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Serious risks of vascular disease with two-arm blood pressure difference

ScienceDaily (Mar. 20, 2012) ? In January a research team from the Peninsula College of Medicine and Dentistry reported the first systematic review of findings related to the risk factors associated with a difference in blood pressure between arms.

The first study, which was published in The Lancet, suggested that a difference of more than 10mmHg or 15mmHg in systolic blood pressure (the ‘top’ reading) was an indicator of increased risk of vascular disease and mortality.

The second study, which was published on the 20th March 2012 by the British Medical Journal (BMJ Online) looks at data from patients over a 10-year period. The findings of the study support that of the first — that there is a link between a difference in blood pressure between arms and vascular disease and mortality — and further emphasise the need for two-arm blood pressure checks to become the norm.

The study was supported by: the Scientific Foundation Board of the Royal College of General Practitioners; the South West GP trust; and the National Institute for Health Research Peninsula Collaboration for Leadership in Applied Health Research and Care (PenCLAHRC).

Measurements for the study were carried out at The Mid Devon Medical Practice in Witheridge, Devon where Dr. Christopher Clark, lead author of both studies, is a GP.

The study followed up 230 patients receiving treatment in the practice for hypertension. Two-arm blood pressure readings were taken from participating patients at the start of the study during three successive surgery attendances and they were then followed for 10 years.

Of the 230 patients, 24 percent had a difference between the arms in systolic blood pressure measurements of more than 10mmHg and nine per cent registered a difference of more than 15mmHg. From the authors’ previous review, a difference of 10mmHg indicates an increased risk of peripheral vascular disease (the narrowing and hardening of the arteries that supply blood to the legs and feet). A difference of 15mmHg or more is associated with increased risk of peripheral vascular disease; pre-existing cerebrovascular disease (affecting the blood supply to the brain and often associated with conditions such as dementia); and mortality, both as a result of cardiovascular problems and generally.

By carrying out a study over 10 years, the research team was able to assess the impact of an inter-arm difference in blood pressure over a longer period of time and so witness the long-term effect on patients’ health. During the study period 52 cardiovascular and 27 cerebrovascular events occurred in 76 patients. Fifty-nine patients died and a total of 100, 44 per cent of the total participating number, either suffered a cardiovascular or cerebrovascular event, or died.

Dr. Christopher Clark commented: “Our 10-year follow-up on hypertensive patients has for the first time shown in a primary care setting that, over time, an interarm difference in systolic blood pressure of 10 mm Hg or more or 15 mm Hg or more predicts reduced mortality and event free survival. The risk of a first vascular event, in the presence of an interarm difference, appears to be as great as that found in patients with pre-existing cardiovascular disease.”

He added: “This study supports the potential value of an interarm difference as a simple clinical indicator of increased cardiovascular risk. Assessment of blood pressure in both arms is recommended by guidelines and should become a core component of initial blood pressure measurement in primary care. Detection of an inter-arm difference should prompt consideration of further vascular assessment and aggressive management of risk factors.”

Professor John Campbell, Professor of General Practice and Primary Care at Peninsula College of Medicine and Dentistry said: “This study highlights the vital importance of carefully conducted clinical research derived from community based settings. Nearly one-million consultations take place each day in GP surgeries and practices. UK general practitioners are in a unique position to identify and follow-up cohorts of their patients over extended periods of time using their personal knowledge of patients and their families, and drawing on the availability of high quality clinical records in UK primary care settings. This is a prime example of the benefit of providing continuous care for patients over a period of time acting as the basis for important clinical research, and highlights the importance of addressing clinically relevant questions generated by health professionals delivering care at the coal-face. We hope the results will be used to develop further research examining exactly how the findings can best be used to inform evidence-based care for NHS patients in the UK.”

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Story Source:

The above story is reprinted from materials provided by The Peninsula College of Medicine and Dentistry.

Note: Materials may be edited for content and length. For further information, please contact the source cited above.


Journal Reference:

  1. Christopher E Clark, Rod S Taylor, John L Campbell. The difference in blood pressure readings between arms and survival: primary care cohort study. BMJ, 2012; 344 DOI: 10.1136/bmj.e1327

Note: If no author is given, the source is cited instead.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

Source: http://feeds.sciencedaily.com/~r/sciencedaily/~3/bxUQMVycAP8/120320195749.htm

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Santorum: “I don’t care” about unemployment rate

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Social Media Can Help Take Leads Through Your Sales Process …

People who have never owned a business commonly think that customers simply make a purchase as soon as they come into contact with a business. However, as a business owner with years or even decades of experience under your belt, you know that’s quite far from the truth. Although it would be nice if it was that easy to close sales, the reality is it normally takes multiple interactions for a promising lead to become an actual customer.

Although the Internet has not eliminated the standard buying habits that people follow, the good news is it has made it easier to guide them from an interested lead into a customer who actually pays for something. If you are wondering how you can make your sales process more efficient, social media is the answer. By properly utilizing social media, you will be able to guide leads through your sales process and end up with customers who are very happy.

Here are the details of exactly how it works:

Start with Free

Today’s consumers have more options than ever. In addition to their increased options, chances are they have been disappointed or completely ripped off by multiple companies. As a result, they are generally hesitant to jump right into making a purchase.

Although that may seem like a major obstacle for your business, there is an easy way to accommodate it. The solution is to begin your sales process with something free. What you give away will depend on your specific business and industry. In addition to being free, the key to getting the most out of this step is to provide something of value. Once you figure out what you should give away, you can use outlets like Twitter to share it with potential customers.

Move Towards Commitment

Some businesses try to skip directly from a free giveaway to paid customers. However, studies have found that adding an intermediary step to your sales process is a more effective option. If you sell a physical product, this will generally be a free sample. And if what you offer falls into a different category, a free trial is usually the best option.

The way that social media can complement this step of your sales process is by allowing warm leads to directly communicate with you. Additionally, when they discuss your free sample or trial through an outlet like Facebook, it creates opportunities for other potential customers to discover your business.

Close the Sale

The last step in a successful sales process is to actually close and gain a new customer. This is arguably the step where social media has the biggest impact. The reason social media can be so beneficial for closing a sale is because people realize they have a public venue for discussing your business. As a result, they understand that you stand behind what you offer. This combination creates a level of trust that would be difficult to achieve without the support of social media.

How big of a role does social media play in your sales process?

About The Author


Brian Waraksa

Brian Waraksa, founder of Raxa Design in Houston, Texas has been in marketing and small business branding since 2002. He writes the Raxa Design blog on issues affecting small business marketing and corporate brands. Posted on Mon, March 19, 2012 by Brian Waraksa filed under

Source: http://www.raxadesign.com/social-media-can-help-take-leads-through-your-sales-process

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Conference explores ethical dimension of NHS

[ Back to EurekAlert! ] Public release date: 14-Mar-2012
[ | E-mail | Share Share ]

Contact: Dr. Andrew Edgar
Edgar@cardiff.ac.uk
44-292-087-4935
Cardiff University

Health professionals, patients and philosophers will come together at a special conference next month to explore the moral basis of the National Health Service.

Among the questions for discussion will be: Is the NHS merely an efficient resource for the economy repairing citizens to make them fit for work? Or is it grounded in something more compassionate?

The NHS as ‘Civil Association’ is the spring conference of the Think About Health network, and is driven by research in Cardiff University’s School of English, Communication and Philosophy. It takes place on April 13-14 at the British School of Osteopathy.

“The point of the conference is to ask whether ethics plays the part it should in both day-to-day medical practice and in the planning and reform of the health care service,” explained conference organiser, Dr Andrew Edgar of Cardiff University.

“Since its conception in the 1940s, the nature and purpose of the welfare state has been interpreted in two complementary ways. On one hand, it can be seen as efficient economic practice, and on the other, as an expression of our moral commitment to fellow citizens – in the words of the British philosopher Michael Oakeshott, a ‘civil association’.”

He added: “The conference is especially timely, as the England Health Care bill is focusing public and media attention on fundamental questions about the nature of the NHS.

“Our conference will in particular address the dangers that arise when instrumental or economic justifications of the NHS start to dominate.”

Dr Edgar and his Cardiff colleague Dr Peter Sedgwick are among the key speakers at the conference, which also includes Dr John Gillies, Chair of the Royal College of General Practitioners, Scotland, who will compare the NHS in Scotland and England; Professor Heather Widdows, Professor of Global Ethics at the University of Birmingham; and Dr Ann Gallagher, Reader in Nursing Ethics at St George’s Hospital and Kingston University.

Further information on the conference, including a booking form, is available at www.thinkabouthealth.net

###

Notes to editors:

1. Think About Health is the outreach arm of a Cardiff University-led research programme, spanning two decades. It is an interdisciplinary network of professionals, users and academics that aims to improve the ‘intellectual plumbing’ of the NHS as well participants’ own thinking and practice. Think about Health involves targeted interventions that bring applied ethics to the heart of policy making, practical healthcare, patient expectations and media discussion, with the aim of influencing the capacity to explore, and take informed and mature decisions about, what really matters to us in healthcare provision. http://www.thinkabouthealth.net/

2. The conference is inspired by a research paper by Andrew Edgar entitled ‘The NHS as Civil Association’, published Michael Parker (ed.) Ethics and Community in the Health Care Professions, Routledge 1999.

3. Cardiff School of English, Communication and Philosophy

The School of English, Communication and Philosophy has a world-wide reputation as a centre for research and publication in English Literature, Language Communication, Critical and Cultural Theory and Philosophy.

Within English, Communication and Philosophy, the School has expertise across a wide range of topics, from Old Norse to post-modernism, post-colonialism and sociolinguistics. Its Philosophy staff are internationally recognised and regularly cited in fields ranging as widely as: the philosophy of health care, environmental philosophy, political philosophy, ethics, feminist philosophy, philosophy of mind, logic and epistemology, and Continental philosophy. Within the School, the Centre for Applied Ethics has led and contributed to international research projects on health care resource allocation, the treatment of the chronically ill, and the dignity of the older European. . www.cardiff.ac.uk/encap

4. Cardiff University is recognised in independent government assessments as one of Britain’s leading teaching and research universities and is a member of the Russell Group of the UK’s most research intensive universities. Among its academic staff are two Nobel Laureates, including the winner of the 2007 Nobel Prize for Medicine, University President Professor Sir Martin Evans.

Founded by Royal Charter in 1883, today the University combines impressive modern facilities and a dynamic approach to teaching and research. The University’s breadth of expertise in research and research-led teaching encompasses: the humanities; the natural, physical, health, life and social sciences; engineering and technology; preparation for a wide range of professions; and a longstanding commitment to lifelong learning. Three major new Research Institutes, offering radical new approaches to neurosciences and mental health, cancer stem cells and sustainable places were announced by the University in 2010. www.cardiff.ac.uk

Further information:

Dr Andrew Edgar
School of English
Cardiff University
Tel: 029 2087 4935
Email: Edgar@cardiff.ac.uk

Amy Stackhouse
Public Relations
Cardiff University
Tel: 029 2087 0997
Email: StackhouseAJ@cardiff.ac.uk



[ Back to EurekAlert! ] [ | E-mail | Share Share ]

?

AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.

[ Back to EurekAlert! ] Public release date: 14-Mar-2012
[ | E-mail | Share Share ]

Contact: Dr. Andrew Edgar
Edgar@cardiff.ac.uk
44-292-087-4935
Cardiff University

Health professionals, patients and philosophers will come together at a special conference next month to explore the moral basis of the National Health Service.

Among the questions for discussion will be: Is the NHS merely an efficient resource for the economy repairing citizens to make them fit for work? Or is it grounded in something more compassionate?

The NHS as ‘Civil Association’ is the spring conference of the Think About Health network, and is driven by research in Cardiff University’s School of English, Communication and Philosophy. It takes place on April 13-14 at the British School of Osteopathy.

“The point of the conference is to ask whether ethics plays the part it should in both day-to-day medical practice and in the planning and reform of the health care service,” explained conference organiser, Dr Andrew Edgar of Cardiff University.

“Since its conception in the 1940s, the nature and purpose of the welfare state has been interpreted in two complementary ways. On one hand, it can be seen as efficient economic practice, and on the other, as an expression of our moral commitment to fellow citizens – in the words of the British philosopher Michael Oakeshott, a ‘civil association’.”

He added: “The conference is especially timely, as the England Health Care bill is focusing public and media attention on fundamental questions about the nature of the NHS.

“Our conference will in particular address the dangers that arise when instrumental or economic justifications of the NHS start to dominate.”

Dr Edgar and his Cardiff colleague Dr Peter Sedgwick are among the key speakers at the conference, which also includes Dr John Gillies, Chair of the Royal College of General Practitioners, Scotland, who will compare the NHS in Scotland and England; Professor Heather Widdows, Professor of Global Ethics at the University of Birmingham; and Dr Ann Gallagher, Reader in Nursing Ethics at St George’s Hospital and Kingston University.

Further information on the conference, including a booking form, is available at www.thinkabouthealth.net

###

Notes to editors:

1. Think About Health is the outreach arm of a Cardiff University-led research programme, spanning two decades. It is an interdisciplinary network of professionals, users and academics that aims to improve the ‘intellectual plumbing’ of the NHS as well participants’ own thinking and practice. Think about Health involves targeted interventions that bring applied ethics to the heart of policy making, practical healthcare, patient expectations and media discussion, with the aim of influencing the capacity to explore, and take informed and mature decisions about, what really matters to us in healthcare provision. http://www.thinkabouthealth.net/

2. The conference is inspired by a research paper by Andrew Edgar entitled ‘The NHS as Civil Association’, published Michael Parker (ed.) Ethics and Community in the Health Care Professions, Routledge 1999.

3. Cardiff School of English, Communication and Philosophy

The School of English, Communication and Philosophy has a world-wide reputation as a centre for research and publication in English Literature, Language Communication, Critical and Cultural Theory and Philosophy.

Within English, Communication and Philosophy, the School has expertise across a wide range of topics, from Old Norse to post-modernism, post-colonialism and sociolinguistics. Its Philosophy staff are internationally recognised and regularly cited in fields ranging as widely as: the philosophy of health care, environmental philosophy, political philosophy, ethics, feminist philosophy, philosophy of mind, logic and epistemology, and Continental philosophy. Within the School, the Centre for Applied Ethics has led and contributed to international research projects on health care resource allocation, the treatment of the chronically ill, and the dignity of the older European. . www.cardiff.ac.uk/encap

4. Cardiff University is recognised in independent government assessments as one of Britain’s leading teaching and research universities and is a member of the Russell Group of the UK’s most research intensive universities. Among its academic staff are two Nobel Laureates, including the winner of the 2007 Nobel Prize for Medicine, University President Professor Sir Martin Evans.

Founded by Royal Charter in 1883, today the University combines impressive modern facilities and a dynamic approach to teaching and research. The University’s breadth of expertise in research and research-led teaching encompasses: the humanities; the natural, physical, health, life and social sciences; engineering and technology; preparation for a wide range of professions; and a longstanding commitment to lifelong learning. Three major new Research Institutes, offering radical new approaches to neurosciences and mental health, cancer stem cells and sustainable places were announced by the University in 2010. www.cardiff.ac.uk

Further information:

Dr Andrew Edgar
School of English
Cardiff University
Tel: 029 2087 4935
Email: Edgar@cardiff.ac.uk

Amy Stackhouse
Public Relations
Cardiff University
Tel: 029 2087 0997
Email: StackhouseAJ@cardiff.ac.uk



[ Back to EurekAlert! ] [ | E-mail | Share Share ]

?

AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.

Source: http://www.eurekalert.org/pub_releases/2012-03/cu-cee031412.php

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ARTICLES MANIAC ? Travel Smarter With These Great, Easy Tips

Many people have vacation horror stories to tell. The most common reason someone has a bad vacation is because they did not plan ahead. Don?t worry about this happening to you, though. This article will address the most common causes of travel problems and give advice on how to avoid them.

Exchanging currency abroad is highly discouraged. Getting foreign currency can be done in a better way. Use a bank ATM whenever possible. ATMs usually offer better exchange rates, and are more convenient than going to a currency exchange anyway.

Be aware of food allergies when you visit a foreign country or new place. The more severe your food allergies are, the more important it is to learn key food terms in the local language. That way you can ask the wait staff if their selections have the allergen in their ingredients.

Are you traveling overnight via an airplane? Take some sleeping pills with you. Many people cannot sleep on a plane because of the unfamiliar surroundings, the uncomfortable seats, and the noise from the plane and passengers. Try a sleeping pill might help get you some rest on a long flight if you have trouble falling asleep otherwise. Don?t take any pills until after the plan has taken off. If there is an issue or delay you would be sleeping in the terminal!

If you are going on a road trip, be sure to take turns driving so nobody gets too tired. By driving until you?re too tired, the next driver will not have anyone to talk to during the trip as you sleep. Driving until you are exhausted is not a great idea. Develop a schedule, instead, where you and another driver switch every couple of hours. This will stop you from becoming so tired while you are behind the wheel.

Take a minimum of valuable items with you when you travel. With a lot of different activities in unfamiliar surroundings, losing things is very common on vacation. Even worse, you could be the victim of a theft.

Whenever possible, purchase tickets for admission to attractions online, then print them instantly or opt for will-call. The small fee for such a service is worth it to avoid long lines. For big attractions that have timed entry available, you can use that, too, to get you in faster.A desert vacation delivers a unique environment that few will ever encounter, including interesting plants and animals. Deserts offer a special experience for the first time visitor. It should be the goal of anyone interested in the world to experience the wonder of the desert at least once.

You do not have to go a long distance to have a great quick trip. Your home state or neighboring ones can offer great getaways at a fraction of the cost. Support your area businesses and save money at the same time by taking local trips. You can find fun activities you didn?t even know existed.As stated initially in this guide, travel is fun although planning for a trip may not be. There are certain ways to help make planning a trip easier, creating a more successful journey. Follow the travel tips in this article to make planning and going on your trip as enjoyable as possible.

If you want to learn more about travel,you can read more topics related to travel and tour tips.. This article, Travel Smarter With These Great, Easy Tips is available for free reprint.

Source: http://articles-maniac.tk/travel-smarter-with-these-great-easy-tips/travel-leisure/

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Softball Coaching Tips – How Willing Are You to Change?

?

Tonight I had a very interesting discussion with one of my students. She was my last lesson of the night and we had a little time to chat before her mom came back to pick her up. We spoke of many things, but then we got into the idea of players being willing to change what they’re doing to get better. I then?mentioned that my teaching had changed somewhat since the days when my sons had played baseball. That?s when Jenna asked an interesting question: If you found better mechanics than what you’re currently doing, would you make your students change? I paused for only a moment and then said yes. She seemed a little surprised at first, but then I asked her “If I discovered something that could add five mph to your pitches wouldn’t you want me to share that with you, even if it’s different?” It didn’t take her long to nod her head yes.

This is something coaches need to be willing to do ? give up what they believe when something better comes along. That might seem self-evident but it’s really not.

Certainly anyone who hangs around the forum long enough sees posters who like to defend an indefensible position, or will split hairs on a technique in an attempt to prove they’re right. Yet it’s not about being right; it’s about finding the best way to do (or teach) a particular skill. Changing what you’re teaching doesn’t necessarily mean you were teaching the skill incorrectly before. It just means you didn’t have as much information then as you do now. Former UCLA coach Sue Enquist is famous for many things, but one of my favorites is her answer to a coaching clinic attendee who was not happy that she was contradicting what he had learned from one of her old tapes with the information she was presenting at the clinic.

When the coach asked her why she was changing, she replied “Because I didn’t know then what I know now” or words to that effect.

It’s not easy to decide to change what you’re teaching. Some worry that their credibility will be questioned ? after all, if you changed once you might change again. Yet parents and players should appreciate the fact that you are constantly working to improve your own knowledge in order to make your players the best you can be. Here’s a good rule of thumb: if you ever think you finally know THE way to teach hitting, pitching, throwing or any other skill, it’s probably time for you to do some soul searching. Because that knowledge level doesn’t exist. If there was only ONE way that worked, everyone would be doing it that way. Again, a look around the Discuss Fastpitch Forum shows that’s not the case.

Do the best you can with the information you have, but always be on the lookout for something better. Sure, it can be painful to admit you didn’t know it all, and that you don’t now. But in the long run you, your players and everyone else around you will be the better for it.

Anyway, that’s the way I see it.

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Source: http://leisure.ezinemark.com/softball-coaching-tips-how-willing-are-you-to-change-7d34af719bce.html

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