OBJECTIVES
The purpose of this study was to evaluate the prevalence and prognostic importance of lower extremity arterial disease (LEAD) in patients with multivessel coronary artery disease.
...BACKGROUND
The presence of clinically evident LEAD increases the risk of death in patients with known coronary artery disease. Because studies have lacked noninvasive measures of subclinical LEAD, the true prognostic importance of lower extremity atherosclerosis in this population has probably been underestimated.
METHODS
Ankle blood pressures were measured in 405 consecutive patients with angiographically documented multivessel coronary disease from seven Bypass Angioplasty Revascularization Investigation (BARI) sites and a parallel study site within 3 years of enrollment. Lower extremity arterial disease was defined as an ankle/arm systolic blood pressure ratio of 0.90 or less.
RESULTS
Among patients studied, 69 (17%) had LEAD. These patients were more likely to be current smokers, treated for diabetes, older and present with unstable angina compared with patients without LEAD. Among patients who underwent coronary arterial bypass grafting, major complications occurred in 2.8% of those without LEAD compared with 20.7% of those with LEAD (p = 0.002). Five-year mortality rates were similar for symptomatic LEAD (14%) and asymptomatic LEAD (14%). Patients without LEAD had a 3% mortality. After adjusting for baseline differences, the relative risk of death was 4.9 times greater for patients with LEAD compared with those without (95% confidence interval CI: 1.8, 13.4, p < 0.01).
CONCLUSIONS
Patients with LEAD have a significantly higher risk of death than patients without LEAD, regardless of the presence of symptoms. An abnormal ankle/arm index is a strong predictor of mortality and can be used to further stratify risk among patients with multivessel coronary artery disease.
Pediculosis is a population‐based problem that is a priority concern for many communities. Public health nurses in a county health department collaborated with epidemiologists, nursing students, and ...faculty to design and implement an effective population‐based pediculosis management project. The focus of the project was the development of pediculosis treatment and prevention guidelines based on recognized best practices that were acceptable to both epidemiologists and practicing public health nurses. Public health nurses disseminated these guidelines to community providers and reinforced their use through consultation and educational sessions. Two critical changes occurred as a result of the project. First, community providers significantly changed their recommendations for the treatment of pediculosis after nursing intervention. Second, public health nurses increased their population‐based practice skills, continued to use those skills to address pediculosis, and extended those skills to additional population‐based initiatives.
Health policy and healthy populations Rosenau, Pauline Vaillancourt; Heflin, Colleen M; Iceland, John ...
Social science quarterly,
12/2009, Letnik:
90, Številka:
5
Journal Article
We have investigated the role of myosin in contraction of the terminal web in brush borders isolated from intestinal epithelium. At 37°C under conditions that stimulate terminal web contraction (1 μM ...Ca++ and ATP), most (60-70%) of the myosin is released from the brush border. Approximately 80% of the myosin is also released by ATP at 0°C, in the absence of contraction. Preextraction of this 80% of the myosin from brush borders with ATP has no effect on either the time course or extent of subsequently stimulated contraction. However, contraction is inhibited by removal of all of the myosin with 0.6 M KCl and ATP. Contraction is also inhibited by an antibody to brush border myosin, which inhibits both the ATPase activity of brush border myosin and its ability to form stable bipolar polymers. These results indicate that although functional myosin is absolutely required for terminal web contraction only ∼20% of the brush border myosin is actually necessary. This raises the possibility that there are at least two different subsets of myosin in the terminal web.
A National Model for Engineering Mathematics Education: Highlights from a CCLI Phase 3 Initiative, Volume 3AbstractThe inability of incoming students to advance past the traditional first-year ...calculus sequence is aprimary cause of attrition in engineering programs across the country. As a result, this paper willsummarize an NSF funded initiative at Wright State University to redefine the way engineeringmathematics is taught, with the goal of increasing student retention, motivation and success inengineering.The Wright State model begins with the development of a novel first-year engineeringmathematics course, EGR 101 “Introductory Mathematics for Engineering Applications.”Taught by engineering faculty, the course includes lecture, laboratory and recitation components.Using an application-oriented, hands-on approach, the course addresses only the salient mathtopics actually used in core engineering courses. These include the traditional physics,engineering mechanics, electric circuits and computer programming sequences. The EGR 101course replaces traditional math prerequisite requirements for the above core courses, so thatstudents can advance in the curriculum without first completing a traditional first-year calculussequence. The Wright State model concludes with a more just-in-time structuring of the requiredmath sequence, in concert with college and ABET requirements. The result has shifted thetraditional emphasis on math prerequisite requirements to an emphasis on engineeringmotivation for math.Since its inception in Fall of 2004, the Wright State model has had an overwhelming impact onthe retention, motivation and success of engineering students at Wright State University. As partof a CCLI Phase 3 initiative, various aspects of the approach are now being piloted by 15institutions across the country (primarily university, but also at the community college and K-12levels). These institutions represent strategic pockets of interest in some of our nation's mostSTEM critical regions, including Ohio, Michigan, Texas, Oklahoma, California, Maryland andVirginia. The dissemination component of the project has resulted in the addition of numerousunfunded collaborators, and the approach is now under consideration by at least two dozeninstitutions across the country.Our last two papers have highlighted progress at a subset of these institutions, including thedetails of their diverse implementations and a preliminary assessment of their results. This year'spaper (Volume 3) will highlight progress at several additional institutions, including at least oneinstitution not even funded under the CCLI Phase 3 award. It will also include the latest datafrom Wright State's own implementation, including its cumulative impact on student retentionand success from first-year through graduation.
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