It’s not all about the music:online fan communities and collecting Hard Rock Café pins

Previous studies of music fan culture have largely centered on the diverse range of subcultures devoted to particular genres, groups, and stars. Where studies have moved beyond the actual music and examined the fashion, concerts, and collecting ephemera such as vinyl records and posters, they have tended to remain closely allied to notions of subcultural distinction, emphasizing hierarchies of taste. This paper shifts the focus in music fan studies beyond the appreciation of the music and discusses the popular fan practice of collecting souvenir pins produced and sold by the Hard Rock Café (HRC) within a framework of fan tourism. Traveling to and collecting unique pins from locations across the globe creates a fan dialogue that centers on tourism and the collecting practices associated with souvenir consumption. Collectors engage in practices such as blogging, travel writing, and administration that become important indicators of their particular expression of fandom: pin collecting. Membership requires both time and money; recording visits around the world and collecting unique pins from every café builds fans' cultural capital. This indicates an internationalization of popular fandom, with the Internet acting as a connective virtual space between local and national, personal and public physical space. The study of HRC pin collecting and its fan community suggests that HRC enthusiasts are not so because they enjoy rock music or follow any particular artist but due to the physical ephemera that they collect and the places and spaces they visit

Living with Star trek: utopia, community, self-improvement and the Star trek universe

Living with Star Trek investigates the connections between Star Trek fandom and the Star Trek text. This study identifies and examines the American themes of utopia, community and self-improvement inherent within the fictional text which also form the thematic framework for letters written by fans to express their affection for the series. These letters represent a `network of support', whereby a community of fans is able to communicate with each other through written correspondence sent to producers, edited collections, and fan magazines. In talking about the series, fans confess and share intimate stories, often based around trauma or bereavement, and at the same time describe how Star Trek has played an important and inspirational part in their daily lives; Star Trek's utopian vision and communal spirit has given them the impetus to enact positive change. Drawing together the themes identified in the text and fan letters, the first half of the thesis examines Star Trek's use of history, narrative and myth to tell its futuristic stories. In particular, I examine how Star Trek has used the distinctive literary tradition of the Puritan American Jeremiad to create a didactic narrative that emphasises the attainment of utopia through communal effort and personal change. The second half of the thesis continues this inquiry by examining a range of letters that describe how fans are able to tap into the open nature of the Star Trek text and use it to fulfil needs and desires in their own daily lives. In particular, I stress how the letters are not just examples of fan affection but also represent a reciprocal relationship where fans can criticise and engage with the programme as well as use it as a form of motivation

Destination Antwerp! Fan tourism and the transcultural heritage of <i>A Dog of Flanders</i>

Antwerp, the fictional home of Nello &amp; Patrasche from A Dog of Flanders (1872) written by Marie Louise de la Ram&#233;e, attracts thousands of tourists every year to see the city and get close to the fictional text. European children&#8217;s literature such as this inspires dedicated fans who long to make more real the imagined spaces described by authors. The city and associated monuments and markers become sites of secular pilgrimage; people traveling to them experience children&#8217;s literary culture as localheritage. Traveling across borders, visiting these European spaces of children&#8217;s literature, taking official and unofficial tours, and listening to the stories which people share while physically present help to secure a place in which international fans can play with notions of local identity and culturalheritage. Or, as Yi-Fu Tuan argues, &#8220;When space feels thoroughly familiar to us, it has become place.&#8221; This case study seeks to interrogate the importance of place in the transcultural fan community of A Dog of Flanders. I analyse the touristic pilgrimage to Antwerp and the social/communal rituals associated with what John Urry calls the &#8220;mediatised gaze&#8221; as fans inhabit spaces typically reserved for city locals. This paper also considers the importance of place in the transcultural fan community of European children&#8217;s literature, discussing how glocalization allows texts to travel across international borders and encourage transcultural appropriation

Results of a UK-wide vignette study with occupational therapists to explore cognitive screening post-stroke

Background. There is a paucity of evidence in the UK regarding occupational therapy (OT) cognitive screening, and whether, and how, cognitive impairments are identified and assessed. AimsTo identify current OT practice for the assessment of cognitive problems in patients following stroke.MethodsOTs were invited to complete an online vignette study. Participants were asked to identify any presenting cognitive problems, decide whether to complete cognitive assessments and list any assessments they would use. Data were analysed using descriptive analysis.Findings Fifty-three OTs from across the UK participated. OTs identified key cognitive issues but some problems, such as apraxia and attention, were overlooked. A large number of potential assessments were suggested: the most common were the Montreal Cognitive Assessment and Oxford Cognitive Screen. Conclusion The variation found in OTs’ recognition and assessment of cognitive problems has potential to impact on management and rehabilitation in stroke services, survivor outcomes, education and research

Why Are Outcomes Different for Registry Patients Enrolled Prospectively and Retrospectively? Insights from the Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF).

Background: Retrospective and prospective observational studies are designed to reflect real-world evidence on clinical practice, but can yield conflicting results. The GARFIELD-AF Registry includes both methods of enrolment and allows analysis of differences in patient characteristics and outcomes that may result. Methods and Results: Patients with atrial fibrillation (AF) and ≥1 risk factor for stroke at diagnosis of AF were recruited either retrospectively (n = 5069) or prospectively (n = 5501) from 19 countries and then followed prospectively. The retrospectively enrolled cohort comprised patients with established AF (for a least 6, and up to 24 months before enrolment), who were identified retrospectively (and baseline and partial follow-up data were collected from the emedical records) and then followed prospectively between 0-18 months (such that the total time of follow-up was 24 months; data collection Dec-2009 and Oct-2010). In the prospectively enrolled cohort, patients with newly diagnosed AF (≤6 weeks after diagnosis) were recruited between Mar-2010 and Oct-2011 and were followed for 24 months after enrolment. Differences between the cohorts were observed in clinical characteristics, including type of AF, stroke prevention strategies, and event rates. More patients in the retrospectively identified cohort received vitamin K antagonists (62.1% vs. 53.2%) and fewer received non-vitamin K oral anticoagulants (1.8% vs . 4.2%). All-cause mortality rates per 100 person-years during the prospective follow-up (starting the first study visit up to 1 year) were significantly lower in the retrospective than prospectively identified cohort (3.04 [95% CI 2.51 to 3.67] vs . 4.05 [95% CI 3.53 to 4.63]; p = 0.016). Conclusions: Interpretations of data from registries that aim to evaluate the characteristics and outcomes of patients with AF must take account of differences in registry design and the impact of recall bias and survivorship bias that is incurred with retrospective enrolment. Clinical Trial Registration: - URL: http://www.clinicaltrials.gov . Unique identifier for GARFIELD-AF (NCT01090362)

Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.

BACKGROUND: The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. METHODS AND RESULTS: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012-2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3-2.3) versus 2.3 (IQR 1.8-2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32-9.35) vs 4.34 (4.16-4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. CONCLUSION: Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

Improved risk stratification of patients with atrial fibrillation: an integrated GARFIELD-AF tool for the prediction of mortality, stroke and bleed in patients with and without anticoagulation.

OBJECTIVES: To provide an accurate, web-based tool for stratifying patients with atrial fibrillation to facilitate decisions on the potential benefits/risks of anticoagulation, based on mortality, stroke and bleeding risks. DESIGN: The new tool was developed, using stepwise regression, for all and then applied to lower risk patients. C-statistics were compared with CHA2DS2-VASc using 30-fold cross-validation to control for overfitting. External validation was undertaken in an independent dataset, Outcome Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF). PARTICIPANTS: Data from 39 898 patients enrolled in the prospective GARFIELD-AF registry provided the basis for deriving and validating an integrated risk tool to predict stroke risk, mortality and bleeding risk. RESULTS: The discriminatory value of the GARFIELD-AF risk model was superior to CHA2DS2-VASc for patients with or without anticoagulation. C-statistics (95% CI) for all-cause mortality, ischaemic stroke/systemic embolism and haemorrhagic stroke/major bleeding (treated patients) were: 0.77 (0.76 to 0.78), 0.69 (0.67 to 0.71) and 0.66 (0.62 to 0.69), respectively, for the GARFIELD-AF risk models, and 0.66 (0.64-0.67), 0.64 (0.61-0.66) and 0.64 (0.61-0.68), respectively, for CHA2DS2-VASc (or HAS-BLED for bleeding). In very low to low risk patients (CHA2DS2-VASc 0 or 1 (men) and 1 or 2 (women)), the CHA2DS2-VASc and HAS-BLED (for bleeding) scores offered weak discriminatory value for mortality, stroke/systemic embolism and major bleeding. C-statistics for the GARFIELD-AF risk tool were 0.69 (0.64 to 0.75), 0.65 (0.56 to 0.73) and 0.60 (0.47 to 0.73) for each end point, respectively, versus 0.50 (0.45 to 0.55), 0.59 (0.50 to 0.67) and 0.55 (0.53 to 0.56) for CHA2DS2-VASc (or HAS-BLED for bleeding). Upon validation in the ORBIT-AF population, C-statistics showed that the GARFIELD-AF risk tool was effective for predicting 1-year all-cause mortality using the full and simplified model for all-cause mortality: C-statistics 0.75 (0.73 to 0.77) and 0.75 (0.73 to 0.77), respectively, and for predicting for any stroke or systemic embolism over 1 year, C-statistics 0.68 (0.62 to 0.74). CONCLUSIONS: Performance of the GARFIELD-AF risk tool was superior to CHA2DS2-VASc in predicting stroke and mortality and superior to HAS-BLED for bleeding, overall and in lower risk patients. The GARFIELD-AF tool has the potential for incorporation in routine electronic systems, and for the first time, permits simultaneous evaluation of ischaemic stroke, mortality and bleeding risks. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier for GARFIELD-AF (NCT01090362) and for ORBIT-AF (NCT01165710)