in those with severe hypertension should be achieved gradually over 6 months. Stricter BP control is required for patients with end organ damage, co-existing risk factors and co-morbidity, e.g. diabetes mellitus. Co-existent risk factors should also be controlled.Benefits. Reduction in risk of stroke, cardiac failure, renal insufficiency and probably coronary artery disease. The major precautions and contraindications to each antihypertensive drug recommended are listed.Recommendations. Correct BP measurement procedure is described. Evaluation of cardiovascular risk factors and recommendations for antihypertensive therapy are stipulated. The total cardiovascular disease risk profile should be determined for all patients and this should inform management strategies. 'Lifestyle modification and patient education plays an essential role in the management strategy. Drug therapy: First line -low dose thiazide-like diuretics; second line -add one of the following: reserpine or β-blockers or ACE inhibitors or calcium channel blockers; third line - add another second line drug or hydralazine or α-blocker. The guideline includes management of specific situations, i.e. hypertensive emergency and urgency, severe hypertension with target organ damage and refractory hypertension (BP >160/95 mmHg on triple therapy), hypertension in diabetes mellitus, etc.Validity. Developed by the Working Groups established by the Executive Committee of the Southern African Hypertension Society with broader consensus meeting endorsement. The 2001 version was endorsed by the South African Medical Association Guideline Committee. The 2003 revisions were endorsed by the Executive Committee and a wider Working Group

The dynamics of Abell 2634

We have amassed a large sample of velocity data for the cluster of galaxies Abell 2634 which contains the wide-angle tail (WAT) radio source 3C 465. Robust indicators of location and scale and their confidence intervals are used to determine if the cD galaxy, containing the WAT, has a significant peculiar motion. We find a cD peculiar radial velocity of 219 plus or minus 98 km s(exp -1). Further dynamical analyses, including substructure and normality tests, suggest that A 2634 is an unrelaxed cluster whose radio source structure may be bent by the turbulent gas of a recent cluster-subcluster merger

Improving typography and minimising computation for documents with scalable layouts

Since the 1980s, two paradigms have dominated the representation of formatted electronic documents: flowable and fixed. Flowable formats, such as HTML, EPUB, or those used by word processors, allow documents to scale to any arbitrary page size, but typographical compromises must be made since the layout is computed in real time, and is re-computed each time the document is displayed. Conversely, fixed formats such as SVG or PDF are afforded the potential for arbitrarily complex typography, but are constrained to the fixed layout that is set at the time of creation. With the recent surge in popularity of low-powered portable reading devices -- from tablets to e-readers to mobile phones -- there is an expectation that documents should scale to any size, maintain their high-quality typography, and not provide unnecessary strain on an already overloaded battery. This thesis defines a novel paradigm for electronic document representation -- the Malleable Document -- whereby documents are partially typeset at the time of creation, leaving enough flexibility that their content can be flowed to arbitrary page sizes with minimal computation. One tradeoff encountered is that of increased file size, and this is addressed with a bespoke, computationally-light compression scheme. A sample implementation is presented that transforms documents from a source format into Malleable Document format, alongside a lightweight display engine that enables the documents to be viewed and resized on a wide range of devices, mobile and otherwise. Reviews of the technical aspects and a user study to evaluate the quality of the system's rendering and layout show that the Malleable Document paradigm is a promising alternative to both fixed and flowable formats, and builds upon the best of both approaches

Reflowable documents composed from pre-rendered atomic components

Mobile eBook readers are now commonplace in today’s society, but their document layout algorithms remain basic, largely due to constraints imposed by short battery life. At present, with any eBook file format not based on PDF, the layout of the document, as it appears to the end user, is at the mercy of hidden reformatting and reflow algorithms interacting with the screen parameters of the device on which the document is rendered. Very little control is provided to the publisher or author, beyond some basic formatting options. This paper describes a method of producing well-typeset, scalable, document layouts by embedding several pre-rendered versions of a document within one file, thus enabling many computationally expensive steps (e.g. hyphenation and line-breaking) to be carried out at document compilation time, rather than at ‘view time’. This system has the advantage that end users are not constrained to a single, arbitrarily chosen view of the document, nor are they subjected to reading a poorly typeset version rendered on the fly. Instead, the device can choose a layout appropriate to its screen size and the end user’s choice of zoom level, and the author and publisher can have fine-grained control over all layouts

Substructure in clusters containing wide-angle tailed radio galaxies. I. New redshifts

We present new redshifts and positions for 635 galaxies in nine rich clusters containing Wide-Angle Tailed (WAT) radio galaxies. Combined with existing data, we now have a sample of 18 WAT-containing clusters with more than 10 redshifts. This sample contains a substantial portion of the WAT clusters in the VLA 20 cm survey of Abell clusters, including 75% of WAT clusters in the complete survey (z0.09. It is a representative sample which should not contain biases other than selection by radio morphology. We graphically present the new data using histograms and sky maps. A semi-automated procedure is used to search for emission lines in the spectra in order to add and verify galaxy redshifts. We find that the average apparent fraction of emission line galaxies is about 9% in both the clusters and the field. We investigate the magnitude completeness of our redshift surveys with CCD data for a test case, Abell 690. This case indicates that our galaxy target lists are deeper than the detection limit of a typical MX exposure, and they are 82% complete down to R=19.0. The importance of the uniformity of the placement of fibers on targets is posited, and we evaluate this in our datasets. We find some cases of non-uniformities which may influence dynamical analyses. A second paper will use this database to look for correlations between the WAT radio morphology and the cluster's dynamical state.Comment: 15 pages, 5 figures, 7 tables. To appear in the Astronomical Journa

Improving typography and minimising computation for documents with scalable layouts

Since the 1980s, two paradigms have dominated the representation of formatted electronic documents: flowable and fixed. Flowable formats, such as HTML, EPUB, or those used by word processors, allow documents to scale to any arbitrary page size, but typographical compromises must be made since the layout is computed in real time, and is re-computed each time the document is displayed. Conversely, fixed formats such as SVG or PDF are afforded the potential for arbitrarily complex typography, but are constrained to the fixed layout that is set at the time of creation. With the recent surge in popularity of low-powered portable reading devices -- from tablets to e-readers to mobile phones -- there is an expectation that documents should scale to any size, maintain their high-quality typography, and not provide unnecessary strain on an already overloaded battery. This thesis defines a novel paradigm for electronic document representation -- the Malleable Document -- whereby documents are partially typeset at the time of creation, leaving enough flexibility that their content can be flowed to arbitrary page sizes with minimal computation. One tradeoff encountered is that of increased file size, and this is addressed with a bespoke, computationally-light compression scheme. A sample implementation is presented that transforms documents from a source format into Malleable Document format, alongside a lightweight display engine that enables the documents to be viewed and resized on a wide range of devices, mobile and otherwise. Reviews of the technical aspects and a user study to evaluate the quality of the system's rendering and layout show that the Malleable Document paradigm is a promising alternative to both fixed and flowable formats, and builds upon the best of both approaches

Admission Decision-Making in Hospital Emergency Departments: the Role of the Accompanying Person

In resource-stretched emergency departments, people accompanying patients play key roles in patients' care. This article presents analysis of the ways health professionals and accompanying persons talked about admission decisions and caring roles. The authors used ethnographic case study design involving participant observation and semi-structured interviews with 13 patients, 17 accompanying persons and 26 healthcare professionals in four National Health Service hospitals in south-west England. Focused analysis of interactional data revealed that professionals’ standardization of the patient-carer relationship contrasted with accompanying persons' varied connections with patients. Accompanying persons could directly or obliquely express willingness, ambivalence and resistance to supporting patients’ care. The drive to avoid admissions can lead health professionals to deploy conversational skills to enlist accompanying persons for discharge care without exploring the meanings of their particular relations with patients. Taking a relationship-centered approach could improve attention to accompanying persons as co-producers of healthcare and participants in decision-making

Genetic Susceptibility Determines β-Cell Function and Fasting Glycemia Trajectories Throughout Childhood: A 12-Year Cohort Study (EarlyBird 76)

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