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Introduction: Haemodynamic atrioventricular delay (AVD) optimisation has primarily focussed on signals that are not easy to acquire from a pacing system itself, such as invasive left ventricular catheterisation or arterial blood pressure (ABP). In this study, standard clinical central venous pressure (CVP) signals are tested as a potential alternative. Methods: Sixteen patients with a temporary pacemaker after cardiac surgery were studied. AV delay optimisation was performed by alternating between a reference AVD of 120ms and tested settings ranging from 40 to 280ms, with 8 replicates for each setting. Alongside (a) the raw data, three methods of correcting for respiration were tested: (b) limiting analysis to a respiratory cycle, (c) asymmetric least squares (ALS) and (d) discrete wavelet transform (DWT). The utility of a quality control step was tested. Results: CVP signals were a mirror image of the systolic ABP signals: The four R values were -0.674, -0.692, -0.631, -0.671 respectively (all p<0.001). With quality control, the mirror image was best for DWT (R = -0.76, p<0.001), with the CVP and ABP optima agreeing well (R = 0.78, p<0.001). The automated quality control signal correctly predicted the gap between the AVD optima calculated from ABP and CVP (R = 0.8, p<0.001). Conclusions: Central venous pressure signals could be used to optimise AVD, because they have a reliable inverse relationship with ABP when pacemaker settings undergo protocolised testing. However, protocols need careful design to circumvent spontaneous biological variability. [ABSTRACT FROM AUTHOR]

This naturalistic study was designed to examine the effectiveness of a 4-week skill-based group therapy that focuses on building resilience. The group, informed by Dialectical Behavior Therapy (DBT; Linehan, 1993, 2015), targets general clients at college counseling centers and emphasizes mindfulness as a coping strategy to stress, cognitive rigidity, emotion dysregulation, and interpersonal difficulties. Results indicated that group members showed clinically significant improvement in psychological resilience and general mental health at the conclusion of group therapy. Implications are discussed.

We defend in this paper the importance of redistributing power in the field of education development by enhancing the self-sustainability of education initiatives and minimizing their roots in dependency -- these as pre-requisites for improving their sustainable development outcomes. We do this by considering an education development initiative run by the Barefoot College in India, and then developing an explanatory model based in complexity theory (as expounded by Edgar Morin) and in the capability approach (as developed principally by Amartya Sen and Martha Nussbaum). We conclude that such a redistribution of power would help to ensure that education is better connected to its development context, more relevant to the interests and needs of the community it serves, and its quality enhanced. More generally, we reinforce existing arguments -- but from the perspective and imperative of sustainability -- why it is in the interests of policy-makers to devolve power and to provide resources to such initiatives. Doing so would enhance governments' prospects of realizing their education and social development goals. The arrogation of power and resources towards the centre, an almost natural impulse in policy-making, is, in the end, counter-productive, and threatens sustainable education and social development.

In the post-Apartheid era South Africa's universities have faced serious questions about the quality of their student learning in the face of near impossible challenges. The University of Cape Town, widely seen as the country's leading higher education institution, has shown remarkable resilience, however, in the range of initiatives it has launched to support and enhance student learning. These initiatives, designed with a common purpose, are of course intended to work together so that their effects might be compounded and realized in enhanced student learning outcomes. Drawing substantially on the power of compounding (which is itself redolent of the claim made by complexity theory that relations and emergence are crucial concepts), complexity theory offers unique insights into how and why things change – and also into how and why things remain largely the same or inexorably grind towards failure. The networked initiatives undertaken by the University of Cape Town constitute a case of learning refurbishment that is also well explained and understood in terms of complexity theory. This paper draws on concepts from complexity theory both to understand how learning might be enhanced in higher education institutions in severely straitened circumstances and to offer insights for education leaders and policy-makers in this domain. [ABSTRACT FROM AUTHOR]