Time From Symptom Onset to Treatment and Outcomes after Thrombolytic Therapy

OBJECTIVES: This study sought to examine the relations among patient characteristics, time to thrombolysis and outcomes in the international GUSTO-I trial. BACKGROUND: Studies have shown better left ventricular function and decreased infarct size as well as increased survival with earlier thrombolysis, but the relative benefits of various thrombolytic agents with earlier administration are uncertain. METHODS: We evaluated the relations of baseline characteristics to three prospectively defined time variables: symptom onset to treatment, symptom onset to hospital arrival (presentation delay) and hospital arrival to treatment (treatment delay). We also examined the relations of delays to clinical outcomes and to the relative 30-day mortality benefit with accelerated tissue-type plasminogen activator (t-PA) versus streptokinase. RESULTS: Female, elderly, diabetic and hypertensive patients had longer delays at all stages. Previous infarction or bypass surgery was an additional risk factor for treatment delay. Early thrombolysis was associated with lower overall mortality rate ( 4 h, 9.0%), but no additional relative benefit resulted from earlier treatment with accelerated t-PA versus streptokinase (p = 0.38). Longer presentation and treatment delays were both associated with increased mortality rate (presentation delay 4 h, 8.6%; treatment delay 90 min, 8.1%). As time to treatment increased, the incidence of recurrent ischemia or reinfarction decreased, but the rates of shock, heart failure and stroke increased. CONCLUSIONS: Earlier treatment resulted in better outcomes, regardless of thrombolytic strategy. Elderly, female and diabetic patients were treated later, adding to their already substantial risk

Whole Brain Size and General Mental Ability: A Review

We review the literature on the relation between whole brain size and general mental ability (GMA) both within and between species. Among humans, in 28 samples using brain imaging techniques, the mean brain size/GMA correlation is 0.40 (N = 1,389; p < 10−10); in 59 samples using external head size measures it is 0.20 (N = 63,405; p < 10−10). In 6 samples using the method of correlated vectors to distill g, the general factor of mental ability, the mean r is 0.63. We also describe the brain size/GMA correlations with age, socioeconomic position, sex, and ancestral population groups, which also provide information about brain–behavior relationships. Finally, we examine brain size and mental ability from an evolutionary and behavior genetic perspective

An Econometric Analysis of Countries' Repayment Performance to the International Monetary Fund

While the literature on external debt repayment performance by sovereign debtors is extensive, repayment performance vis-�-vis the International Monetary Fund has not been dealt with separately. Given differences between the Fund and other providers of financial resources, this paper considers whether it is possible to distinguish through logit analysis between the countries that make timely repayments to the Fund and those that become overdue. The paper finds that the inclusion of Fund-specific financial variables and a small number of macroeconomic variables yields a highly significant econometric model of the probability of a country incurring Fund arrears.

Models for Building Knowledge in a Technology-Rich Setting: Teacher Education

Technology offers promising opportunities for creating new types of classroom learning environments. This paper describes three technology models used by teacher education interns: electronic portfolios, negotiative concept mapping, cognote-supported electronic discussions. As implemented in the current study, these models invoke graduated attributes of knowledge building and as such serve as a useful continuum of examples of the potential of technology to assist in promoting progressive knowledge construction. A description of the models is followed by a discussion of the relationship of these classrooms to Knowledge-Building principles. Résumé La technologie offre des possibilités prometteuses pour la création de nouveaux types d’environnements d’apprentissage en classe. Le présent article décrit trois modèles technologiques utilisés par les stagiaires en enseignement : portfolios électroniques, cartographie conceptuelle de négociation, discussions électroniques avec codage. Tels que mis en œuvre dans le cadre de la présente étude, ces modèles font appel à des attributs hiérarchiques de coélaboration des connaissances et constituent donc en eux-mêmes un continuum utile d’exemples illustrant comment la technologie peut aider à encourager l’élaboration progressive des connaissances. Une description des modèles est suivie d’une discussion portant sur la relation de ces classes avec les principes de coélaboration des connaissances

Accommodating Disability at University

Disabled students in Canadian universities obtain academic accommodations through an individualized service approach. The implementation of these learning supports is dependent on students' ability to navigate institutional policies and procedures that require engagement with faculty who are variably willing to respond. This study documents the experiences of disabled students and their professors as they worked to make these individual arrangements on three Nova Scotia university campuses. Findings centre the relational elements of accommodation procedures and expose their potential to reinforce and naturalize the marginal status of disabled learners while also elucidating the possibility for meaningful systemic change. Findings also situate the student/faculty relationship as an important site of inquiry and analysis for Canadian post-secondary institutions working to become more accessible for a diversity of disabled students

Countries' Repayment Performance Vis-Ã -Vis the IMF: An Empirical Analysis

While the literature on external debt repayment performance by sovereign debtors is extensive, repayment performance vis-à-vis the International Monetary Fund has not been dealt with separately. Given differences between the IMF and other providers of financial resources, this paper considers whether it is possible to distinguish through logit analysis between the countries that make timely repayments to the Fund and those that become overdue. The paper finds that the inclusion of IMF-specific financial variables and a small number of macroeconomic variables yields a highly significant econometric model of the probability of a country incurring IMF arrears.