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

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

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

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

Interlinking neofunctionalism and intergovernmentalism: Sidelining governments and manipulating policy preferences as "passerelles"

The EU's founding fathers had the protection of the EU's constituent units as a key concern and set up serious hurdles to policy innovation in the absence of unanimous governmental agreement. These institutional design features, aptly characterised as "joint-decision trap" by Fritz W. Scharpf, were only softened but not erased over time. Nonetheless, the problem of how to innovate has, at times, been overcome through eclectic means. There are indeed some well known and quite visible practices as well as some less expected and more obscure strategies that have propelled the EU's policy system beyond what has for a long time been expected. This paper argues that there are two strategic moves the European Commission (and, at times, other supranational actors such as the European Court of Justice) can use to actively overcome member state opposition: first, sidelining some or even all national governments; and, second, manipulating relevant policy preferences. These two basic strategies can be seen to interconnect the diverging basic assumptions of intergovernmentalism and neofunctionalism as 'passerelles'.political science; joint decision making; unanimity; integration theory; intergovernmentalism; neo-functionalism

European Integration and the Welfare State(s) in Europe

This paper summarizes the state-of-the-art on European social policy integration. It summarises the controversy over the 'social dimension of European integration', which has been ongoing ever since the founding fathers of European integration in 1957 agreed that the economies should be integrated basically without social regulation to counterbalance liberalisation effects. It presents the historical development of EU social policy as well as criteria for evaluating the state of "social Europe" and finally discusses how the EU is impacting on different types of welfare states. The argument is that the EU contributes to framework conditions that promote more 'bounded varieties of welfare' in Europe. In other words, it is held that there will be a more restricted variety, oscillating within limits that are directly or indirectly imposed or reinforced by European integration.social policy; Europeanization; Europeanization; political science; welfare state; discourse