Much of the recent debate that has surrounded the development and use of 'performance', or 'communicative' language tests has focused on a supposed trade-off between two sets of desirable qualities: correspondence between test tasks and test performance to nontest language use for content relevance; and reliability of scores derived from test performance. One area that has been of particular concern with performance tests is the potential variability in tasks and rater judgements, and this has been investigated in the language testing literature with two complementary approaches: generalizability the ory and many faceted Rasch modelling. GENOVA, which performs general izability theory analyses, estimates the relative contribution of variation in test tasks and rater judgements to variation in test scores. FACETS, which performs many faceted Rasch modelling, estimates differences in task difficulty and rater severity, and adjusts ability estimates of test takers, taking these differences into account. In this article we first discuss the design and development of a foreign language (Spanish) test battery that was designed for two purposes: first, to place University of California Education Abroad students into programmes at universities abroad that are appropriate for their level of language ability, and secondly to provide diagnostic information that will be useful for designing appropriate teaching and learning pro grammes for prospective education abroad students. The test battery consists of four subtests: reading, listening and note-taking, speaking, and writing. All subtests share a common theme or topic, and are interdependent. We then discuss the results of the GENOVA and FACETS analyses of the speaking subtest, based on a full field trial with a group of University of California undergraduate students who had been selected for participation in the Education Abroad Program. Finally, we discuss the implications of these results for the use of G-theory and many faceted Rasch modelling for the development of performance tests of foreign language ability.

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Objective-To review the eYcacy of intraaortic balloon counterpulsation (IABCP) in medically refractory ventricular arrhythmia. Design-Retrospective analysis of the outcome of patients with ventricular arrhythmia treated with IABCP after transfer between 1992 and 1997. Setting-Tertiary cardiac referral centre. Patients-21 patients (mean age 58 years) who underwent IABCP for control of ventricular arrhythmia. All had significant left ventricular impairment (mean ejection fraction 28.6%); 18 had coronary artery disease. Results-Before IABCP, 10 patients had incessant monomorphic ventricular tachycardia and 11 had paroxysmal ventricular tachycardia and/or ventricular fibrillation (VT/VF). IABCP resulted in suppression of ventricular arrhythmia in 18 patients, of whom 13 were weaned from IABCP. After stabilisation of ventricular arrhythmia, 10 patients were maintained on medical treatment alone and one underwent endocardial resection. IABCP was maintained until cardiac transplantation in five patients. One patient had a fatal arrest before discharge and one died from progressive heart failure. IABCP failed to control ventricular arrhythmia in three patients and was subsequently discontinued. A cardiac assist device was employed in one of these until cardiac transplantation; the other two were eventually stabilised on medical treatment. Nineteen patients were discharged from hospital. Overall survival was 95% at mean follow up of 25.7 months. Conclusions-IABCP can be an eVective means of controlling refractory ventricular arrhythmia, allowing time for the institution of more definitive treatment. (Heart 1999;82:96-100)

ObjectiveWe hypothesised that, compared with culprit-only primary percutaneous coronary intervention (PCI), additional preventive PCI in selected patients with ST-elevation myocardial infarction with multivessel disease would not be associated with iatrogenic myocardial infarction, and would be associated with reductions in left ventricular (LV) volumes in the longer term.MethodsIn the preventive angioplasty in myocardial infarction trial (PRAMI; ISRCTN73028481), cardiac magnetic resonance (CMR) was prespecified in two centres and performed (median, IQR) 3 (1, 5) and 209 (189, 957) days after primary PCI.ResultsFrom 219 enrolled patients in two sites, 84% underwent CMR. 42 (50%) were randomised to culprit-artery-only PCI and 42 (50%) were randomised to preventive PCI. Follow-up CMR scans were available in 72 (86%) patients. There were two (4.8%) cases of procedure-related myocardial infarction in the preventive PCI group. The culprit-artery-only group had a higher proportion of anterior myocardial infarctions (MIs) (55% vs 24%). Infarct sizes (% LV mass) at baseline and follow-up were similar. At follow-up, there was no difference in LV ejection fraction (%, median (IQR), (culprit-artery-only PCI vs preventive PCI) 51.7 (42.9, 60.2) vs 54.4 (49.3, 62.8), p=0.23), LV end-diastolic volume (mL/m2, 69.3 (59.4, 79.9) vs 66.1 (54.7, 73.7), p=0.48) and LV end-systolic volume (mL/m2, 31.8 (24.4, 43.0) vs 30.7 (23.0, 36.3), p=0.20). Non-culprit angiographic lesions had low-risk Syntax scores and 47% had non-complex characteristics.ConclusionsCompared with culprit-only PCI, non-infarct-artery MI in the preventive PCI strategy was uncommon and LV volumes and ejection fraction were similar.

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