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In a trial involving 10,003 patients with suspected coronary artery disease, clinical outcomes at 2 years were not improved with an initial strategy of CT angiography, as compared with functional testing (exercise ECG, nuclear stress testing, or stress echocardiography). New-onset, stable chest pain is a common clinical problem that results in approximately 4 million stress tests annually in the United States in ambulatory patients without diagnosed heart disease. 1 Despite advances in cardiac testing, there is scant information on health-related outcomes and little consensus about which noninvasive test is preferable. 2 – 4 As a result, current patterns of care have been questioned, including the testing of very-low-risk populations 5 and the catheterization of patients who do not have obstructive coronary artery disease (CAD). 6 – 8 The development of coronary computed tomographic angiography (CTA) and its application in this context has the potential to . . .

The widespread availability of the coronary artery calcium scan to diagnose coronary artery atheroma semiquantitatively and its prognostic significance has frequently resulted in a difficult therapeutic decision for physicians caring for asymptomatic patients.Patients and Risk Factors:Of particular concern are patients over 40 years of age and young adults characterized by multiple cardiovascular risk factors. The correct prognostic interpretation of coronary artery calcium scores and the potential benefits and risks of various therapeutic modalities need to be understood.Conclusion:This review describes the therapeutic choices available to endocrinologists and provides recommendations for various treatment options.The endocrinologist is often consulted concerning a positive coronary artery calcium scan in an asymptomatic patient. This article provides a pertinent data review and suggested clinical management.

Justifiable anger and its expression is not abuse. The fact is that excessive waiting time for people who are hurt and sick is abuse. The comments by Leslie Bell, head of the Ontario Nurses' Association, suggest she does not understand the difference.

The Pilgrim Project serves more than 100 people who live throughout the Montreal Urban Community. They are served by more than 400 volunteers. Anyone interested in becoming a volunteer should call the Pilgrim Project office at the Dorval Community Centre, 750 Dawson Ave., 633- 9315. Brendan Cavanaugh and his wife, Dorinda, are the founders of the Pilgrim Project, which receives funding from Centraide.

PHOTO(S); Martial artists give a tai chi demonstration at the Jing Ying Institute. According the institute?sWeb site, the practice reduces stress and lowers high blood pressure. Christina Muir of Annapolis tries out some basic stances and maneuvers during a free class at the institute.

This qualitative evaluation explored how female undergraduate students developed an understanding of themselves and the broader world as a result of an adventure and service learning experience in Tanzania, Africa. The project built upon theoretical frameworks regarding meaningful learning—active, constructive, intentional, and authentic—and applied activity theory as a framework for interpreting outcomes. The study included multi-faceted examination of student perceptions of the effects of the year-long experience that culminated in a ten day trip to Tanzania, including a climb to the summit of Mount Kilimanjaro. Students’ reflections on the impacts of the trip focused on wanting, doing, reflecting, and relating. Thus, the experience catalyzed change in students’ understanding of the world that strongly indicates a meaningful learning experience.