The Political Spectrum Of South Africa - 1936 Words

With the advent spread of the English language during the colonial conquests the world had undergone a vast array of changes, and some of these changes that seems to have gone unnoticed for some part is how deeply the English language has impacted and changed a country s identity entirely. Then the question arises whether those changes are in fact beneficial or detrimental for language acquisition and maintenance for future generations to come. This essay will focus on my country of choice, South Africa, and will discuss how three different dimensions have been impacted by the English language. I will first focus on the historical dimensions to gain a better understanding of the circumstances within South Africa in the past and in today s context, especially how the English language had arrived and completely shaped South Africa as a whole. Furthermore, following the historical impact, this essay will go deeper into the political spectrum of South Africa, and discuss how the country shifted from the Apartheid era to its contemporary state. Lastly, I will discuss how the educational system has impacted the growing new generation to get a clearer understanding of how the country has been changed to adapt to the more globalised world that we live in now and will raise some questions about how language, being one of the key aspects that makes us human, could be wilfully applied for coercion into a chosen form of hegemony, and will thus demonstrate the importance of language inShow MoreRelatedThe Republic Of South Africa956 Words   |  4 PagesRepublic of South Africa History: The history of South Africa is characterized by racial and political violence, territorial conflict, wars of conquest, and inter-ethnic rivalry. South Africa was colonized by the English and Dutch in the seventeenth century. 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Notes †Human resource management Free Essays

Notes – Human resource management Chapter 7 Notes Human Resource Management DEFINE selection and DISCUSS Its strategic Importance. Reliability and validity and EXPLAIN their importance in selection techniques. DESCRIBE at least four types of testing used in selection and the conflicting legal concerns related to alcohol and drug testing DESCRIBE the major types of selection interviews by degree of structure, type of content, and manner of administration. We will write a custom essay sample on Notes – Human resource management or any similar topic only for you Order Now EXPLAIN the importance of reference checking, strategies to make such checking effective, and ANALYZE the legal issues involved. Selection The process of choosing Individuals to fill Job openings The strategic Importance of selection Quality of human resources determines organizational performance. Inappropriate selection decisions are costly. Significant legal implications Avoiding Legal problems use selection criteria based on the Job assess applicant’s ability to meet expectations scrutinize applicant-provided information obtain authorization for reference checking save all records and Information reject applicants who make false statements The selection process Designing the selection process Faceable) qualified privilege negligent misrepresentation Step 5: Supervisory Interview and realistic Job preview The supervisor: is best qualified to assess Job knowledge/ skills can answer Job-specific questions must feel comfortable with new hire can assess fit with current team members Realistic Job Preview (RIP) provides applicants with realistic information, both positive and negative, about the job Step 6: Hiring decision and Candidate notification compile information from all techniques used evaluate information about each candidate immediate supervisor usually makes final hiring decision think about the offer notify all finalists who were not selected How to cite Notes – Human resource management, Essays

Crowd Sourced Equity Funding

Question: Discuss about theCrowd Sourced Equity Funding. Answer: Introduction Crowd sourced equity funding [CSEF] is a new concept of online fund raising. In order to implement it number of changes has been implemented on the part of the government, so that it becomes less expensive and easier on the part of small businesses that include startups, with the purpose of raising equity from general public, at the same time ensuring protection for the investor (innovation, 2016). With the help of this fundraising approach, up to $5 million/year the entrepreneurs are allowed to raise fund, from a vast number of individuals in exchange for equity in the company. It is mentionable here that, present regulatory requirements of Australia create a barrier to large scale use of CSEF. Hence the main focus of the report would be to discuss upon the aspect of CSEF, while emphasizing upon the laws associated with it like Corporations Amendment Regulations 2015 and its effect upon concept of CSEF. Crowd-Sourced Equity Funding According to Corporations and Market Advisory Committee [CMAC], crowd-sourced equity funding [CSEF] also known as equity crowd funding or investment-based crowd funding is a developing and comparatively new concept associated with corporate capital rising. From a broader perspective, a corporation seeking funds, specifically early or initial stage capital with the help of providing internet users with equity in exchange of cash, is contemplated by CSEF (Camac, 2014). In this regard it is mentionable here that, with the help of website it would be published by issuers regarding their equity offers, following which it operator would act as the intermediary between the issuer and the crowd with the intension of equity transactions. It can also be referred as a type online fundraising that is innovative in nature, which is continuously emerging. With the help of CSEF entrepreneurs can raise funds from a vast number of small investors. CSEF as an innovative finance options has the potenti al to enhance small businesses and start ups fund access in order to develop and execute their products and ideas. Hence with the help of CSEF individuals to a large number can make small financial contributions to a company and in exchange of it receive an equity stake. In terms of providing finance in association to innovative business concepts that may face complications in order to attract funding under conventional models, CSEF has huge potential. It has been further stated in Corporations and Markets Advisory Committee Discussion paper 2013, the process of CSEF includes adverting with the help of online medium that includes a crowd funding website, which acts as a contributing factor as the an intermediary between the business and investors. Corporations Amendment Regulations 2015 is associated with the concept of crowd sourced funding (Treasury, 2016). According to the act, regulations can be formulated by Governor-General in regards to prescribing matters that are permitted or required under the act or necessary to be prescribed in order to execute the act. Proposal of CSF Model for Corporation and Market Advisory Committee 2013 In alternative way investment-based crowd funding or equity crowd funding can be described as alternative way of Corporation and Market Advisory Committee (CSEF). For conducting that review, CAMAC performed in further better way. A company or the issuer is contemplated for fund seeking the initial capital stage. The cash is returned from the equity to internet user who is termed as crowd. Between the issuer and the crown investor the intermediary operation occurs which is done for the purpose of transactions for equity. For corporate fundraising small companies (issuers), does equity investment facilitating and publicizing equity offers which is required for the online users or crowd. In the subcommittee CAMAC has formed some of the members such as: Teresa Handicott, Greg Vickery (chair), Brian Salter, Ian Ramsay and Maan Beydoun (ASIC) which is related to the conjunction of CAMAC Executive. Acknowledgement appreciation and contribution is done by CAMAC outcome from the review done by those persons. A discussion paper was published by CAMAC in September 2013 and updates were given online and in December 2013 and October 2013 the updates of the discussion paper was published. From review aspect, questions raised on discussion paper of the review. On CAMAC website, the discussions are published. In the consideration CAMAC was assisted by information gathered from the respondents. For the review process the committee thanks the participants. There is various scope of review which is related to the nature of internet. The equity offers are given by the issuers, and these things can be incorporated in all the countries and website mediations can also be operated by investors from various countries. There are several facility discussed by CDSEF with various regulatory questions, such as: Under Corporation Act 2001, the issuer can register the company through mode of equity (Symon, 2006). As per Australian Securities and investments Commissions (ASIC), for jurisdiction online intermediary rules of equity offer is made through intermediately website. As per Chapter 6D of Fundraising of Corporation Act, the application of review in term from the global aspect, rules of the jurisdiction of corporation act has to be followed by the crowd investors. The equity offers and the shares of the company are related with the report. Different expectations of investors has to form regulatory arrangements in Australian method. Online fundraisings another name is CSEF. Some obligations of intermediaries, issuers are imposed through the corporation act which falls under Australian law. The anti-money laundering, counter-terrorism of financial legislation and privacy legislation follow the rules of CSEF. The international standard deals with International Organization of Securities Commission (IOSCO) and scope of review the mutual recognition introduced by foreign jurisdiction of Australia. In overseas jurisdiction various approaches has been reviewed by CSEF in consideration of CAMAC. In Newzealand, as per the Financial Markets Conduct Act 2013 Phase 1 Regulation 2014, the CSF conduct pertains the equity fundraising. As per Part 6 of Financial Markets Authority (FMA), crowd funding service implied FMA Crowd Funding arrangement and thus Funding model is adopted by New Zealand. Retail Client Relating Service for Crowd Funding and CSF offer Purpose with Investor Protection According to the subsection, with the CSF 761G (7) states towards determining through tests whether the person in relation to the service regarding crowd funding can be retail client. The service related crowd funding is provided to person shall deem to be retail client based on one or the excess of the tests being satisfied as below The product test and the value test mentioning that the financial product price that means the securities that offered or the financial products value relating to the area of financial service either exceeds or equals according to regulations contained in 7.1.18, 19 and paragraph referred in 761G(7)(a); or The crowd funding service or the securities that provided towards the usage in business that is not considered as small business as per paragraph referred in 761 G(7)(b) with small business being defined as that business with not more than 20 employees (Camac, 2015). However if the business involves the goods manufacture then business needs not more than 100 employees to be employed as per the subsection based on 761(G(12); or Where the service of crowd funding or the securities has not been provided in connection related to business for use, the person in process of acquiring the service related to crowd funding or the securities provides certificate. This should be from the qualified accountant who has prepared the same (as in the section 9 defined) and that is within two years preceding which states that the net assets of the person being $2.5 million, or the last two financial years gross income to be $250,000 at the least. (regulation 7.1.28 and the paragraph 761 G(7)(c); or This crowd funding service being provided to person as professional investor according to definition in Section 9 of the (paragraph in the 761 G (7) (d). This professional investor consist licensee of Australian financial services, an entity listed, a bank, or person controlling at least gross assets worth $10 million. The purpose of this investor protection is to limit the risk of the fraud that required to control in the environment. Discussing Temporary Concessions and Reporting Requirements from Corporate Governance of few Public Companies Eligible towards Crowd Fund that Intends or Completes within Required Period the CSF offer. The temporary concessions this report sets from specific public company with the related corporate governance and the requirements related to reporting that are to a new company that is public available being towards crowd fund eligible with completion or intending to complete with required time frame the offer of CSF (budget, 2016). This stated that unless otherwise all these references are based on the Act of the corporations, 2011. Based on the regime of the CSF that available towards only the public companies these will have exclusion with the start-ups and the other enterprises small scale those need not adopt the structure of the public company. This restriction of the regime related to CSF based on this method might reduce potentially the companies number those using the regime related to CSF and therefore substantially and consequently reduce the regime effectiveness. Therefore this issue related temporary concessions to address are created in the bill from specific public company and the governance related corporate. The requirements of the reporting towards the new public companies satisfying the eligibility criteria of the CSF during the registration time as new company that is public and financial year end relevant with completing CSF offer within timeframe required. The concessions purpose is to decrease barriers to adopting structure of public company Eligibility of CSF offer with Conditions and Restrictions Under CSF regime as per schedule 1, Part 1, item 14 of section 738B, there are some relevant requirements of the offer which is needed to be followed. There is some eligibility requirements of CSF offer: Securities of offer of issue: For an issue there must be an offer and sale of securities should not be related to that and thus primary issuance can be covered under Schedule 1, Part 1, item 14, paragraph 738G (1) (a). If an offer is made3 by the company, as per schedule 1, part v 1, item 14, paragraph 738G (1) (b). The restriction is involved with the size of the company with consolidated turnover related with the eligibility (Ed Husic MP - Federal Labor Member for Chifley, 2016). Critical Analysis of CSEF By CSEF, the effort was to take help of sponsors to provide monetary assistance to issuers who were startup companies in the form of equity investments which were not at large scale. The work was to be done by portals who acted as third parties. The people funding these start ups would be the online customers or buyers of shares issued by these small companies. The money collected is supposed to be small at the beginning. CSEF was not created for big offers by big companies. If looked at a positive sense it provides access to funds for small level enterprises and makes plans to increase their budget which would invariably benefit their projects and their future endeavors. The investors are pivotal in such endeavors since they provide the money in the initial phase of the plans. This might result in production, growth in money and help in employing people. This would help the investors to get healthy dividends for their investment. However this facility would encourage competitive beh avior among capital providers which would result in cost to company being less. It would also help those who are not opting for this funding scheme. However this kind of online funding scheme can never be a primary source of fund raising as it is always entailed with dangers of failure. The negative impact would be that the endeavor would change the course of the funds from being utilized in more beneficial ventures and saving techniques. Hence start ups with better possibilities to contribute economically would fail without even inception (camac.gov.au, 2016). Hence the CSEF will always be a risk on the investors. The investment will be highly volatile and subject to clicking in the Australian market. The onus will be on the offerer to ensure that the money is used judicially and towards correct direction to ensure maximum benefits are derived. However since the concept is new, it is impossible to pre decide the success or failure of the scheme. The government has to give it a fair trial before concluding. According to the New Zealand model of CAMAC the facilitation of CSEF is provided in The Financial Markets Conduct Act 2013 and the Financial Markets Conduct (Phase 1) Regulations 2014. They say that the CSEF is implementable. The Kiwi government said that present scheme will provide money to start up small enterprises and allow them to perform more well compared to customary methods of offerings. The CSF conditions are standard conditions provided in any offer document. However in order to receive success since it is an unknown territory for investors, more efforts should be made on behalf of the start-ups. The CSF offers are volatile in nature since they are less tried and are eligible for unpredictable results. The start-ups have to be careful in investing the moneys and have to ensure that in case there is any chance of loss, immediate intimation should be provided to the investors so that they can act immediately (Treasury.gov.au, 2015). If prompt measures are not taken there will be chance for losses and the entire scheme will be subject to disapproval from the Australian government. Reflective Summary While working through this assignment I got to know about the concept of CSEF and what it spoke about. I also got to know about the various deliberation s taken in various countries especially New Zealand whose report according to CAMAC was most necessary for the purpose of analyzing the entire case. While skimming through it was found out that the framework of CSEF was subject to several amendments by Australian legislations and it was done every year. There were set of conditions and models laid down according to the concept and they were endeavored to be implemented properly to ensure success of the concept. The various advantages and disadvantages of the online scheme have been discussed to justify the scheme. References budget.gov.au. (2016).The Parliament of the commonwealth of Australia House of Representatives. [online] Available at: https://www.budget.gov.au/2015-16/content/appropriation_bills/download/Appropriation-Bill-No6-2014-15-EM.pdf [Accessed 19 Sep. 2016]. Camac.gov.au. (2014).Corporations and Markets Advisory Committee - Final Reports - Final Reports Home. [online] Available at: https://www.camac.gov.au/camac/camac.nsf/byheadline/reportsfinal+reports+home.html [Accessed 19 Sep. 2016]. Camac.gov.au. (2015).Corporations and Markets Advisory Committee - Final Reports - Final Reports Home. [online] Available at: https://www.camac.gov.au/camac/camac.nsf/byheadline/reportsfinal+reports+home.html [Accessed 19 Sep. 2016]. camac.gov.au. (2016).Crowd sourced equity funding. [online] Available at: https://www.camac.gov.au/camac/camac.nsf/byheadline/pdfsubmissions_6/$file/seaview_consulting_csef.pdf [Accessed 19 Sep. 2016]. Ed Husic MP - Federal Labor Member for Chifley. (2016).BILLS: Corporations Amendment (Crowd-sourced Funding) Bill 2015. [online] Available at: https://www.edhusic.com/bills_corporations_amendment_crowd_sourced_funding_bill_2015 [Accessed 19 Sep. 2016]. innovation.gov.au. (2016).Making it easier to access to crowd-sourced equity funding | National Innovation and Science Agenda. [online] Available at: https://www.innovation.gov.au/page/access-crowd-sourced-equity-funding [Accessed 19 Sep. 2016]. Symon, H. (2006).Corporations Act 2001. Melbourne: Leo Cussen Institute. Treasury.gov.au. (2015).Crowd-sourced equity funding. [online] Available at: https://www.treasury.gov.au/ConsultationsandReviews/Consultations/2015/Crowd-sourced-Equity-Funding [Accessed 19 Sep. 2016]. Treasury.gov.au. (2016).Response to the Draft Crowd-Sourced Equity Funding Legislation and Regulations 2015 and Explanatory Material. [online] Available at: https://www.treasury.gov.au/~/media/Treasury/Consultations%20and%20Reviews/Consultations/2015/Crowd-sourced%20Equity%20Funding/Submissions/PDF/LCA.ashx [Accessed 19 Sep. 2016].

Spanish Influence in Puerto Rico Essays - Americas, Spanish Empire

Spanish Influence in Puerto Rico Sarah Osorio Imperialism and Nationalism Final project Sarah Osorio John Poon Imperialism and Nationalism 11-18-17 Spain's Control of Puerto Rico For most of its history, Puerto Rico has been controlled by an outside power, and its people oppressed. While Puerto Rico is currently a U.S. territory, Spanish colonialism has had a significant impact on the island's development and identity. The history of the island itself is proof of this fact, demonstrating each step Puerto Rico took to reach its current state. By examining the stages of Spanish control that Puerto Rico experienced, we can determine how each stage affected the structure of Puerto Rico. Before Spain invaded Puerto Rico, the native population known as the Tainos inhabited it. At the beginning of the 1500's, the Tainos were conquered by the Spanish and, after a series of revolution attempts, virtually disappeared from Puerto Rican life. Those that were left fled to the interior of the island, which was empty for the most part. This part of the island became a refuge for the people who had fled from the approaching Spanish conquerors. This was the first stage in Puerto Rico's development. Spain was the most dominant oppressor of Puerto Rico, and its occupation of the island resulted in many social and economic changes. The native people were marginalized, and Spain took over Puerto Rico in order to turn it into a productive colony. In addition to this, the presence of the Spaniards in Puerto Rico added a different ethnic group to the island's native population. When the official slave trade began in 1518, African slaves were added to Puerto Rico's mixed ethnic heritage. This is the reason for all of the different skin toned people in Puerto Rico. Puerto Rico remained under Spanish control until 1898, but in the 1540's, Spain discovered silver mines in Mexico and Peru. Puerto Rico was virtually abandoned, becoming a frontier zone. Forced into labor, the peasants developed a passive, evasive attitude toward Spanish control. A reflection of this can be seen in Francisco de Valle Atiles article The Spiritual Life of the Jibaro. According to Valle Atiles, The speech of the peasant has the imperfections of those who never had any education; he still uses words that modern Spanish has forgotten, and the impurity and barbarism of his language are notorious. (Valle Atiles 95) This describes the life of the Puerto Rican peasant: poor, uneducated, and deemed inferior by their Spanish tyrants. However, the Puerto Rican peasants had pride in their own culture, and did their best to survive despite their oppressed status. They refused to be controlled by the Spaniards, even to the point of escaping the areas of the island most heavily developed by Spain and living in the uninhabited area. Between 1550 and 1560 Puerto Rico's position as the entry point to the New World began to attract people from countries other than Spain. For this reason, Puerto Rico became the target of many anti-Spain attacks. In 1598, England made an attempt to conquer Puerto Rico, only to be wiped out by an epidemic. San Juan became a Spanish enclave, and it was at this point that Puerto Rican society began to develop dualism. The people who fled to the interior of the island, the Spaniards living in San Juan, and those living in the coastal areas became more familiar with their own identities. In particular, those living in the interior of the island, known as jibaros, were characterized by their dislike of authority and desire for independence. Another aspect of Puerto Rican history that affected the development of the island's structure and identity was the emergence of the sugar and coffee industries. The sugar industry was the first market to emerge, and Spain went so far as to change their policies to encourage commerce on the island. With their new policy, foreign traders could trade with Puerto Rico, building a web of economic interdependence that had a huge effect of Puerto Rican economics. Spain wanted Puerto Rico to become a valuable asset in the sugar industry, and used this reason to tighten its grip on Puerto Rico. This also advanced the class divisions on the island. Although

A comparison between cardiac CT scanning and cardiac digital subtraction angiography (DSA) The WritePass Journal

A comparison between cardiac CT scanning and cardiac digital subtraction angiography (DSA) Abstract A comparison between cardiac CT scanning and cardiac digital subtraction angiography (DSA) ). This review aims to review the literature on coronary CT scanning and digital subtraction angiography, their clinical applications, techniques and comparative value in coronary artery assessment and diagnosis. Cardiac Digital subtraction angiography Coronary angiography is the conventional diagnostic procedure used in coronary artery disease. It is a minimally invasive technique, whereby a catheter is placed into the radial or femoral artery and is advanced through the arterial system to the coronary arteries. A contrast agent is then injected at the aortic root and allows visualization of the arteries using x-ray in real time at up to 30 frames per second. This allows a view of the extent, location and severity of coronary obstructive lesions such as atherosclerosis and enables prognostic indication (Miller et al., 2008). Coronary angiography also enables catheter placement either side of the lesion to assess pressure changes and determines the degree of flow obstruction (Miller et al., 2008). . Digital subtraction angiography (DSA) again works by introducing a contrast agent into the coronary arteries and taking x-rays in real time, however a pre image is taken by x-ray. This allows for the post images to be subtracted from the original mask image, eliminating bone and soft tissue images, which would otherwise overlie the artery under study (Hasegawa, 1987). Unlike conventional angiography, it is possible to conduct DSA via the venous system, through accessing the superior vena cava via the basillic vein (Myerowitz, 1982). This removes the risks associated with arterial cannulation (Mancini Higgins, 1985). The procedure can also be performed with a lower dose of contrast agent and be done more quickly therefore eliminating constraints of using too much contrast during a procedure (Myerowitz, 1982). Whilst DSA is the gold standard in arterial imaging of carotid artery stenosis (Herzig et al., 2004), the application of DSA to the coronary arteries is limited due to motion artefacts associated with each heartbeat and respiration (Yamamoto et al., 2009). There are numerous cardiac clinical applications of DSA, it can be used to assess coronary blood flow (Molloi et al., 1996), valvular regurgitation (Booth, Nissen DeMaria, 1985), cardiac phase (Katritsis et al., 1988), congenital heart shunts (Myerowitz, Swanson, Turnipseed, 1985), coronary bypass grafts and percutaneous coronary intervention outcomes (Katritsis et al, 1988; Guthaner, Wexler Bradley, 1985). However, others have suggested that the coronary arteries are not visualized well due to their small size, movement, their position overlying the opacified aorta and left ventricle, and confusion with other structures such as the pulmonary veins (Myerowitz, 1982). Cardiac CT Scanning Development of CT scanning in the 1990s enabled an increase in temporal resolution that was sufficient to view the beating heart, and they now provide a non-invasive technique for diagnostic and prognostic purposes. Cardiac CT scans have clinical applications that go beyond perfusion investigation, and can be used to assess structure and function of the heart (for example in electrophysiology disorders or congenital heart disease) due to its ability to provide anatomical detail (Achenbach Raggi, 2010). CT scans can be used to assess coronary artery disease with and without injection of contrast agent (Achenbach Raggi, 2010) by calcium scan or CT angiography. Coronary calcium CT scanning uses the evidence base that coronary artery calcium is a correlate of atherosclerosis (Burke et al., 2003) and is a strong prognostic predictor of the future development of coronary artery disease and cardiac events (Arad et al., 2000; Budoff et al., 2009; Achenbach Raggi, 2010). Calcium is easily depicted on CT scan due to its high CT attenuation, and is classified according to the Agatson score, which considers the density and area of the calcification (Hoffman, Brady Muller, 2003). Coronary CT angiography (CTA) allows visualization of the coronary artery lumen to identify any atherosclerosis or stenosis within the vessels. Patients are injected intravenously with a contrast agent and then undergo a CT scan. There are limitations regarding the suitability of patients for coronary CTA due to prerequisites of sinus rhythm, low heart rate and ability to follow breath-holding commands. Additionally, obesity presents a problem for patients that cannot fit into the scanner and affects the accuracy of the procedure. (Achenbach Raggi, 2010). Comparison of cardiac DSA and cardiac CT scanning The technical differences between cardiac DSA and cardiac CT scanning give rise to differences in the clinical indications for the procedures, their diagnostic efficacy and also different risks or relative benefits to the patients. Due to the nature of the images produced by coronary CTA and DSA, each lends itself to different indications for use. Whilst coronary DSA provides imaging of all aspects of perfusion, CTA used with contrast agent also provides this however has the additional advantage of being able to assess structure and function of the heart. Coronary CTA has been shown to have a high accuracy at detection and exclusion of coronary artery stenoses (Achenbach Raggi, 2010). In a multicentre trial conducted by Miller et al. (2008), patients underwent coronary calcium scoring and CT angiography prior to conventional invasive coronary angiography. The diagnostic accuracy of coronary CTA at ruling out or detecting coronary stenoses of 50% was shown to have a sensitivity of 85% and a specificity of 90%. This showed that coronary CTA was particularly effective at ruling out non-significant stenoses. Additionally, coronary CTA was shown to be of equal efficacy as conventional coronary angiography at identifying the patients that subsequently went on to have revascularisation via percutaneous intervention. This was shown by an area under the curve (AUC), a measure of accuracy of 0.84 for coronary CTA and 0.82 for coronary angiography. Miller et al.’s (2008) study included a large number of patients at different study sites, and additionally represented a large variety of clinical patient characteristics. The author’s claim that these factors contribute to the strength and validity of the study findings, and suggest that in addition to using patients with clinical indications for anatomical coronary imaging, should be used as evidence that coronary CTA is accurate at identifying disease severity in coronary artery disease. Miller et al. (2008) did however,, find that positive predictive and negative predictive values of coronary CTA were 91% and 83% respectively and therefore suggested that coronary CTA should not be used in place of the more accurate conventional coronary angiography. A low positive predictive value (in relation to the prevalence of disease) was proposed to be due to a tendency to overestimate stenosis degree as well as the presence of artefacts leading to false positive interpretation (Achenbach Raggi, 2010). Other research providing comparison between coronary CTA and conventional coronary angiogram has highlighted variability in results. A meta-analysis conducted by Gorenoi, Schonermark and Hagen (2012) investigated the diagnostic capabilities of coronary CTA and invasive coronary angiography using intracoronary pressure measurement as the reference standard. The authors found that CT coronary angiography had a greater sensitivity than invasive coronary angiography (80% vs 67%), meaning that coronary CTA was more likely to identify functionally relevant coronary artery stenoses in patients. Despite this,, specificity of coronary CTA was 67%, compared to 75% in invasive coronary angiography, meaning that the technique was less effective at correctly excluding non-diagnoses than invasive coronary angiogram. This research appears to contradict the power of cardiac CTA at excluding diagnoses of coronary artery stenosis as suggested by Miller et al. (2008), he study did combine evidence from over 44 studies to provide their results and therefore had a large statistical power. The authors interpret the results in light of the clinical relevance of cardiac imaging, suggesting that patients with a higher pretest possibility of coronary heart disease will likely require invasive coronary angiography for revascularisation indicating that coronary CTA may be a helpful technique in those patients with an intermediate pre-test probability of coronary heart disease that will therefore not require invasive angiography. Goldberg et al. (1986) investigated the efficacy of DSA in comparison to conventional coronary angiography in 77 patients. They found that the two angiograms agreed within one grade of severity in 84% of single cases and 90% of multiple cases, identifying both patent and lesioned arteries. The results led the authors to conclude that there was no significant difference between the two methods and that DSA could be used in selective coronary angiography to find results comparable to that of conventional angiography. In addition to being a small study into the efficacy of DSA, the study also had several sources of inherent variability that should be considered when interpreting the results. These included differing sizes of digital imaging screen and non-use of calipers, meaning that the interpretation of the images could vary throughout the study. The authors also suggest that whilst showing strong support for the use of DSA in coronary artery disease, the technique may not actually p ermit better prognostic determinations or clinical judgements that are better than conventional angiography, and therefore the further implementation of the techniques may not be founded or necessitated. More recently, there has been further research looking at the effectiveness of DSA as a way of measuring coronary blood flow. Whilst motion artefacts have proven a problem in lots of past research (Marinus, Buis Benthem, 1990; Hangiandreou, 1990), recent research has developed methods to minimise these. Moilloi and colleaues (1996) showed that using a motion-immune dual-energy digital subtraction angiography, absolute volumetric coronary blood flow could be measured accurately and thus provide an indication of the severity of any arterial stenosis.This may provide further suggestion for clinical implementation of DSA. Although these studies provide evidence for the efficacy of cardiac DSA and CTA, they often make comparisons to conventional angiography. This is useful as a baseline comparison, however it is difficult to make comparisons between the two procedures directly due to less available evidence making direct comparisons. Lupon-Roses et al. (1985) conducted a study investigating both coronary CTA and venous DSA. The study looked at the efficacy of both techniques at diagnosing patency of coronary artery grafts compared to the control conventional angiography. CT was shown to diagnose 93% of the patent grafts and 67% of the occluded grafts whereas DSA correctly diagnosed 98% and 100% of patent and occluded grafts respectively. Interestingly, the DSA picked up the 11 grafts that were misdiagnosed by CTA and the CTA picked up the 2 grafts misdiagnosed by the DSA. This data may suggest that individually, DSA has a better profile for diagnosis of coronary artery occlusion, however if the two procedures are used in combination exclusion of patent arteries and diagnosis of occluded arteries would be effective (Lupon-Roses et al., 1985). Coronary DSA and CTA are both non-invasive procedures (unlike the conventional coronary angiography where a wire is placed in the coronary vasculature). With the only invasive part of the procedure being the injection of the contrast material into a vein. This presents a significant advantage to both procedures over that of conventional angiography, and may even permit investigation on an outpatient basis (Meaney et al., 1980). Similarly, both DSA and coronary CTA are favoured because of their intravenous approach, eliminating the risks of bleeding or arterial injury from an intra-arterial catheterization and being able to be used in those with limited arterial access. However, although the intravenous approach used in cardiac DSA makes it favourable, it does lead to difficulty with visualisation of the coronary arteries due to the overlying iodinated pulmonary and cardiac structures (Mancini Higgins, 1985). Therefore,, intra-arterial DSA is also sometimes used (Yamamoto et al., 200 9). As with all CT scanning, coronary CTA carries with it a dose of ionizing radiation (Brenner Hall, 2007). Studies have estimated that for diagnostic CT scanning, patients are on average exposed to 12mSv of radiation during the procedure, the equivalent of 600 x-rays (Hausleiter et al., 2009). Estimates of radiation doses associated with conventional coronary angiography are lower than that of coronary CTA at 7mSv (Einstein et al., 2007). Additionally, DSA technique reduces the radiation dose from that of conventional coronary angiography as the vessels are visualised more clearly (Yamamoto et al., 2008). The dangers of radiation exposure are increased risk of developing cancer, skin injuries and cateracts (Einstein et al., 2007). It is therefore important that the benefits of conducting the procedure greatly outweigh the risk of radiation exposure. CT calcium scanning provides a low radiation dose at around 1mSv (Hunold et al., 2003). Cardiac CT calcium scanning does not require administration of a contrast agent, unlike in coronary CTA and DSA that use iodine based contrast agents. The risks associated with contrast agent include nephrotoxicity and risks of hives, allergic reactions and anaphylaxis (Maddox, 2002). The amount of contrast agent used is partly dependent on the length of the procedure and how clearly the arteries can be visualised. For this reason, both cardiac CTA and DSA use less contrast agent that conventional coronary angiography (Brant-Zawadzki, et al., 1983). CT calcium scanning of the coronary arteries is therefore recommended in those with less likelihood of coronary artery disease (NICE, 2010). Both coronary CTA and DSA require interpretation by trained physicians, and the importance of training and achieving intra-rater reliability should not be underestimated (Pugliese et al., 2009). Conclusion Overall, both coronary CT and DSA have been demonstrated as effective procedures for the imaging of the coronary arteries in CAD (Achenbach Raggi, 2010; Miller et al., 2008; Moilloi et al., 1996; Goldberg et al., 1986). Whilst cardiac CT scanning does provide a wider range of clinical applications, allowing assessment of perfusion as well as cardiac structure and function (Achenbach Raggi, 2010), coronary DSA has many applications that allow assessment of coronary blood flow (Molloi et al., 1996; Katritsis et al, 1988; Booth, Nissen DeMaria, 1985; Guthaner, Wexler Bradley, 1985; Myerowitz, Swanson, Turnipseed, 198). Both cardiac DSA and CTA procedures have their advantages. As non-invasive procedures, these techniques pose less risk to patients, and enable the possibility of outpatient investigation, to be used to rule out diagnoses and to avoid inappropriate invasive coronary angiogram (Gorenori et al., 2012). Additionally, intravenous access is preferential to arterial cannulation for the contrast infusion, removing the risks associated with bleeding or intra-arterial injury. Cardiac DSA exposes the patient to a lower dose of radiation that coronary CTA (Hausleiter et al., 2009; Yamamoto et al., 2008; Einstein et al., 2007), which is beneficial at reducing the risk of genetic mutations and cancer. Cardiac CTA and DSA also have their common disadvantages. The use of contrast agent may present side effects for the patient including kidney damage and risk of allergic reactions and anaphylaxis (Maddox, 2002). For this reason, calcium CT scanning can be useful in patients that are not at high likelihood of coronary artery disease (NICE, 2010b). Additionally, both cardiac DSA and CTA are subject to motion artefacts from respiration and heart beats, which can cause difficulties with interpretation (Achenbach Raggi, 2010; Yamamoto et al., 2009). In the case of cardiac CTA, this excludes a subset of patients that are unable to follow commands and those who have high heart rates. Overall, cardiac CTA and cardiac DSA are effective, non-invasive imaging techniques for assessment of coronary artery disease. Whilst they are not the gold standards in cardiac monitoring, they can provide important diagnostic information without exposing patients to the risks of invasive angiography. Due to this, their use should be weighted against clinical need, the risks of the procedures, and the suitability of the patient. Interpretation of cardiac CTA and DSA imaging should be by trained individuals. References Achenbach, S., Raggi, P. (2010) Imaging of coronary atherosclerosis by computed tomography. European Heart Journal. 31:1442 Arad, Y., Spadaro, L. A., Goodman, K., Newstein, D., Guerci, A. D. (2000). Prediction of coronary events with electron beam computed tomography.Journal of the American College of Cardiology,  36(4), 1253-1260. Booth, D. C., Nissen, S., DeMaria, A. N. (1985). 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