Acute post-stroke blood pressure relative to premorbid levels in intracerebral haemorrhage versus major ischaemic stroke: a population-based study.

BACKGROUND It is often assumed that blood pressure increases acutely after major stroke, resulting in so-called post-stroke hypertension. In view of evidence that the risks and benefits of blood pressure-lowering treatment in acute stroke might differ between patients with major ischaemic stroke and those with primary intracerebral haemorrhage, we compared acute-phase and premorbid blood pressure levels in these two disorders. METHODS In a population-based study in Oxfordshire, UK, we recruited all patients presenting with stroke between April 1, 2002, and March 31, 2012. We compared all acute-phase post-event blood pressure readings with premorbid readings from 10-year primary care records in all patients with acute major ischaemic stroke (National Institutes of Health Stroke Scale >3) versus those with acute intracerebral haemorrhage. FINDINGS Of 653 consecutive eligible patients, premorbid and acute-phase blood pressure readings were available for 636 (97%) individuals. Premorbid blood pressure (total readings 13,244) had been measured on a median of 17 separate occasions per patient (IQR 8-31). In patients with ischaemic stroke, the first acute-phase systolic blood pressure was much lower than after intracerebral haemorrhage (158·5 mm Hg [SD 30·1] vs 189·8 mm Hg [38·5], p<0·0001; for patients not on antihypertensive treatment 159·2 mm Hg [27·8] vs 193·4 mm Hg [37·4], p<0·0001), was little higher than premorbid levels (increase of 10·6 mm Hg vs 10-year mean premorbid level), and decreased only slightly during the first 24 h (mean decrease from <90 min to 24 h 13·6 mm Hg). By contrast with findings in ischaemic stroke, the mean first systolic blood pressure after intracerebral haemorrhage was substantially higher than premorbid levels (mean increase of 40·7 mm Hg, p<0·0001) and fell substantially in the first 24 h (mean decrease of 41·1 mm Hg; p=0·0007 for difference from decrease in ischaemic stroke). Mean systolic blood pressure also increased steeply in the days and weeks before intracerebral haemorrhage (regression p<0·0001) but not before ischaemic stroke. Consequently, the first acute-phase blood pressure reading after primary intracerebral haemorrhage was more likely than after ischaemic stroke to be the highest ever recorded (OR 3·4, 95% CI 2·3-5·2, p<0·0001). In patients with intracerebral haemorrhage seen within 90 min, the highest systolic blood pressure within 3 h of onset was 50 mm Hg higher, on average, than the maximum premorbid level whereas that after ischaemic stroke was 5·2 mm Hg lower (p<0·0001). INTERPRETATION Our findings suggest that systolic blood pressure is substantially raised compared with usual premorbid levels after intracerebral haemorrhage, whereas acute-phase systolic blood pressure after major ischaemic stroke is much closer to the accustomed long-term premorbid level, providing a potential explanation for why the risks and benefits of lowering blood pressure acutely after stroke might be expected to differ. FUNDING Wellcome Trust, Wolfson Foundation, UK Medical Research Council, Stroke Association, British Heart Foundation, National Institute for Health Research.

Competitividade em clusters de alta tecnologia: estudo comparativo de clusters de ciências da saúde no Brasil e na Inglaterra

Este trabalho teve como objetivo desenvolver um modelo específico para analisar a competitividade de clusters de alta tecnologia. Foi realizado um estudo de casos múltiplos em que foram analisados os clusters de ciências da saúde de Ribeirão Preto, no Brasil, e de Oxfordshire, na Inglaterra. Coletaram-se dados primários e secundários. Os dados primários foram coletados por meio de entrevistas em ambos os clusters e os dados secundários por meio de relatórios, papers, websites, além de coleta realizada nos bancos de dados Fame e Orbis. O modelo Zaccarelli et al. (2008), utilizado como ponto de partida para o desenvolvimento do modelo, foi aprimorado de três maneiras: i. Por meio do ajustamento das métricas utilizadas para avaliar cada fundamento, o que incluiu, dentre outras coisas, uma adaptação do modelo para mapeamento de clusters desenvolvido por Todeva (2008); ii. Pela verificação da aderência de seus fundamentos aos clusters de alta tecnologia analisados; e iii. Pela identificação de fatores emergentes, importantes para competitividade de clusters de alta tecnologia. Os resultados mostram evidências de que entre os onze fundamentos do modelo original, nove se mostraram relevantes aos clusters de alta tecnologia, ratificando sua importância para a análise da competitividade de clusters. Além dos fundamentos originais, os resultados sugerem a inclusão de dois fundamentos emergentes: \"Inserção em cadeias globais\" e \"Disponibilidade de investimentos financeiros\", até então ignorados pelo modelo Zaccarelli et al. (2008). A pesquisa traz como contribuição teórica o desenvolvimento de um modelo específico para clusters de alta tecnologia; como contribuição metodológica as novas métricas, incluindo a incorporação da adaptação da metodologia de Todeva (2008); como contribuição empírica traz a comparação entre clusters de ciências da saúde reconhecidamente competitivos, mas pertencentes a países de realidades culturais e econômicas distintas; e como contribuição gerencial um modelo que pode ser utilizado por empresários e instituições pertencentes a clusters e que desejam analisar fatores que influenciam a sua competitividade.

London, England and vicinity, 1890 (Raster Image)

This layer is a georeferenced raster image of the historic paper map entitled: Environs of London. It was published by W.H. Smith & Son ca. 1890. Scale [1:63,360]. Covers London and portions of the counties of Buckinghamshire, Oxfordshire, Hertfordshire, Essex, Kent, Surrey, and Berkshire. The image inside the map neatline is georeferenced to the surface of the earth and fit to the British National Grid coordinate system (British National Grid, Airy Spheroid OSGB (1936) Datum). All map collar and inset information is also available as part of the raster image, including any inset maps, profiles, statistical tables, directories, text, illustrations, index maps, legends, or other information associated with the principal map. This map shows features such as roads, railroads, drainage, ground cover, built-up areas, selected buildings, parks, cemeteries, towns, villlages, union and county boundaries, and more. Relief is shown by hachures. Includes legend. This layer is part of a selection of digitally scanned and georeferenced historic maps from The Harvard Map Collection as part of the Imaging the Urban Environment project. Maps selected for this project represent major urban areas and cities of the world, at various time periods. These maps typically portray both natural and manmade features at a large scale. The selection represents a range of regions, originators, ground condition dates, scales, and purposes.

The ecclesiastical and architectural topography of England.

Many of the ill. in pts. 4 and 7 are wood engravings by C. and O. Jewitt.

Verses wise and otherwise /

Paperbound in brown; printed paper label on front cover.

Heard melodies /

Mode of access: Internet.

Folk-dance airs /

"The dance-airs in this collection were noted down in Oxfordshire, Gloucestershire, Devonshire, Somerset, and Derbyshire."

The Gentleman's magazine library : being a classified collection of the chief contents of the Gentleman's magazine from 1731 to 1868 /

Vol. 4 has cover title: English traditions and foreign customs.

The lately discovered fragments of Menander/

Text in Greek with commentary, notes, and translations in English.

Views of the most interesting collegiate and parochial churches in Great Britain : including screens, fonts, monuments, &c. &c. : with historical and architectural descriptions /

No more published.

The parliaments of England, from 1st George I., to the present time.

I. Bedfordshire to Nottinghamshire inclusive.--II. Oxfordshire to Wales inclusive.--III. The disfranchised boroughs, Scotland, Ireland, &c.

The new Oxford guide, or, Companion through the university : exhibiting every particular worthy, the observation of the curious in each of the public buildings, colleges, halls, &c. : to which is added, A tour to Blenheim, Ditchley, Heythrop, Nuneham, and Stow ... containing an accurate description of their tapestry, paintings, sculptures, temples, gardens, and other curiosities /

Date from NUC vol. 413, p. 268.

Chaucerian and other pieces /

"Being a supplement to the Complete works of Geoffrey Chaucer (Oxford, in six volumes, 1894)."

Experiments and Archives in the Expanded Field

All This Stuff: Archiving the Artist explores the documentation of the creative process. From their different viewpoints, fifteen leading artists, archivists and art historians reflect on the ways that artists and archivists deal with all this stuff , and how artists manage and relate to their own archives. This is a timely and important book, based on work initiated by the Art Archives Committee of ARLIS, the Art Libraries Society of the UK and Ireland. The book addresses issues from the perspectives of the archivist as well as those of the artist. At a time when more members of the library profession are being asked to manage artists archives, it is important to address the challenges associated with the special nature of this material. All This Stuff: Archiving the Artist provides artists and researchers valuable insights into the archival process, addressing questions such as what material should artists be keeping? What will happen to their material after it has been accepted by an archive? It also explores how an archivist or researcher can approach an artist s archive in a non-traditional way. The experiences described by the different contributors offer a practical understanding of the challenges facing researchers working with artists archives, and will help to raise awareness among artists of the longer-term value of their archival material, and the unpredictable ways in which it may be recontextualised, explored and interpreted in the future.

Non-comital women of twelfth-century England: a charter based analysis

This thesis sets out to explore the place and agency of non-comital women in twelfth-century Anglo-Norman England. Until now, broad generalisations have been applied to all aristocratic women based on a long established scholarship on royal and comital women. Non-comital women have been overlooked, mainly because of an assumed lack of suitable sources from this time period. The first aim of this thesis is to demonstrate that there is a sufficient corpus of charters for a study of this social group of women. It is based on a database created from 5545 charters, of which 3046 were issued by non-comital women and men, taken from three case study counties, Oxfordshire, Suffolk and Yorkshire, and is also supported by other government records. This thesis demonstrates that non-comital women had significant social and economic agency in their own person. By means of a detailed analysis of charters and their clauses this thesis argues that scholarship on non-comital women must rethink the framework applied to the study of non-comital women to address the lifecycle as one of continuities and as active agents in a wider public society. Non-comital women’s agency and identity was not only based on land or in widowhood, which has been the one period in their life cycles where scholars have recognised some level of autonomy, and women had agency in all stages of their life cycle. Women’s agency and identity were drawn from and part of a wider framework that included their families, their kin, and broader local political, religious, and social networks. Natal families continued to be important sources of agency and identity to women long after they had married. Part A of the thesis applies modern charter diplomatic analysis methods to the corpus of charters to bring out and explore women’s presence therein. Part B contextualises these findings and explores women’s agency in their families, landholding, the gift-economy, and the wider religious and social networks of which they were a part.