Randomized assessment of imatinib in patients with acute ischaemic stroke treated with intravenous thrombolysis

BackgroundImatinib, a tyrosine kinase inhibitor, has been shown to restore bloodâ brain barrier integrity and reduce infarct size, haemorrhagic transformation and cerebral oedema in stroke models treated with tissue plasminogen activator. We evaluated the safety of imatinib, based on clinical and neuroradiological data, and its potential influence on neurological and functional outcomes.MethodsA phase II randomized trial was performed in patients with acute ischaemic stroke treated with intravenous thrombolysis. A total of 60 patients were randomly assigned to four groups [3 (active): 1 (control)]; the active treatment groups received oral imatinib for 6 days at three dose levels (400, 600 and 800 mg). Primary outcome was any adverse event; secondary outcomes were haemorrhagic transformation, cerebral oedema, neurological severity on the National Institutes of Health Stroke Scale (NIHSS) at 7 days and at 3 months and functional outcomes on the modified Rankin scale (mRS).ResultsFour serious adverse events were reported, which resulted in three deaths (one in the control group and two in the 400â mg dose group; one patient in the latter group did not receive active treatment and the other received two doses). Nonserious adverse events were mostly mild, resulting in full recovery. Imatinib ameliorated neurological outcomes with an improvement of 0.6 NIHSS points per 100 mg imatinib (P = 0.02). For the 800â mg group, the mean unadjusted and adjusted NIHSS improvements were 4 (P = 0.037) and 5 points (P = 0.012), respectively, versus controls. Functional independence (mRS 0â 2) increased by 18% versus controls (61 vs. 79; P = 0.296).ConclusionThis phase II study showed that imatinib is safe and tolerable and may reduce neurological disability in patients treated with intravenous thrombolysis after ischaemic stroke. A confirmatory randomized trial is currently underway.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/136298/1/joim12576_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/136298/2/joim12576.pd

Youth representations of environmental protest

A necessary condition for a functioning democracy is the participation of its citizens, including its youth. This is particularly true for political participation in environmental decisions because these decisions can have intergenerational consequences. In this article we examine young people’s beliefs about one form of political participation - protest - in the context of communities affected by fracking and associated anti-fracking protest, and discuss the implications of these representations for education. Drawing on focus groups with 121 young people (age 15-19) in 5 schools and colleges near sites which have experienced anti-fracking protest in England and Northern Ireland, we find young people well-informed about avenues for formal and non-formal political participation against a background of disillusionment with formal political processes and varying levels of support for protest. We find representations of protest as disruptive, divisive, extreme, less desirable than other forms of participation, and ineffective in bringing about change but effective in awareness-raising. These representations are challenging, not least because the way protest is interpreted is critical to the way people think and act in the world. These representations of environmental protest must be challenged through formal education in order to safeguard the UN Convention on the Rights of the Child and ensure that the spirit of Article 11 of the UK Human Rights Act is protected

Risk Society and Representations of Risks: Earthquakes and Beyond

This chapter explores how lay publics respond to potential disasters. It contends that the current risk perception field largely neglects the common-sense beliefs and emotions that lie at the root of public responses to risks. The chapter challenges several of the assumptions that buttress the conventional construal of the terms ‘risk’ and ‘perception’. It proposes that the current focus on how the individual mind cognitively processes predictable, calculable phenomena should be replaced by emphasis on how emotional and socio-cultural beings represent often unknowable potential catastrophes. Social representations theory is put forward as a viable theoretical framework within which this shift could be achieved. The chapter illustrates the value of a social representations approach to studying risk by presenting the findings of a cross-cultural study examining social representations of earthquakes in cities at risk of earthquakes in the US, Japan and Turkey. The chapter concludes by proposing routes by which the findings of such studies could be channelled into behavioural intervention programmes

Taking global crises in the news seriously: Notes from the dark side of globalization

From climate change to the war on terror, from financial meltdowns to forced migrations, from pandemics to world poverty and from humanitarian disasters to the denial of human rights, these and other global crises represent the dark side of our global age. They are spawned by it. When represented within today’s world news ecology such ‘global crises’ can also shape processes of globalization — deepening our sense of globality and, possibly, contributing to what Ulrich Beck’s discerns as a ‘cosmopolitan outlook’ (Beck, 2006). With too few exceptions, however, researchers have yet to theorize and examine today’s endemic, interpenetrating and proliferating global crises or their complex dependencies on the world’s news media and emergent forms of global journalism. This article elaborates on these claims and sets out the case for taking global crises seriously, both ontologically and epistemologically, and how they can variously become enacted within the complex flows and formations of global news