Smoking and elevated blood pressure are the most important risk factors for subarachnoid hemorrhage in the Asia-Pacific region - An overview of 26 cohorts involving 306,620 participants

Background and Purpose - The cause of subarachnoid hemorrhage ( SAH) is poorly understood and there are few large cohort studies of risk factors for SAH. We investigated the risk of SAH mortality and morbidity associated with common cardiovascular risk factors in the Asia-Pacific region and examined whether the strengths of these associations were different in Asian and Australasian ( predominantly white) populations. Methods - Cohort studies were identified from Internet electronic databases, searches of proceedings of meetings, and personal communication. Hazard ratios (HRs) for systolic blood pressure (SBP), current smoking, total serum cholesterol, body mass index (BMI), and alcohol drinking were calculated from Cox models that were stratified by sex and cohort and adjusted for age at risk. Results - Individual participant data from 26 prospective cohort studies ( total number of participants 306 620) that reported incident cases of SAH ( fatal and/or nonfatal) were available for analysis. During the median follow-up period of 8.2 years, a total of 236 incident cases of SAH were observed. Current smoking (HR, 2.4; 95% CI, 1.8 to 3.4) and SBP > 140 mm Hg ( HR, 2.0; 95% CI, 1.5 to 2.7) were significant and independent risk factors for SAH. Attributable risks of SAH associated with current smoking and elevated SBP ( similar to 140 mm Hg) were 29% and 19%, respectively. There were no significant associations between the risk of SAH and cholesterol, BMI, or drinking alcohol. The strength of the associations of the common cardiovascular risk factors with the risk of SAH did not differ much between Asian and Australasian regions. Conclusions - Cigarette smoking and SBP are the most important risk factors for SAH in the Asia-Pacific region.

IS/IT outsourcing practices of small- and medium-sized manufacturers

Firms began outsourcing information system functions soon after the inception of electronic computing. Extant research has concentrated on large organizations and large-valued outsourcing contracts from a variety of different industries. Smaller-sized firms are inherently different from their large counterparts. These differences between small and large firms could lead to different information technology/information system (IT/IS) items being outsourced and different outsourcing agreements governing these arrangements. This research explores and examines the outsourcing practices of very small through to medium-sized manufacturing organizations. The in-depth case studies not only explored the extent to which different firms engaged in outsourcing but also the nuances of their outsourcing arrangements. The results reveal that all six firms tended to outsource the same sorts of functions. Some definite differences existed, however, in the strategies adopted in relation to the functions they outsourced. These differences arose for a variety of reasons, including size, locality, and holding company influences. The very small and small manufacturing firms tended to make outsourcing purchases on an ad hoc basis with little reliance on legal advice. In contrast, the medium-sized firms often used a more planned initiative and sought legal advice more often. Interestingly, not one of the six firms outsourced any of their transaction processing. These findings now give very small, small-, and medium-sized manufacturing firms the opportunity to compare their practices against other firms of similar size.