Not all children identified with high blood pressure under the new guidelines will require medication for the condition.”For most children with high blood pressure that is not caused by a separate medical condition or a medication, lifestyle changes are the cornerstone of treatment. It’s important to maintain a normal weight, avoid excess salt, get regular physical activity and eat a healthy diet that is high in fruit, vegetables, legumes, nuts, whole grains, lean protein and limited in salt, added sugars, saturated – and trans- fats to reduce blood pressure,” said Bazzano.Bazzano stressed that lifestyle changes can improve the health of the entire family as well as the child who has been found to have high blood pressure.The study is limited by the lack of data on actual heart attacks and strokes during adulthood. That data is currently being collected, according to the researchers. Results on participants in the Bogalusa Heart Study, who are from one community in Louisiana, may not be generalizable to the nation as a whole. 11 percent of the participants would be identified as having high blood pressure using 2017 guidelines, compared with 7 percent using 2004 guidelines; and 19 percent of those with high blood pressure under 2017 guidelines developed thickening of the heart muscle during the follow-up period, compared with 12 percent of those considered to have high blood pressure under 2004 guidelines. Reviewed by James Ives, M.Psych. (Editor)Apr 22 2019New guidelines that classified more children as having elevated blood pressure are better at predicting which kids are likely to develop heart disease when they reach adulthood, according to new research in the American Heart Association’s journal Hypertension. The guidelines were issued by the American Academy of Pediatrics (AAP) in 2017 and endorsed by the American Heart Association.Compared with the 2004 guidelines from the AAP, the 2017 guidelines increased the number of children classified as being in higher blood pressure categories, but it was not clear if the new criteria effectively identified children who were at higher risk of premature heart disease.”After reviewing years of information from the Bogalusa Heart Study, we concluded that compared with children with normal blood pressure, those reclassified as having elevated or high blood pressure were more likely to develop adult high blood pressure, thickening of the heart muscle wall and the metabolic syndrome – all risk factors for heart disease,” said Lydia A. Bazzano, M.D., Ph.D., senior author of the study and associate professor of epidemiology at the Tulane School of Public Health and Tropical Medicine in New Orleans.Related StoriesStroke should be treated 15 minutes earlier to save lives, study suggestsCancer incidence among children and young adults with congenital heart diseaseDon’t Miss the Blood-Brain Barrier Drug Delivery (B3DD) Summit this AugustThe Bogalusa Heart Study enrolled participants in childhood and has followed them for 36 years. Childhood test results on 3,940 children (47 percent male, ages 3-18 years and 35 percent African-American) and adult follow-up revealed that: Source:https://newsroom.heart.org/news/new-pediatric-blood-pressure-guidelines-identify-more-kids-at-higher-risk-of-premature-heart-disease
QoE and QoS monitoring for pay TV services is increasingly seen as a key feature of the churn reduction toolset, while web-based services are throwing up challenges of their own. Anna Tobin reports.There was a time when the quality control department of most major broadcasters consisted of one person tucked away in a back room somewhere watching output for any sign of poor picture or sound quality. Now that content providers have to distribute hundreds of hours of programming, some live, some pre-recorded and on-demand in several different formats to dozens of different platforms things have got a little bit more complicated.Customers may moan when their PC delivers a few seconds of buffering before their catch-up programme arrives at it or when the box office film they have paid for has frozen on their TV, but given the technological feat of delivering all this stuff, it’s amazing that everything arrives without a hitch for the large majority of the time.Video quality can be helped along by proactive Quality of Experience (QoE) and Quality of Service (QoS) checks and balances that are put in place by content distributors. It is difficult to quantitatively measure QoE, however, and so the focus tends to be on the more objective QoS metrics. The first is based on subjective measurements and analytics and the latter is based on objective real data.“The subjective side is about how the picture looks, what type of pixilation is happening to the image, but if you are going to measure pixilation issues you have to measure every different picture, which is quite a challenge,” says Simen Frostad, chairman of Bridge Technologies. “The objective side looks at real data, is there packet loss, are there any detailed errors, etc. Whilst it is important to be able to measure and quantify what the users are seeing, you have to start with objective data and if you have this you have 100% reference to what is going on. So you can measure packet loss, find the error and cure it before the customer notices it.”It is the fear of disappointing the customer that largely drives interest in this technology. Each operator is competing for eyeballs and if those eyeballs don’t like what they see they will jump ship to another provider. Superior service is becoming a key distinguishing factor in maintaining a competitive edge. All it takes is one slip up, poorly timed in the middle of a World Cup football final, and customers will leave in droves.“In the highly competitive markets in Europe and North America, providing your customers with a high QoE is very important, as there are a multitude of delivery platforms available and each platform is competing for delivery,” says Andrew Sachs, Volicon’s vice-president of product management. In this situation, operators need to be so on top of their output that they can foresee problems even before they’ve played out, says Sachs. “In a hypercompetitive market such as the US, you have to be very proactive. Move over to India, however, and QoE isn’t such a high priority.”Operators in highly developed multi-channel, multi-platform markets tend to be more focused on quality control than their counterparts in less developed regions where technical hitches are almost a given, because audiences in countries such as India have different expectations of quality of output. But, even in more error-tolerant markets, we will increasingly see more proactive monitoring put in place, says Seth Vermulm, application engineering manager at Sencore. “QoE monitoring is an essential part of the service provider’s toolset. You can’t do without it. If you do you risk customer churn. Without proper monitors you are driving blind and if anything goes wrong there is no easy way to find out where the problem is occurring and no simple way of remedying it quickly,” says Vermulm.Even in the current economic climate, with delivery platforms looking to make savings, it is seen as vital that they don’t make any drastic cuts to test and measurement systems, which are often seen as an easy target, says Vermulm. “Leave an integrated overall proactive solution out of the picture and customer churn is proven to increase. Those companies that do have this in place actually tend to grow faster than those that don’t.”Cutting back on monitoring is a false economy, says Eric Le Trehour, marketing director at Witbe. “Customer complaints generate an increase in operational costs with greater demands on people at the customer care centre and people for the truck-rolls,” he says.Customer complaints generate an increase in operational costs with greater demands on people at the customer care centre and people for the truck-rolls.Eric Le Trehour, WitbeYou can pick and choose where in your delivery network you want to place monitors to predict potential problems, but unless operators have a fully integrated system they are never fully covered. It’s not an area of their business where they can afford to cut corners.“A good monitoring coverage from service creation at the headend to consumption in the home is the foundation for correct and efficient decisions,” says Mikael Dahlgren, CEO at Agama Technologies.Most providers have now added to their networks some kind of error recovery mechanism. John Williams, director, emerging markets, at JDSU communications test and measurement business segment points out a couple of examples: “MediaRoom from Microsoft includes an error recovery approach that re-transmits to the set-top box lost packets, thus repairing, up to certain limits, network performance problems in this key area and Cisco offers a similar error recovery approach based on re-transmission of lost packets.”Adding to the burdenAs demand increases, a growing number of operators are now offering, or imminently plan to offer, IPTV services, as well as a host of catch-up and on-demand choices. And, of course, the more there is on the menu, the more likelihood there is of something going wrong. “Whenever you add an interactive service it increases the complexity of the system. There are more moving parts and more opportunities for error, so testing and monitoring becomes even more crucial,” says Volicon’s Sachs.In a competitive market, where operators are having to fight to stop content choosing their rival’s pipes for delivery, QoS and QoE becomes a vital part of their armoury and content providers want to see proof of low margins of error.The digitisation of cable set the quality threshold that is generally applied today, says Frostad of Bridge Technologies. “At the time of cable moving over to digital, there was an FCC recommendation that you shouldn’t have more than one noticeable artefact in the picture in the hour; if you have more than that then it isn’t broadcast quality. We see this as the same with packet loss, but there are some subjectives to this. If you are talking about a huge soccer game, for example, the threshold for putting up with even this is much lower than it would be for, say, a rerun of Cheers,” says Frostad. “We say that in a modern IPTV technology system you shouldn’t have packet loss in any part of your system as it’s a huge indication that something is wrong with the system architecture or operations.” [icitspot id=”16077″ template=”box-story”]There are some key parameters that any IPTV system is going to be measuring against, including jitter, dropped packets, MPEG and compression. “The thresholds are often very syste-dependent,” says Vermulm at Sencore, “so it’s key to normalise the system and understand what thresholds are tolerable and what needs to be in place to prevent errors. There are no specific industry standard thresholds that need to be met; recommendations will develop but hard numbers are a long way off.”With no standardization in this area, however, quality is difficult to measure, although you could judge by customer loyalty or the lack of it. “If people show that they are happy to pay for a service, could you say that quality of service and experience is being met?” says Sachs at Volicon. He argues that it is better to take a proactive stance so that any errors are picked up and fixed before the customer has even noticed them and had a chance to call customer service. He explains: “If we are talking about network issues, customer care shouldn’t be telling your network engineers that they have issues, they should know that already. If you have to wait until 35 people complain to customer care before your engineers react, then that is an indication that your internal processes have failed.”In the event that a problem does filter through to the viewer and customer service calls rise, the QoE system needs to help the customer care operative turn the situation into a positive. “If a customer calls in and says ‘my Box Office is out’, the customer care operative should be able to look at the monitoring system and say ‘yes, we can see the problem and it will be fixed shortly.’ This saves them having to go through the whole tiresome questioning process that irritates customers,” says Kirk George, director of marketing at IneoQuest.To use the data obtained from QoE and QoS checks most effectively, you need to be able to use them and apply them to all areas of your system from service creation to consumption, says Dahlgren at Agama Technologies. “Headend technicians need information on technical quality of the service creation, both real-time, such as alarms, and historical, as well as aggregated information. In the same way, staff at the NOC need filtered root causes as alarms to escalate the right situations to the right part of the organization, whilst in the customer care centre the focus is instead easy-to-understand problem isolation information for a quick problem resolution.”To aim for or maintain market leader status, content providers need to work through dozens of different scenarios that their users can play out from their networks and ensure that they have the QoE and QoS systems in place to ensure that each of these scenarios is played out at optimum performance. As the scenarios keep developing it isn’t going to be easy to stay ahead of the game.
The long-awaited 2014 Xining first allocation of public rental Yaohao ceremony was held on September 28th, from the four district housing tenants, low income households, through the computer Yaohao system, quickly won the 700 set of public rental lease qualifications. Part of the staff to obtain the qualifications of the lease in the wave of the day was happy to get the key. A machine community low household show fresh life more difficult, long renting, no heat, no water, life is very inconvenient, the access to public rental, she sincerely thank the government for their low income people in low-income housing in terms of priority. The allocation of more humane way of housing security in our city gradually changed from a single low-cost housing to public rental and other types of transformation, and to achieve the public rental housing and low-cost housing, two rooms merger. The first batch of this year allocated 700 units of public rental still adopts the advanced computer Yaohao way, but more humane in the form of distribution, mainly reflected in the following three aspects: one is to reflect the distribution principle of fairness and justice, to determine the distribution of scoring and ranking for order; two is for the convenience of the applicant living conditions. According to the voluntary choice of the way of piecewise partition and allocation of rent Yaohao, severe disability, physical mobility disability or blind personnel in multi-storey residential, in the absence of voluntary, rocking priority housing 1; three is the year of the public rental ratio also has adjusted the proportion the last assignment is 1:2, this year reached 1:1, to ensure that all tenants have a room to live. 700 units of public rental with rent what the city launched 700 units of public rental with rent for social, among them, 500 sets of high-rise residential district Ruihua, located in Nanchuan Road No. 139, the use of centralized heating; and the living area is 200 sets of multi-storey residential, is located in the Qaidam Road No. 135, using household heating, two small floor space, apartment layout compact layout, complete function, economical environment, green and beautiful, supporting facilities. The rent of public rental housing to implement differentiated the city rent in rent to implement differentiated rent collection methods, the rents for the district: Ruihua 10.5 yuan per square meter per month, and the living area 12.25 yuan per square meter per month. In order to improve affordable housing residential environment, at the same time according to the low-income people in affordable housing requirements, on the basis of full investigation, the public rental rent will implement differentiated treatment, namely: the minimum living family rent by the standard rent relief for 80% low-income families, according to the standard rent relief for 60%, rents are charged by the housing construction area.
NATHAN Brown expects Lance Hohaia to return to the line-up this Friday when Saints take on Leeds Rhinos.The Kiwi injured his foot during July’s win in London but has recovered in time for the trip to Headingley.“The last couple of weeks have been good for us and importantly we went into it on the back of a win,” Brown said. “That has given us confidence ahead of this week. It’s a boost that Lance will come back too. He’s trained with us for the last fortnight and hasn’t been rushed in anyway.“It’s huge to have him back. Lance knows his way around and has had a good year for us.“There’s a lot at stake on Friday. Realistically, if we win two games then nothing can change on the ladder. We will go into all three games as underdogs and that isn’t a bad thing but probably right with the number of people we have missing.”Saints head into Friday’s game four points clear of Leeds who will be buoyed by their Challenge Cup win at the weekend.Historically, it can be difficult to back up the week after a Final appearance but Brown is expecting the usual tough match in Yorkshire.“Let’s be honest, it’s always hard playing Leeds,” he said. “They have been together for a long time and retained that nucleus of players. That has been the key cornerstone of their success.“If they go lose someone they replace with someone good or better. When Keith Senior moved on Kallum Watkins came in. They needed another centre so they brought in Joel Moon. That’s what Leeds do; they are well run at the top and whatever coach they bring in always seems to be right for the team.“I enjoy going to Headingley. It is a good field and you have to rise to the challenge. The players enjoy going there too and if you do well you deserve a pat on the back.“We know what they are capable of at their best, so all we can do is prepare for that.”Tickets for Friday’s match at Headingley (kick off 8pm) remain on sale from the Ticket Office at Langtree Park, by calling 01744 455 052 or by logging on here.