Background-There is an effort to build an anatomically and biophysically detailed virtual heart, and, although there are models for the atria and ventricles, there is no model for the sinoatrial node (SAN

The ‘holdings versus access’ dilemma encouraged the University of Leeds Library to undertake a project to compare the costs of periodical subscription and inter‐library lending. This article provides a brief synopsis of the project, which paid particular attention to calculating a cost for qualitative variables linked to ‘wait time’.

The sinoatrial node, the pacemaker of the heart, is a structurally and functionally complex and heterogeneous structure. Histology, immunohistochemistry, electrophysiology and mathematical modeling of the sinoatrial node are reviewed to reveal the structure-function relationships of the sinoatrial node. It is argued that contact between the sinoatrial node and surrounding atrial muscle is limited to permit driving of the atrial muscle by the sinoatrial node but not suppression of the sinoatrial node by the atrial muscle (which is more hyperpolarized). It is argued that a protective conduction block zone on one side of the sinoatrial node is the result of a lack of myocytes. Finally, it is argued that the cellular organization of the sinoatrial node is best described by the gradient model.

Sally Wright is a Medical Student, based at University of Leeds, Leeds, UK. AbstractPurpose -The purpose of this paper is to focus on the precipitants of physical and psychological abuse of individuals with intellectual disabilities in order to understand why mistreatment continues to be prevalent. In particular, the importance of contributing factors were explored such as challenging behaviour and lack of staff training, in an attempt to prevent another "Winterbourne". Design/methodology/approach -A literature search using the search terms "Intellectual disability", "learning disability", "abuse", "challenging behaviour" and "residential" was conducted. Articles were included using the criteria: adults with intellectual disabilities, concentration on neglect and physical abuse, abuse by staff members and articles written within the last 15 years. Using these criteria, a total of 19 articles were isolated. Additional articles were located through reference to citation lists. In total, 31 relevant articles were identified. Findings -The majority of research agrees that a meaningful increase in risk of abuse does exist for individuals with intellectual disabilities. There is a lack of recent empirical evidence discussing the incidence of abuse, potential causes and the long-term impact of staff training in reducing the incidence of abuse. These gaps may be due to the subjective definition of abuse, the current "reactive" approach to abuse, the ability of perpetrators to hide mistreatment and difficulty in quantifying the difference that increased staff training has on performance. More research is required to adequately protect individuals with intellectual disabilities in the residential setting. Originality/value -The paper highlights gaps in the current literature and identifies potential areas that could be improved in order to reduce the prevalence of abuse in residential care.