5,101 research outputs found
Katrina\u27s Animal Legacy: The PETS Act
This article discusses issues related to the federal Pets Evacuation and Transportation Standards Act of 2006 (PETS Act), which was signed into law in the aftermath of Hurricane Katrina. Issues discussed in this article include: Various problems concerning animal evacuations and sheltering that Hurricane Katrina brought to light; Provisions of the PETS Act and related laws and policies which were developed in response to the tragedies brought about by Hurricane Katrina; and Strengths and weaknesses of the PETS Act and recommends next steps to improve implementation of the PETS Act
Addressing Alcohol\u27s Role in Campus Sexual Assault: A Toolkit by and for Prevention Specialists
This toolkit provides specific guidance on addressing alcohol\u27s role in campus sexual assault, centering Sexual Assault Prevention Specialists as the intended audience
Adaptability: Does Students’ Adjustment to University Predict Their Mid-Course Academic Achievement and Satisfaction?
Selective serotonin reuptake inhibitors (SSRIs) for stroke recovery.
BACKGROUND:
Stroke is the major cause of adult disability. Selective serotonin reuptake inhibitors (SSRIs) have been used for many years to manage depression. Recently, small trials have demonstrated that SSRIs might improve recovery after stroke, even in people who are not depressed. Systematic reviews and meta-analyses are the least biased way to bring together data from several trials. Given the promising effect of SSRIs on stroke recovery seen in small trials, a systematic review and meta-analysis is needed.
OBJECTIVES:
To determine whether SSRIs improve recovery after stroke, and whether treatment with SSRIs was associated with adverse effects.
SEARCH METHODS:
We searched the Cochrane Stroke Group Trials Register (August 2011), Cochrane Depression Anxiety and Neurosis Group Trials Register (November 2011), Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2011, Issue 8), MEDLINE (from 1948 to August 2011), EMBASE (from 1980 to August 2011), CINAHL (from 1982 to August 2011), AMED (Allied and Complementary Medicine) (from 1985 to August 2011), PsycINFO (from 1967 to August 2011) and PsycBITE (Pyschological Database for Brain Impairment Treatment Efficacy) (March 2012). To identify further published, unpublished and ongoing trials we searched trials registers, pharmaceutical websites, reference lists, contacted experts and performed citation tracking of included studies.
SELECTION CRITERIA:
We included randomised controlled trials that recruited stroke survivors (ischaemic or haemorrhagic) at any time within the first year. The intervention was any SSRI, given at any dose, for any period. We excluded drugs with mixed pharmacological effects. The comparator was usual care or placebo. In order to be included, trials had to collect data on at least one of our primary (dependence and disability) or secondary (impairments, depression, anxiety, quality of life, fatigue, healthcare cost, death, adverse events and leaving the trial early) outcomes.
DATA COLLECTION AND ANALYSIS:
We extracted data on demographics, type of stroke, time since stroke, our primary and secondary outcomes, and sources of bias. For trials in English, two review authors independently extracted data. For Chinese papers, one review author extracted data. We used standardised mean differences (SMD) to estimate treatment effects for continuous variables, and risk ratios (RR) for dichotomous effects, with their 95% confidence intervals (CIs).
MAIN RESULTS:
We identified 56 completed trials of SSRI versus control, of which 52 trials (4059 participants) provided data for meta-analysis. There were statistically significant benefits of SSRI on both of the primary outcomes: RR for reducing dependency at the end of treatment was 0.81 (95% CI 0.68 to 0.97) based on one trial, and for disability score, the SMD was 0.91 (95% CI 0.60 to 1.22) (22 trials involving 1343 participants) with high heterogeneity between trials (I(2) = 87%; P < 0.0001). For neurological deficit, depression and anxiety, there were statistically significant benefits of SSRIs. For neurological deficit score, the SMD was -1.00 (95% CI -1.26 to -0.75) (29 trials involving 2011 participants) with high heterogeneity between trials (I(2) = 86%; P < 0.00001). For dichotomous depression scores, the RR was 0.43 (95% CI 0.24 to 0.77) (eight trials involving 771 participants) with high heterogeneity between trials (I(2) = 77%; P < 0.0001). For continuous depression scores, the SMD was -1.91 (95% CI -2.34 to -1.48) (39 trials involving 2728 participants) with high heterogeneity between trials (I(2) = 95%; P < 0.00001). For anxiety, the SMD was -0.77 (95% CI -1.52 to -0.02) (eight trials involving 413 participants) with high heterogeneity between trials (I(2) = 92%; P < 0.00001). There was no statistically significant benefit of SSRI on cognition, death, motor deficits and leaving the trial early. For cognition, the SMD was 0.32 (95% CI -0.23 to 0.86), (seven trials involving 425 participants) with high heterogeneity between trials (I(2) = 86%; P < 0.00001). The RR for death was 0.76 (95% CI 0.34 to 1.70) (46 trials involving 3344 participants) with no heterogeneity between trials (I(2) = 0%; P = 0.85). For motor deficits, the SMD was -0.33 (95% CI -1.22 to 0.56) (two trials involving 145 participants). The RR for leaving the trial early was 1.02 (95% CI 0.86 to 1.21) in favour of control, with no heterogeneity between trials. There was a non-significant excess of seizures (RR 2.67; 95% CI 0.61 to 11.63) (seven trials involving 444 participants), a non-significant excess of gastrointestinal side effects (RR 1.90; 95% CI 0.94 to 3.85) (14 trials involving 902 participants) and a non-significant excess of bleeding (RR 1.63; 95% CI 0.20 to 13.05) (two trials involving 249 participants) in those allocated SSRIs. Data were not available on quality of life, fatigue or healthcare costs.There was no clear evidence from subgroup analyses that one SSRI was consistently superior to another, or that time since stroke or depression at baseline had a major influence on effect sizes. Sensitivity analyses suggested that effect sizes were smaller when we excluded trials at high or unclear risk of bias.Only eight trials provided data on outcomes after treatment had been completed; the effect sizes were generally in favour of SSRIs but CIs were wide.
AUTHORS' CONCLUSIONS:
SSRIs appeared to improve dependence, disability, neurological impairment, anxiety and depression after stroke, but there was heterogeneity between trials and methodological limitations in a substantial proportion of the trials. Large, well-designed trials are now needed to determine whether SSRIs should be given routinely to patients with stroke
Values Mapping and Counter-Mapping in Contested Landscapes: an Olympic Peninsula (USA) Case Study
Indigenous peoples, local communities, and other groups can use counter-mapping to make land claims, identify areas of desired access, or convey cultural values that diverge from the dominant paradigm. While sometimes created independently, counter-maps also can be formulated during public participation mapping events sponsored by natural resource planning agencies. Public participation mapping elicits values, uses, and meanings of landscapes from diverse stakeholders, yet individuals and advocacy groups can use the mapping process as an opportunity to make visible strongly held values and viewpoints. We present three cases from the Olympic Peninsula in Washington State to illustrate how stakeholders intentionally used landscape-values mapping workshops to amplify their perspectives in attempts to further political outcomes. We combine geospatial analysis with qualitative data to explore ways that landscape-values mapping were used as a political tool and how social scientists engaged in similar efforts can defend the scientific integrity of results
Multiple Methods of Public Engagement: Disaggregating Socio-spatial Data for Environmental Planning in Western Washington, USA
Highlights
• The effectiveness of participatory GIS approaches at engaging different publics was explored.
• Online surveys engaged urbanites; community workshops engaged rural residents.
• Urban and rural residents went to similar places but engaged in different activities.
• Use of multiple data collection methods will broaden public engagement.
• Mapping behavior studies are needed to improve understandings of PPGIS data quality
Items on a Perceived Environment Tool are Grouped Differently in Low and High Income African American Women
Purpose: Prevalence of physical inactivity is greater in African American (AA) women than any other population sub group. The neighborhood environment is an important influence on physical activity, and accurate measurement of neighborhood perceptions is needed to determine the influence of neighborhood environment on physical activity. The purpose of this study was to investigate the stability of constructs represented by items from the International Prevalence Study (IPS) environmental module among high and low income AA women. Method: African American women (N=387) completed the IPS environmental module questionnaire which measured perception of neighborhood environment. A principle component analysis with varimax rotation was conducted using fifteen of seventeen items from the survey. Factor analysis was conducted separately for high and low income participants. Results: Four factors with eigenvalues ≥ 1.0 were extracted from the 15 item questionnaire for both groups. These four factors accounted for 56.6% of total variance in the high income group, and 53.1% of total variance in the low income group. The four factors for the high income group were Aesthetic Qualities and Social Environment, Neighborhood Safety, Neighborhood Infrastructure, and Destinations and Street Connectivity. The four factors for the low income group were Aesthetic Qualities and Social Environment, Neighborhood Safety, Opportunities to be active and Street Connectivity, and Public Transportation. Conclusion: The factors extracted for high and low income AA women may have been different due to dissimilarities in neighborhood infrastructure, design and quality. Inconsistent grouping of items into factors from the same instrument used to measure perceptions of neighborhood environment underscores the importance of accounting for differences in how high and low income residents perceive their neighborhood when considering physical activity interventions and policies
Methods and Compositions Comprising a C-Terminal Bax Peptide (US)
The invention describes the use of the protein, Bax, as a potential therapeutic treatment for cancer
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