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Risk assessments are calculated using a number of factors including age, gender, race, cholesterol and blood pressure levels, diabetes and smoking status, and the use of blood pressure-lowering medications. Typically, these factors are used to estimate a patient's risk of developing cardiovascular disease in the next 10 years. For example, someone who is young with no risk factors for cardiovascular disease would have a very low 10-year risk for developing cardiovascular disease. However, someone who is older with risk factors like diabetes and high blood pressure will have a much higher risk of developing cardiovascular disease in the next 10 years.

If a preventive treatment plan is unclear based on the calculation of risk outlined above, care providers should take into account other factors such as family history and level of C-reactive protein. Taking this additional information into account should help inform a treatment plan to reduce a patient's 10-year risk of developing cardiovascular disease.

Calculating the 10-year risk for cardiovascular disease using traditional risk factors is recommended every 4-6 years in patients 20-79 years old who are free from cardiovascular disease. However, conducting a more detailed 10-year risk assessment every 4-6 years is reasonable in adults ages 40-79 who are free of cardiovascular disease. Assessing a patient's 30-year risk of developing cardiovascular disease can also be useful for patients 20-59 years of age who are free of cardiovascular disease and are not at high short-term risk for cardiovascular disease.

Risk estimations vary drastically by gender and race. Patients with the same traditional risk factors for cardiovascular disease such as high blood pressure can have a different 10-year risk for cardiovascular disease as a result of their sex and race.

After care providers and patients work together to conduct a risk assessment, it's important that they discuss the implications of their findings. Together, patients and their care providers should weigh the risks and benefits of various treatments and lifestyle changes to help reduce the risk of developing cardiovascular disease.

The "2013 AHA/ACC Guideline on Lifestyle Management to Reduce Cardiovascular Risk" provides recommendations for heart-healthy lifestyle choices based on the latest research and evidence. The guidelines focus on two important lifestyle choices--diet and physical activity--which can have a drastic impact on cardiovascular health. Here's what every patient should know about the latest recommendations for reducing cardiovascular disease risk through diet and exercise.


Physical Activity


The "2013 AHA/ACC/TOS Guideline for the Management of Overweight and Obesity in Adults" was created to reflect the latest research to outline best practices when it comes to treating obesity--a condition that affects more than one-third of American adults. These guidelines help address questions like "What's the best way to lose weight?" and "When is bariatric surgery appropriate?". Here is what every patient should know about the treatment of overweight and obesity:


Definition of obesity: Obesity is a medical condition in which excess body fat has accumulated to the extent that it can have an adverse effect on one's health. Obesity can be diagnosed using body mass index (BMI), a measurement of height and weight, as well as waist circumference. Obesity is categorized as having a BMI of 30 or greater. Abdominal obesity is defined as having a waist circumference greater than 40 inches for a man or 35 inches for a woman.

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Home // Monitor on Psychology // September 2002 Monitor on Psychology // How to publish your journal paper


Understanding the nuances of the process smooths the publishing ride.



September 2002, Vol 33, No. 8

Print version: page 50

The Catch 22 in research publishing is that few authors work effectively in the process until after they've published a few manuscripts. The good news is that experienced journal editors and authors are willing to pass on their secrets of success. Here is their best advice.

Have a focus and a vision

Angela M. Neal-Barnett, PhD, of Kent State University and author of the forthcoming book, "Bad Nerves" (Simon Schuster, 2003), as well as numerous papers in multiple journals believes that the key to successfully publishing an article is to "get a vision"--a reason and purpose for writing. That concept isn't always familiar to academicians who often write because they have to for tenure or promotion, she says. But, she advises, while "academic wisdom [says] 'publish or perish,' ancient wisdom says 'without vision, the people will perish.'"

Once you have a vision, says Neal-Barnett, write it down and keep it in constant view to remind you of your mission.

Write clearly

"There is no substitute for a good idea, for excellent research or for good, clean, clear writing," says Nora S. Newcombe, PhD, of Temple University, former editor of APA's .

Newcombe endorses the advice of Cornell University's Daryl J. Bem, PhD, who in (Vol. 118, No. 2) wrote that a review article should tell "a straightforward tale of a circumscribed question in want of an answer. It is not a novel with subplots and flashbacks, but a short story with a single, linear narrative line. Let this line stand out in bold relief."

Newcombe also admits that neatness counts. Though she tries not get in a "bad mood" about grammar mistakes or gross violations of APA style, she says, such mistakes do "give the impression that you're not so careful."

Get a pre-review

Don't send the manuscript to an editor until you have it reviewed with a fresh eye, warns Newcombe. Recruit two objective colleagues: one who is familiar with the research area, another who knows little or nothing about it. The former can provide technical advice, while the latter can determine whether your ideas are being communicated clearly.

Many academic departments form reading groups to review each others' papers, says Elizabeth M. Altmaier, PhD, editor of . "New faculty should and can form reading groups where they can exchange drafts and get feedback to each other," she says.

After you've gotten that fresh critique of your work, says Newcombe, listen to the pre-reviewer's advice. If the reviewer down the hall "didn't really understand page six and therefore got lost in page 13," she says, "don't just say they didn't read carefully--other people are going to make that same error."

For a final check, some editors suggest having the manuscript professionally copy-edited (see Further reading ).

Send your manuscript to the right journal

Many rejections are the result of manuscript-journal mismatch--a discrepancy between the submitted paper and the journal's scope or mission. Newcombe advises authors to consider the "theoretical bent" of the papers that regularly appear in the journal before they submit a paper to it.

A major faux pas is submitting your manuscript simply to get it reviewed, says Newcombe. She's heard authors say, "This is a small experiment that I know would never get published in that journal, but I would like to get some feedback." Not a good idea, Newcombe says, because it wastes editors' and reviewers' time, and those who reject it from the journal may also be the ones who have to review the paper when it's submitted to a different journal. "It's a small community out there. Don't use up your reviewers," she says.

Beef up your cover letter

Many authors don't realize the usefulness of cover letters, Newcombe says. In addition to stating "here it is" and that the paper conforms to ethical standards, Newcombe says the letter can contain the author's rationale for choosing the editor's journal--especially if it's not immediately apparent.

The letter can also suggest reviewers for your manuscript, she says, especially in the case of a field that an editor isn't well-versed in. The flip side is also acceptable: Authors can suggest that certain people not review the manuscript for fear of potential bias. In both cases, authors can't expect the editor to follow the recommendations, says Newcombe. In fact, the editor may not follow any of them or may use all of them.

Don't panic

The overwhelming majority of initial journal manuscripts are rejected at first. "Remember, to get a lot of publications, you also will need to get lots of rejections," says Edward Diener, PhD, editor of APA's . Only a small proportion--5 to 10 percent--are accepted the first time they are submitted, and usually they are only accepted subject to revision. Since most papers are rejected from the start, says Newcombe, the key is whether the journal editors invite you to revise it.

Read the reviews carefully

In fact, anything aside from simply "reject," Neal-Barnett reminds, is a positive review. These include:

Some reviewers may recommend submitting your work to a different journal. "They're not saying the article is hopeless," says Neal-Barnett, "they're just saying that it may not be right for that journal."

If revision isn't invited following the initial rejection, many new authors may toss the manuscript and vow to never write again to or change programs. Newcombe's advice, though, is to read the reviews carefully and determine why that decision was made.

If the research needs more studies or if the methodology needs to be changed somehow, "if you have a sincere interest in the area, do these things," says Newcombe. You can resubmit it as a new paper, noting the differences in the cover letter.

Also keep in mind that "quite often, unfortunately, a journal will reject an article because it's novel or new for its time," says Newcombe. "If you feel that it is valid and good, then by all means, send it off to another journal."

Gary R. VandenBos, PhD, APA's publisher, adds, "once you have published, you take a feedback letter for what it is--a good-news sign telling what you need to do to transform it into an acceptance." It can take three or so journal-paper publishing experiences to get the hang of the process, he says.

Don't put off the revisions

If you are invited to revise, "Do it, do it fast and don't procrastinate," says Newcombe. Also, she warns that because reviewers can at times ask for too much, authors should take each suggestion into consideration, but decide themselves which to implement.

Be diplomatic

What if reviewers disagree? "There is a wrong and a right way" to address dissention among reviewers, says Newcombe. She quotes from Daryl Bem's article:

Wrong: "I have left the section on the animal studies unchanged. If reviewers A and C can't even agree on what the animals have developed, I must be doing something right."

Right: "You will recall that reviewer A thought the animal studies should be described more fully whereas reviewer C thought they should be omitted. Other psychologists in my department agree with reviewer C that the animals cannot be a valid analogue to the human studies. So, I have dropped them from the text and have attached it as a footnote on page six."

Ultimately, it's good to keep in mind that the road to being published isn't a lonely one: "All authors get lots of rejections--including senior authors such as me," says Diener. "The challenge," he says, "is to persevere, and improve one's papers over time."

Accept: "Which almost nobody gets," she says.

Although not permanent – almost all of the EFP-related forces deployed to northeastern Europe do so on a rotational basis – the initiative nonetheless represents a strengthening of the alliance’s deterrence and reassurance posture. It is also a substantial re-embrace of sale 2015 Stuart Weitzman CapToe Suede Flats cheap sale newest buy cheap brand new unisex uW5cEyJfI4
. From roughly the end of the Cold War until 2014, the alliance hasn’t seriously had to worry about defending one of its members from an attack. Instead, the alliance spent almost a quarter-century focused on crisis response, counterterrorism, and stability operations in places like Bosnia, Kosovo, and Afghanistan, as well as military diplomacy and outreach to promote security sector reform.

What is also striking about the EFP initiative is the degree of participation . This reflects both the emerging consensus among NATO allies that Russia’s actions in 2014 were more than just a passing storm in the European security environment and the allies’ durable commitment to collective security despite occasional dustups over issues like burden-sharing. In Estonia, where the United Kingdom has the lead as the framework country – and hence contributes the most forces – Denmark and Iceland also contribute personnel. In Latvia, the Canadians are in the lead, with additional troops contributed by Albania, Italy, Poland, Slovakia, Slovenia, and Spain. Personnel from Belgium, Croatia, France, Iceland, the Netherlands, and Norway have joined the Germans in Lithuania. Finally, in Poland, where the United States leads as the framework nation, Croatia, Romania, and the United Kingdom also contribute forces.

If, in the worst-case scenario, Russia were to invade one of the four host nations, several alliance member states would likely sustain casualties. This would probably spur a faster, more unified response from the alliance. If the primary purpose of EFP is to act as a tripwire triggering broader allied involvement, it seems suitable for the task, even though there are legitimate doubts over whether it’s large enough and – as argued in a forthcoming Security Studies Institute monograph by cheap manchester great sale Madden Girl Womens PRISSLEY Fabr cheap get to buy brnL9ra3D1
and Michael A. Hunzeker – whether Russia would actually trip over it.

Spreading risk in this way is similar to multinational formations used by NATO during the Cold War. In particular, the former Allied Command Europe Mobile Force—Land was a brigade-sized force comprising 14 of NATO’s then-15 member states. It was meant to quickly deploy to an emerging crisis zone and to be a tangible manifestation of allied solidarity.

Operational Problems with EFP

However, NATO characterizes the EFP units as “ robust… combat-ready forces ,” and here there are significant questions yet to be answered. Most importantly, it remains to be seen whether the allies can overcome the challenges associated with the aforementioned multinationality that characterizes each battlegroup. The difficulties of multinationality at the batallion or battlegroup level should have been no great surprise for an alliance that spent years experimenting – with mixed results – with similar arrangements in the International Security Assistance Force in Afghanistan. Nonetheless, on a recent research trip I conducted to northeastern Europe, it’s clear that multinationality is creating a number of problems, especially in terms of equipment compatibility, English-language proficiency, and duplicative capabilities such as medical support. These conclusions are based an array of discussions I conducted with officers and enlisted personnel, as well as my own observations.

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