The Effect of Computed Tomography Perfusion (CTP) Scans on Acute Ischemic Stroke Patients at a Comprehensive Stroke Center

Objective: The DEFUSE 3 and DAWN trials have revealed that stroke patients may be eligible for mechanical thrombectomy up to 24 hours from symptom onset with appropriate perfusion imaging. The purpose of the study is to evaluate the impact CTP imaging will have patient selection and outcomes at a Comprehensive Stroke Center. Methods: This study is a retrospective and prospective chart review comparing acute ischemic stroke patients evaluated for mechanical thrombectomy utilizing CT angiogram verses CT perfusion imaging from January 1, 2018- June 30th 2019 at a Comprehensive Stroke Center. Results: Of the 129 patients who received CTAs, 36 patients received mechanical thrombectomy. This is compared to the 73 patients that received CTP scanning, and 26 patients were found to be eligible for mechanical thrombectomy. There were no significant findings regarding patient selection for mechanical thrombectomy regarding the number of patients that received mechanical thrombectomy, complication rates, and change in NIHSS from admission to discharge. Conclusion: The addition of CTP imaging at the Comprehensive Stroke Center demonstrated that patients can successfully be given mechanical thrombectomy in the extended intervention window of up to 24 hours from last known well

Questions of agency: capacity, subjectivity, spatiality and temporality

Geographies of Children, Youth and Families is flourishing, but its founding conceptions require critical reflection. This paper considers one key conceptual orthodoxy: the notion that children are competent social actors. In a field founded upon liberal notions of agency, we identify a conceptual elision between the benefits of studying agency and the beneficial nature of agency. Embracing post-structuralist feminist challenges, we propose a politically-progressive conceptual framework centred on embodied human agency which emerges within power. We contend this can be achieved though intensive/extensive analyses of space, and a focus on biosocial beings and becomings within dynamic notions of individual/intergenerational time

Geographies of education and learning

Geographies of education and learnin

Investment in Education Technology Across the Globe: Where Profit Meets Purpose

Increasing demand for educational technology (Ed Tech) products and services has coincided with rapid growth in the marketplace, sparking opportunity for both innovation and entrepreneurship. This paper seeks to advise ed tech entrepreneurs on what motivates investors to support certain products over others, the importance of balancing financial returns (profit) and educational outcomes (purpose), and best practices in planning and execution to help ensure success when taking their products to market

Neoliberalism, policy localisation and idealised subjects: a case study on educational restructuring in England

Debate about neoliberalism has been a defining drama of twenty-first century geography. Appreciation of the contingent nature of neoliberalization has promoted interest in the localization of policy, and this paper furthers debate in three ways. Firstly, it highlights the importance of the peopling of the state and more specifically the importance of everyday public sector workers in the localized production of roll-out neoliberalization. Secondly, it illustrates the significance of these actors’ ideas about idealised policy subjects -- and the ways they relate these to their own client groups in different socio-economic neighbourhoods -- in the localised emergence of policy. Thirdly, it explores the consequences of this for geographically and socially uneven service provision under neoliberalization. These arguments are illustrated through a case study focus on educational restructuring under New Labour. Our focus is on the Extended Service initiative which combines workfare and family policy agenda by giving primary schools a duty provide/signpost: wraparound childcare; enrichment activities for children; and parenting support. The case study explores how headteachers’ understandings of idealised neoliberal parenting subject positions, and their notions of ideal childhoods, shape their attitudes to the implementation of this programme in schools serving different socio-economic communities. This process not only involves the reproduction of classed, (de)gendered, and heterosexed discourses seen in national policy, but also moments where local actors draw on alternative models of parenting and/or childhood to influence school-based policy, with the result that what is perceived to be ‘good’ for families of one social class is not seen to be so for others. There is a complex politics at play here. Academics must both expose the class biases inherent in neoliberal policies, at the same time as they work as ‘critical friends’ in improving public service provision which impacts positively on some individuals’ lives

Enriching children, institutionalizing childhood? Geographies of play, extracurricular activities, and parenting in England

Geographical research on children, youth, and families has done much to highlight the ways in which children's lives have changed over the last twenty-five years. A key strand of research concerns children's play and traces, in the Global North, a decline in children's independent access to, and mobility through, public space. This article shifts the terrain of that debate from an analysis of what has been lost to an exploration of what has replaced it. Specifically, it focuses on children's participation in enrichment activities, including both individual and collective extracurricular sporting, cultural, and leisure opportunities in England. The research reveals that middle-class children have much higher participation rates in enrichment activities than their working-class counterparts. Parents value enrichment activities in very similar ways across the class spectrum-seeing them as fun, healthy, and social opportunities. The ability to pay for enrichment, however, means that it is incorporated into, and transforms, middle-class family life in ways not open to working-class families. Nevertheless, support across the class spectrum for these instrumental forms of play that institutionalize childhood in school, community, and commercial spaces leads to calls for subsidized provision for low-income children through schools. The article thus traces the "enrichment" and "institutionalization" of childhood and draws out the implications of this for how we think about play, education, parenting, and class in geography. © 2014 Copyright © Sarah L. Holloway and Helena Pimlott-Wilson. Published by Taylor & Francis

“Any advice is welcome isn’t it?”: neoliberal parenting education, local mothering cultures and social class

Geographers have shown considerable interest in neoliberal educational restructuring as states across the Global North have sought to respond to the challenges of economic change through the development of a skilled population. Existing research provides a wide-ranging analysis of the ways neoliberal states seek to shape individual citizens through their own learning. Greater attention now needs to be paid to new and developing ways in which they seek to influence the context in which future citizen-workers are raised. This paper focuses on parenting education which is growing across OECD countries. Social science critiques suggest that parenting classes are part of a professionalisation of parenting which has sought to impose middle-class mores on working-class parents, at the same time as parenting has been unwarrantedly cast as a context-free skill. This paper uses quantitative and qualitative data to explore the attitudes of parents of different social class positions to parenting education, tracing the ways these emerge in and through particular sociospatial contexts. The paper reveals the importance of local class-based cultures of mothering in influencing both the attitudes of individual mothers to parenting classes, and the success of neoliberal policy implementation in diverse socioeconomic neighbourhoods. In conclusion the paper emphasises: the importance of geographical research into newly emerging forms of education; the value of engaging with the subjects of neoliberal education policy because their attitudes influence its implementation in practice; and the need to set educational provision in its wider geographical context, as this can shape the success of policies delivered in and through educational institutions

New economy, neoliberal state and professionalized parenting: mothers’ labour market engagement and state support for social reproduction in class-differentiated Britain

Contemporary economic, political and social shifts in the Global North are reconfiguring the resolution of productive and reproductive labour. This paper explores how the emergence of the New Economy, the rolling out of the neoliberal state, and the professionalization of parenting are transforming: (i) the landscape in which mothers with primary-school-aged children make decisions about how to secure a living and care for their children; and (ii) what role they think the state should play in facilitating the provision of childcare to support working parenthood. The paper makes two innovation contributions to knowledge. Firstly, it pinpoints strongly class-differentiated changes in women’s reconciliation of paid employment and caring work in contemporary Britain. The academically dominant one-and-a-half breadwinner model is commonly reflected in middle-class lifestyles, but has little analytical purchase for working-class women in this study, as they are more likely to mother full-time in state-dependent family households. It is vital that we understand these differences in women’s labour-force participation and their implications for class inequality. Secondly, the paper concentrates academic attention on the sweeping expansion in the state’s role in social reproduction through the provision of wraparound childcare (breakfast and afterschool clubs) in primary schools. Novel insights into parental attitudes reveal that middle-class women demand choice and feel entitled to state-sponsored childcare provision which underpins the feminisation of the labour force. Working class women value provision for others, but fear being coerced into using childcare instead of mothering in the home. Their responses reveal competing understandings of what counts as equality for women, and stark variations in different women’s abilities to achieve this

Educational mobility and the gendered geography of cultural capital: the case of international student flows between Central Asia and the UK

International student mobility from East to West has grown rapidly as the middle classes have sought to reproduce their advantage in the context of changing socioeconomic circumstances. Existing research shows that middle-class students and their parents are increasingly using overseas educational qualifications — an institutionalised form of cultural capital — to ensure that they stand out in the competition for lucrative employment. This paper makes two unique contributions to these debates. Firstly, it broadens the spatial frame away from East Asia to the emerging educational markets in post-Soviet Central Asia, and specifically Kazakhstan. This shift allows examination of similarities in students’ accrual of cultural capital between regions, but also highlights spatial specificity in these flows. Secondly, it moves beyond narrowly class-based approaches to spotlight the importance of gender, sexuality, and religion in geographies of cultural capital. Middle-class social reproduction helps drive international student mobility, but class is experienced diff erently by young men and women in the context of locally specific forms of heterosexuality which in this case study reflect the cultural importance of Islam. Class matters, but to fully understand its importance in student mobility we must trace its intersections with other axes of social difference

New economics of assistive technology: A call for a missions approach

An estimated 90% of the one billion people who require a particular assistive product (AP) do not have access to that device. The lack of an AP, a device which helps to enable human life, is especially poignant within low- and middle-income countries. Issues that affect access to appropriate AP are currently seen through the lens of supply and demand-side failures. Actions and policies that try to address access to assistive technology (AT) through a limited market failure perspective will not be able to deliver AT in the comprehensive way necessary to meet need, while ensuring the AT is user-appropriate and of high quality. In order to meet user need, new thinking is needed that recognises the value of AT by considering how the AT innovation ecosystem creates meaningful economic and social value. In order to unleash the full potential of AT value, this paper proposes a public sector-led, mission-oriented approach. While setting the mission and the directionality is the role of government, NGOs, industry, AT users and the charity sector are able to drive forward the agenda of AT access through their own essential and complementary roles. A mission-oriented approach will use tools such as market-shaping and stakeholder co-creation to set an agenda by which AT innovation and access can be positioned as a meaningful step in tackling societal challenges. Through a missions approach the value of AT will be properly captured and society can come closer to addressing issues surrounding healthy ageing, enabling human capability and equity