Empowering Female Entrepreneurs Through Mentorship in Medellin, Colombia: Results from the Field

Utilizing the power of local knowledge and peer networking, this study attempts to quantify the impacts of mentorship among female micro-entrepreneurs in Medellin, Colombia on empowerment. Developing countries such as Colombia have disproportionately high rates of unprofitable micro-businesses, many of which are managed by women. Internal constraints, such as disempowerment, play a central role in perpetuating poverty. We implement a 6-month mentoring intervention by pairing 18 successful entrepreneurs with 52 disadvantaged female, micro-entrepreneurs in Medellin, Colombia to measure the additional benefit of localized knowledge to micro-borrowers. Using a process of random assignment, I measure the change in female empowerment, measured by its impact on support, self-confidence, self-efficacy, locus of control, aspirations, and positivity among mentees. I use principal component analysis and ANCOVA analysis to measure the mentorship effect on these psychological well-being variables. I find that mentorship increases female empowerment by .71 deviations in the short-run. Treatment effects disappear in the long-run. Moderation analysis suggests that mentor-quality is an important indicator of heterogenous treatment effects

An Overview of Antithrombotics in Ischemic Stroke

The use of antithrombotic medications is an important component of ischemic stroke treatment and prevention. This article reviews the evidence for best practices for antithrombotic use in stroke with focused discussion on the specific agents used to treat and prevent stroke

Telehealth Stroke Education For Rural Elderly Virginians

Objective: Stroke is a prevalent condition found in elderly, rural populations. However, stroke education, which can be effective in addressing the risks, is often difficult to provide in these remote regions. The objective of this study is to evaluate the effectiveness of delivering stroke education to elderly individuals through telehealth versus in-person stroke prevention education methods. Materials and Methods: A quasi-experimental nonequivalent control group design was used in this study. A convenience sample of 11 elderly adults (36% men, 64% women) with a mean age of 70 was selected from an Appalachian Program for All Inclusive Care for the Elderly (day care) facility. Subjects completed preintervention surveys, received a 20-min group in-person or telehealth delivered education session, and then completed the postintervention surveys. Results: Satisfaction with delivery method and post-education knowledge was equivalent between the two groups. Knowledge increased in both groups after the educational programs. Likelihood of reducing risk factors showed no differences pre-posttest. However, there were significant improvements in the pre-post likelihood scores of the telehealth group in contrast to the in-person group. Conclusions: This project provided a rural, high-risk population access to telehealth stroke education, thus enabling these individuals to receive education at a distance from experts in the field. The telehealth program was found to be equivalent to in-person stroke education in regards to satisfaction, knowledge, and likelihood of making changes to decrease vascular risk factors. The study demonstrated feasibility in providing effective stroke education through telehealth, thus suggesting an often overlooked route for providing patient education at a distance

The TeleStroke Mimic (TM)‐Score: A Prediction Rule for Identifying Stroke Mimics Evaluated in a Telestroke Network

Background: Up to 30% of acute stroke evaluations are deemed stroke mimics (SM). As telestroke consultation expands across the world, increasing numbers of SM patients are likely being evaluated via Telestroke. We developed a model to prospectively identify ischemic SMs during Telestroke evaluation. Methods and Results: We analyzed 829 consecutive patients from January 2004 to April 2013 in our internal New England–based Partners TeleStroke Network for a derivation cohort, and 332 cases for internal validation. External validation was performed on 226 cases from January 2008 to August 2012 in the Partners National TeleStroke Network. A predictive score was developed using stepwise logistic regression, and its performance was assessed using receiver‐operating characteristic (ROC) curve analysis. There were 23% SM in the derivation, 24% in the internal, and 22% in external validation cohorts based on final clinical diagnosis. Compared to those with ischemic cerebrovascular disease (iCVD), SM had lower mean age, fewer vascular risk factors, more frequent prior seizure, and a different profile of presenting symptoms. The TeleStroke Mimic Score (TM‐Score) was based on factors independently associated with SM status including age, medical history (atrial fibrillation, hypertension, seizures), facial weakness, and National Institutes of Health Stroke Scale >14. The TM‐Score performed well on ROC curve analysis (derivation cohort AUC=0.75, internal validation AUC=0.71, external validation AUC=0.77). Conclusions: SMs differ substantially from their iCVD counterparts in their vascular risk profiles and other characteristics. Decision‐support tools based on predictive models, such as our TM Score, may help clinicians consider alternate diagnosis and potentially detect SMs during complex, time‐critical telestroke evaluations

Acute Physiology and Chronic Health Evaluation II and Simplified Acute Physiology Score II in Predicting Hospital Mortality of Neurosurgical Intensive Care Unit Patients

We study the predictive power of Acute Physiology and Chronic Health Evaluation II (APACHE II) and Simplified Acute Physiology Score II (SAPS II) in neurosurgical intensive care unit (ICU) patients. Retrospective investigation was conducted on 672 consecutive ICU patients during the last 2 yr. Data were collected during the first 24 hours of admission and analyzed to calculate predicted mortality. Mortality predicted by two systems was compared and, multivariate analyses were then performed for subarachnoid hemorrhage (SAH) and traumatic brain injury (TBI) patients. Observed mortality was 24.8% whereas predicted mortalities were 37.7% and 38.4%, according to APACHE II and SAPS II. Calibration curve was close to the line of perfect prediction. SAPS II was not statistically significant according to a Lemeshow-Hosmer test, but slightly favored by area under the curve (AUC). In SAH patients, SAPS II was an independent predictor for mortality. In TBI patients, both systems had independent prognostic implications. Scoring systems are useful in predicting mortality and measuring performance in neurosurgical ICU setting. TBI patients are more affected by systemic insults than SAH patients, and this discrepancy of predicting mortality in each neurosurgical disease prompts us to develop a more specific scoring system targeted to cerebral dysfunction

Angiopoietin-1 is associated with cerebral vasospasm and delayed cerebral ischemia in subarachnoid hemorrhage

<p>Abstract</p> <p>Background</p> <p>Angiopoietin-1 (Ang-1) and -2 (Ang-2) are keyplayers in the regulation of endothelial homeostasis and vascular proliferation. Angiopoietins may play an important role in the pathophysiology of cerebral vasospasm (CVS). Ang-1 and Ang-2 have not been investigated in this regard so far.</p> <p>Methods</p> <p>20 patients with subarachnoid hemorrhage (SAH) and 20 healthy controls (HC) were included in this prospective study. Blood samples were collected from days 1 to 7 and every other day thereafter. Ang-1 and Ang-2 were measured in serum samples using commercially available enzyme-linked immunosorbent assay. Transcranial Doppler sonography was performed to monitor the occurrence of cerebral vasospasm.</p> <p>Results</p> <p>SAH patients showed a significant drop of Ang-1 levels on day 2 and 3 post SAH compared to baseline and HC. Patients, who developed Doppler sonographic CVS, showed significantly lower levels of Ang-1 with a sustained decrease in contrast to patients without Doppler sonographic CVS, whose Ang-1 levels recovered in the later course of the disease. In patients developing cerebral ischemia attributable to vasospasm significantly lower Ang-1 levels have already been observed on the day of admission. Differences of Ang-2 between SAH patients and HC or patients with and without Doppler sonographic CVS were not statistically significant.</p> <p>Conclusions</p> <p>Ang-1, but not Ang-2, is significantly altered in patients suffering from SAH and especially in those experiencing CVS and cerebral ischemia. The loss of vascular integrity, regulated by Ang-1, might be in part responsible for the development of cerebral vasospasm and subsequent cerebral ischemia.</p

Sozialberatung in Sozialdienst der Bundeswehr als paedagogische Aufgabe

'Aus dem komplexen Bereich der Beratungsvielfalt soll auf empirischer Grundlage speziell die Sozialberatung im Sozialdienst der Bundeswehr als paedagogische Aufgabe untersucht werden. Zu diesem Zweck sollen wissenschaftliche Erkenntnisse darueber gewonnen werden, inwieweit es moeglich ist, unter den gegebenen administrativen Voraussetzungen dem hohen Anspruch der vom Dienstherrn gesetzlich festgelegten Fuersorgepflicht gegenueber den Bediensteten zu entsprechen. Ordnungsfunktional wird aus Verstaendnisgruenden strukturierend vorgegangen. In einem ersten Schritt erfolgt die deskriptive Darlegung der Beratung allgemein in der sozialen Arbeit. In einem zweiten Schritt wird Beratung im massgeblichen Sozialhilferecht aufgezeigt. Der dritte Schritt ist befasst mit der Entwicklung und Aufgabenstellung des Sozialdienstes der Bundeswehr und dessen zwei Komponenten Sozialberatung und Sozialarbeit.' Aus der Auseinandersetzung mit der verwaltungsjuristischen Festlegung des sozialberatenden Auftrags und mit den paedagogischen Grundvoraussetzungen, Bezuegen und Strukturen fuer die Sozialberatung als paedagogische Aufgabe folgend, wird die Sozialberatung als Gespraech untersucht und erlaeutert. 'Die sich daraus ergebenden Klarstellungen und Richtigstellungen ergeben die Unterteilung der Sozialberatung in zwei Aufgabenbereiche, den beratungsadaequaten Individualbereich und den Unterrichtsbereich unter Beruecksichtigung bundeswehrspezifischer Eigenheiten. Eine besondere Untersuchung gilt der Sozialberatung im Alter, bei Krankheit und in Todesfaellen. Die aus wissenschaftlicher Sicht praxisrelevanten Folgerungen fuer die Vermittlung von Beratungskompetenzen an die Beratenden beschliessen diese Arbeit in einem Organisationsmodell fuer die dienstliche Fortbildung der Sozialberatenden.' (IAB2)Available from IAB-91-LA75.4-40 BG 584 / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekSIGLEDEGerman