CarolFest 2008, December 2, 2008

Concert Program for CarolFest 2008, December 2, 2008

International survey of acute stroke imaging used to make revascularization treatment decisions.

BACKGROUND: To assess the differences across continental regions in terms of stroke imaging obtained for making acute revascularization therapy decisions, and to identify obstacles to participating in randomized trials involving multimodal imaging. METHODS: STroke Imaging Repository (STIR) and Virtual International Stroke Trials Archive (VISTA)-Imaging circulated an online survey through its website, through the websites of national professional societies from multiple countries as well as through email distribution lists from STIR and the above mentioned societies. RESULTS: We received responses from 223 centers (2 from Africa, 38 from Asia, 10 from Australia, 101 from Europe, 4 from Middle East, 55 from North America, 13 from South America). In combination, the sites surveyed administered acute revascularization therapy to a total of 25,326 acute stroke patients in 2012. Seventy-three percent of these patients received intravenous (i.v.) tissue plasminogen activator (tPA), and 27%, endovascular therapy. Vascular imaging was routinely obtained in 79% (152/193) of sites for endovascular therapy decisions, and also as part of standard IV tPA treatment decisions at 46% (92/198) of sites. Modality, availability and use of acute vascular and perfusion imaging before revascularization varied substantially between geographical areas. The main obstacles to participate in randomized trials involving multimodal imaging included: mainly insufficient research support and staff (50%, 79/158) and infrequent use of multimodal imaging (27%, 43/158) . CONCLUSION: There were significant variations among sites and geographical areas in terms of stroke imaging work-up used tomake decisions both for intravenous and endovascular revascularization. Clinical trials using advanced imaging as a selection tool for acute revascularization therapy should address the need for additional resources and technical support, and take into consideration the lack of routine use of such techniques in trial planning.

L'Oeuvre sociale : revue des indépendants

1901/01 (NOUV SER,N1)-1901/08 (A2,NOUV SER,N8).

L'Oeuvre sociale (Paris. 1900)

Variante(s) de titre : L'Oeuvre sociale : revue de propagande socialiste

L'Oeuvre sociale : revue des indépendants

1900/05/15 (N5)-1900/08 (N8).

The book of Niagara Falls /

On cover : Steele's book of Niagara Falls.

A guide to travelers visiting the Falls of Niagara : containing much interesting and important information respecting the Falls and vicinity /

Twelve editions published between 1834 and 1849. 1st and 2d eds. published under title: A guide to travelers visiting the Falls of Niagara ; 3d-6th eds. under title: The book of Niagara Falls ; and 7th-12th eds. under title: Steele's book of Niagara Falls.

Steele's book of Niagara Falls /

"Illustrated by maps of the Falls and immediate vicinity, and of the Niagara River, from Lake Erie to Lake Ontario, and six new views."

Exploring Perceptions of Accessibility, Necessity and Use of Social Support for Wilderness Therapy Field Instructors

Organizations offering therapeutic wilderness programming have a responsibility to ensure the well-being of their front line employees. A system of social support that is formed through communication with others, either personally or professionally, can assist field instructors in effectively managing the demands arising from their work. Phenomenological analysis of semi-structured interview transcripts from seven participants provided insight on perceptions of necessity, accessibility and use of social support. Fourteen main themes and thirteen subthemes emerged from the data. Findings are presented using the six components of Parsons’ (1980) staff development model and strongly suggest program managers consider and apply specific measures aimed at increasing the social support for front line field instructors in a wilderness therapy work context.