A team decision framework for quality decision outcomes.

This paper outlines the Team Decision Framework which follows on from our previous work on optimising the quality of decision-making in groups.The TDF is proposed as a model of the skills and abilities which we have termed 'intelligences' that should ideally be present in order for groups making decisions to achieve their full potential. The paper describes the intelligences and outlines the development of the measuring instrument,using Structural Equation Modelling and exploratory factor analysis. The TDF is designed to profile groups' decision-making capabilities. It is anticipated that such profiling might be used for diagnostic, training and comparative research purposes

Gray matter injury associated with periventricular leukomalacia in the premature infant

Neuroimaging studies indicate reduced volumes of certain gray matter regions in survivors of prematurity with periventricular leukomalacia (PVL). We hypothesized that subacute and/or chronic gray matter lesions are increased in incidence and severity in PVL cases compared to non-PVL cases at autopsy. Forty-one cases of premature infants were divided based on cerebral white matter histology: PVL (n = 17) with cerebral white matter gliosis and focal periventricular necrosis; diffuse white matter gliosis (DWMG) (n = 17) without necrosis; and

Co-55-PET in stroke:relation to bloodflow, oxygen metabolism and gadolinium-MRI

BACKGROUND: Several studies have shown the feasibility of Co-isotopes (Co-55 and Co-57) in imaging of neuronal damage in stroke, multiple sclerosis, cerebral tumors and trauma. These studies indicate that Co-isotopes allow visualization of brain pathology related to inflammatory processes, reactive gliosis and cell death. Until now, it is not clear if Co-55 accumulation occurs in the core of infarction or in the penumbra. Therefore, in the present study, we compared Co-55-PET with functional parameter such as cerebral bloodflow (rCBF) using (CO2)-O-15, oxygen metabolism (rCMRO(2)) using O-15(2) and cerebral bloodvolume (CBV) using (CO)-O-15 in PET and with the anatomical parameter Gd-MRI. PATIENTS AND METHODS: Seventeen patients (11 male; 6 female) age 43 to 84 (mean 69) with middle cerebral artery (mca) stroke, as proven by CT or MRI, were examined with Co-55-PET (0.5-1.0 mCi (CoCl2)-Co-55), (CO2)-O-15-, O-15(2)- and (CO)-O-15-PET in one session 0-30 days after stroke-onset. Regions of infarction were defined by rCMRO(2) being smaller than 65% or rCBF below 45% of the contralateral value and were subsequently superimposed on the cobalt scan. To compare the Cobalt uptake with the Gd-MRI, a realignment program was used that matches the MRI with the blood-flow images. Clinical status was established using the Orgogozo stroke scale at admission and at discharge (at least 6 weeks after admission) and the Barthel index. RESULTS: Eight patients showed a positive Co-PET scan and were used for further analysis. It appeared that Co accumulates in areas with a diminished oxygen metabolism and with a preserved bloodflow. We found Co-uptake in only a part of the Gd enhanced brain tissue with a tendency to be located peripherally or outside the Gd demarcated brain tissue. CONCLUSION: The results of the present study suggest that Co accumulates into infarcted brain tissue with a rather preserved flow independently of blood-brain barrier breakdown