The Virtual International Stroke Trials Archive

BACKGROUND AND PURPOSE: Stroke has global importance and it causes an increasing amount of human suffering and economic burden, but its management is far from optimal. The unsuccessful outcome of several research programs highlights the need for reliable data on which to plan future clinical trials. The Virtual International Stroke Trials Archive aims to aid the planning of clinical trials by collating and providing access to a rich resource of patient data to perform exploratory analyses. METHODS: Data were contributed by the principal investigators of numerous trials from the past 16 years. These data have been centrally collated and are available for anonymized analysis and hypothesis testing. RESULTS: Currently, the Virtual International Stroke Trials Archive contains 21 trials. There are data on \u3e15,000 patients with both ischemic and hemorrhagic stroke. Ages range between 18 and 103 years, with a mean age of 69+/-12 years. Outcome measures include the Barthel Index, Scandinavian Stroke Scale, National Institutes of Health Stroke Scale, Orgogozo Scale, and modified Rankin Scale. Medical history and onset-to-treatment time are readily available, and computed tomography lesion data are available for selected trials. CONCLUSIONS: This resource has the potential to influence clinical trial design and implementation through data analyses that inform planning

Interprofessional collaboration in primary health care organizations

Results of a study conducted by the Health Care Research Unit, Newcastle upon Tyne UnivSIGLEAvailable from British Library Document Supply Centre- DSC:6219.836(RCGP-OP--52) / BLDSC - British Library Document Supply CentreGBUnited Kingdo

Development and validation of an instrument to predict infant feeding

SIGLEAvailable from British Library Document Supply Centre- DSC:7623.4525(UNUT-CHSR-R--52) / BLDSC - British Library Document Supply CentreGBUnited Kingdo

The use of hyperventilation therapy after traumatic brain injury in Europe: an analysis of the BrainIT database.

Objective To assess the use of hyperventilation and the adherence to Brain Trauma Foundation-Guidelines (BTF-G) after traumatic brain injury (TBI). Setting Twenty-two European centers are participating in the BrainIT initiative. Design Retrospective analysis of monitoring data. Patients and participants One hundred and fifty-one patients with a known time of trauma and at least one recorded arterial blood–gas (ABG) analysis. Measurements and results A total number of 7,703 ABGs, representing 2,269 ventilation episodes (VE) were included in the analysis. Related minute-by-minute ICP data were taken from a 30 min time window around each ABG collection. Data are given as mean with standard deviation. (1) Patients without elevated intracranial pressure (ICP) (<20 mmHg) manifested a statistically significant higher PaCO2 (36 ± 5.7 mmHg) in comparison to patients with elevated ICP (≥20 mmHg; PaCO2: 34 ± 5.4 mmHg, P < 0.001). (2) Intensified forced hyperventilation (PaCO2 ≤ 25 mmHg) in the absence of elevated ICP was found in only 49 VE (2%). (3) Early prophylactic hyperventilation (<24 h after TBI; PaCO2 ≤ 35 mmHg, ICP < 20 mmHg) was used in 1,224 VE (54%). (4) During forced hyperventilation (PaCO2 ≤ 30 mmHg), simultaneous monitoring of brain tissue pO2 or SjvO2 was used in only 204 VE (9%). Conclusion While overall adherence to current BTF-G seems to be the rule, its recommendations on early prophylactic hyperventilation as well as the use of additional cerebral oxygenation monitoring during forced hyperventilation are not followed in this sample of European TBI centers.J.-O. Neumann, I. R. Chambers, G. Citerio, P. Enblad, B. A. Gregson, T. Howells, J. Mattern, P. Nilsson, I. Piper, A. Ragauskas, J. Sahuquillo, Y. H. Yau, K. Kiening on behalf of the BrainIT Grou

The rise and fall of HIV prevalence in Zimbabwe: The social, political and economic context

For more than 10 years Zimbabwe has experienced social, political and economic instability, including the near collapse in 2008 of its health system. Paradoxically, this period has also seen a fall in estimated HIV prevalence, from 25.6% in 1996 to 13.7% in 2009. This article examines this development in a socio-political and historical context. We focus on the complex interplay of migration, mortality, individual behaviour change, and economic patterns in shaping the presumed epidemiological waning of HIV prevalence in Zimbabwe and explore the evolution and management of the country's HIV/AIDS response. Our assessment of the role that the Zimbabwean state has played in this development leads to the conclusion that a decline in HIV prevalence has been as much an artefact of dire social, political and economic conditions as the outcome of deliberate interventions. Lastly, we propose the need to contextualise available epidemiological data through qualitative research into the social aspects of HIV and the everyday lives of individuals affected by it

No Man's Brand-Brands, Institutions, and Fashion

Branding has become so intertwined with consumption that today's consumers have often deeply personal relationships to brands and brand histories. Branding is an attempt to strategically "personify" products and to encapsulate a balance between different economic values: quality, utility, symbolic, and cultural worth. In this paper we argue that the relationship between the contemporary consumer and producer is mediated by and governed by a reflexive construction of brands. As such brands are best understood from an institutional perspective. The paper illustrates the institutional role of brands by using the example of the fashion industry. It is argued that in the fashion industry, a focus on consumer-producer brand-building and brand loyalty is central to the commodity and value chains built around products. We conclude by suggesting that economic geography has consistently undervalued brands as an area of study. By taking brands as a core product in industrial production rather than as an interesting aside for sociologists, historians, and cultural theorists, economic geography can better understand the institutions governing the economy. In particular, better understanding the institution of brands helps us better appreciate the dynamics systems within which commodities and commodity chains are formed. Copyright 2008 Blackwell Publishing.