The Virtual International Stroke Trials Archive

Background and Purpose - Stroke has global importance and it causes an increasing amount of human suffering and economic burden, but its management is far from optimal. The unsuccessful outcome of several research programs highlights the need for reliable data on which to plan future clinical trials. The Virtual International Stroke Trials Archive aims to aid the planning of clinical trials by collating and providing access to a rich resource of patient data to perform exploratory analyses. Methods - Data were contributed by the principal investigators of numerous trials from the past 16 years. These data have been centrally collated and are available for anonymized analysis and hypothesis testing. Results - ”Currently, the Virtual International Stroke Trials Archive contains 21 trials. There are data on 15 000 patients with both ischemic and hemorrhagic stroke. Ages range between 18 and 103 years, with a mean age of 6912 years. Outcome measures include the Barthel Index, Scandinavian Stroke Scale, National Institutes of Health Stroke Scale, Orgogozo Scale, and modified Rankin Scale. Medical history and onset-to-treatment time are readily available, and computed tomography lesion data are available for selected trials. Conclusions - This resource has the potential to influence clinical trial design and implementation through data analyses that inform planning. (Stroke. 2007;38:1905-1910.)

Stroke severity, early recovery and outcome are each related with clinical classification of stroke: data from the 'Tinzaparin in Acute Ischaemic Stroke Trial (TAIST)

Introduction: Baseline severity and clinical stroke syndrome (Oxford Community Stroke Project, OCSP) classification are predictors of outcome in stroke. We used data from the ‘Tinzaparin in Acute Ischaemic Stroke Trial’ (TAIST) to assess the relationship between stroke severity, early recovery, outcome and OCSP syndrome. Methods: TAIST was a randomised controlled trial assessing the safety and efficacy of tinzaparin versus aspirin in 1,484 patients with acute ischaemic stroke. Severity was measured as the Scandinavian Neurological Stroke Scale (SNSS) at baseline and days 4, 7 and 10, and baseline OCSP clinical classification recorded: total anterior circulation infarct (TACI), partial anterior circulation infarct (PACI), lacunar infarct (LACI) and posterior circulation infarction (POCI). Recovery was calculated as change in SNSS from baseline at day 4 and 10. The relationship between stroke syndrome and SNSS at days 4 and 10, and outcome (modified Rankin scale at 90 days) were assessed. Results: Stroke severity was significantly different between TACI (most severe) and LACI (mildest) at all four time points (p<0.001), with no difference between PACI and POCI. The largest change in SNSS score occurred between baseline and day 4; improvement was least in TACI (median 2 units), compared to other groups (median 3 units) (p<0.001). If SNSS did not improve by day 4, then early recovery and late functional outcome tended to be limited irrespective of clinical syndrome (SNSS, baseline: 31, day 10: 32; mRS, day 90: 4); patients who recovered early tended to continue to improve and had better functional outcome irrespective of syndrome (SNSS, baseline: 35, day 10: 50; mRS, day 90: 2). Conclusions: Although functional outcome is related to baseline clinical syndrome (best with LACI, worst with TACI), patients who improve early have a more favourable functional outcome, irrespective of their OCSP syndrome. Hence, patients with a TACI syndrome may still achieve a reasonable outcome if early recovery occurs.

Results of a feasibility study: barriers and facilitators in implementing the Sherbrooke model in France.

International audience

Chronic low back pain, chronic disability at work, chronic management issues.

International audience

Gender and East Asian Welfare States: from Confucianism to Gender Equality

How can we understand the gender logic underpinning the welfare states/systems of East Asia? Does the comparative literature, which has largely been concerned with western Welfare states, whether in The Three Worlds of Welfare Capitalism (Esping-Andersen 1990), or in gender-based analysis of the male breadwinner model (Lewis 1992, 2001, 2006), have anything to offer in understanding the gender assumptions underpinning East Asian welfare states? Are the welfare systems of East Asian countries distinctive, with Confucian assumptions hidden beneath the surface commitment to gender equality? We will use the (mainly western) comparative literature, but argue that Confucian influences remain important, with strong assumptions of family, market and voluntary sector responsibility rather than state responsibility, strong expectations of women’s obligations, without compensating rights, a hierarchy of gender and age, and a highly distinctive, vertical family structure, in which women are subject to parents-in-law. In rapidly changing economies, these social characteristics are changing too. But they still put powerful pressures on women to conform to expectations about care, while weakening their rights to security and support. Nowhere do welfare states’ promises bring gender equality in practice. Even in Scandinavian countries women earn less, care more, and have less power than men. We shall compare East Asian countries (Japan, Korea, Taiwan where possible) with some Western ones, to argue that some major comparative data (e.g. OECD) show the extreme situation of women in these countries. Some fine new qualitative studies give us a close insight into the experience of mothers, including lone and married mothers, which help us to understand how far the gender assumptions of welfare states are from Scandinavia’s dual earner model. There are signs of change in society as well as in economy, and room for optimism that women’s involvement in social movements and academic enquiry may be challenging Confucian gender hierarchies.

Low Test Scores in Latin America: Poor Schools, Poor Families, or Something Else?

Latin American students consistently score low on international tests of cognitive skills. In the PISA 2012 results, students in seven Latin American countries had an average score of 395, or about 100 points lower than the average score of 497 in four Scandinavian countries. We examine why Latin American scores are lower and conclude that 50 points are explained by Latin American families’ lower average educational and socioeconomic characteristics, 25 points are explained by Latin America’s weak cultural orientation toward reading books, and the remaining 25 points are explained by the lower effectiveness of educational systems in teaching cognitive skills.

Conflicts of interest in dermatology

Conflicts of interest exist in dermatology when professional judgement concerning a primary interest, such as research validity, may be influenced by a secondary interest, such as financial gain from a for-profit organization. Conflict of interest is a condition and not a behaviour, although there is clear evidence that gifts influence behaviour. Little has been written about conflicts of interest in dermatology. This series of papers raises awareness of the subject by exploring it in greater depth from the perspective of a dermatology researcher, an industry researcher, a dermatology journal editor, a health services researcher and a patient representative. Collectively, they illustrate the many ways in which conflicts can pervade the world of dermatology publications and patient support group activities.

Wind turbine indirect ice detection and operational analysis

Wind energy is one of the most promising and fast growing sector of energy production. Wind is ecologically friendly and relatively cheap energy resource available for development in practically all corners of the world (where only the wind blows). Today wind power gained broad development in the Scandinavian countries. Three important challenges concerning sustainable development, i.e. energy security, climate change and energy access make a compelling case for large-scale utilization of wind energy. In Finland, according to the climate and energy strategy, accepted in 2008, the total consumption of electricity generated by means of wind farms by 2020, should reach 6 - 7% of total consumption in the country [1]. The main challenges associated with wind energy production are harsh operational conditions that often accompany the turbine operation in the climatic conditions of the north and poor accessibility for maintenance and service. One of the major problems that require a solution is the icing of turbine structures. Icing reduces the performance of wind turbines, which in the conditions of a long cold period, can significantly affect the reliability of power supply. In order to predict and control power performance, the process of ice accretion has to be carefully tracked. There are two ways to detect icing – directly or indirectly. The first way applies to the special ice detection instruments. The second one is using indirect characteristics of turbine performance. One of such indirect methods for ice detection and power loss estimation has been proposed and used in this paper. The results were compared to the results directly gained from the ice sensors. The data used was measured in Muukko wind farm, southeast Finland during a project 'Wind power in cold climate and complex terrain'. The project was carried out in 9/2013 - 8/2015 with the partners Lappeenranta university of technology, Alstom renovables España S.L., TuuliMuukko, and TuuliSaimaa.

Português língua de herança em contexto plurilingue na Finlândia : aspetos de aquisição/aprendizagem da competência pragmática e expressão da delicadeza

Os fluxos migratórios das últimas décadas têm contribuído para que as comunidades de falantes de português se estabeleçam um pouco por todo o mundo, nomeadamente, nos países escandinavos. Um desses países de acolhimento, a Finlândia, tem desenvolvido esforços para a integração dos imigrantes que aí se estabelecem, designadamente, através da promoção de políticas de língua, que visam o ensino da língua de herança aos alunos em idade escolar. Tem sido neste contexto que as pequenas comunidades lusófonas, a viverem no país, têm podido facultar aos filhos, imigrantes de primeira e segunda gerações, acesso ao ensino formal da sua língua de herança, o português. Os sujeitos da nossa amostra fazem parte de uma dessas pequenas comunidades e residem em Tampere, na Finlândia, onde frequentam escolas cuja língua de ensino é o finlandês. O presente trabalho pretende, por um lado, dar conta da realidade sociocultural daqueles alunos de Português Língua Não-Materna, e, por outro, visa refletir sobre a aquisição/ aprendizagem da competência pragmática por parte destes sujeitos, falantes de herança, através da realização que fazem de atos ilocutórios diretivos – de pedido e de ordem –, bem como, sobre o grau de formalização das expressões de delicadeza que fazem. Por conseguinte, elaborámos uma Ficha Sociolinguística para recolha de dados referentes ao contexto familiar, sociocultural e linguístico dos alunos. Posteriormente, elaborámos e aplicámos um teste linguístico, de Tarefas de Elicitação do Discurso, com vista à recolha de dados para a construção de um corpus linguístico que nos permitisse desenvolver o presente estudo. A aplicação do teste linguístico e consequente tratamento dos dados recolhidos revelaram que as escolhas pragmáticas dos sujeitos são condicionadas pelo contexto sociocultural e linguístico em que estão imersos. Constatámos, igualmente, que a generalidade dos alunos recorre a duas estratégias de mitigação do discurso, pelo uso de duas expressões de delicadeza: a fórmula «se faz favor»/«por favor» e o verbo modal «poder».

The Westerly Index as complementary indicator of the North Atlantic oscillation in explaining drought variability across Europe

This paper analyses the influence of different atmospheric circulation indices on the multi-scalar drought variability across Europe by using the Standardized Precipitation Evapotranspiration Index (SPEI). The monthly circulation indices used in this study include the North Atlantic oscillation (NAO), the East Atlantic (EA), the Scandinavian (SCAN) and the East Atlantic-Western Russia (EA-WR) patterns, as well as the recently published Westerly Index (WI), defined as the persistence of westerly winds over the eastern north Atlantic region. The results indicate that European drought variability is better explained by the station-based NAO index and the WI than by any other combination of circulation indices. In northern and central Europe the variability of drought severity for different seasons and time-scales is strongly associated with the WI. On the contrary, the influence of the NAO on southern Europe droughts is stronger than that exerted by the WI. The correlation patterns of the NAO and WI with the SPEI show a spatial complementarity in shaping drought variability across Europe. Lagged correlations of the NAO and WI with the SPEI also indicate enough skill of both indices to anticipate drought severity several months in advance. As long as instrumental series of the NAO and WI are available, their combined use would allow inferring European drought variability for the last two centuries and improve the calibration and interpretation of paleoclimatic proxies associated with drought.

Significant Attributes and Challenges Related to Cross-Functional Team Communications

Purpose The purpose of the research work is to investigate the importance of the communication in the cross-functional teams and in what which communicational tools provide better convenience of communication in cross-functional team members. Methodology An empirical study including the data collection from the interviews conducted from the participants working in cross-functional teams. Qualitative approach has been adopted to understand the communicational attributes in the cross-functional teams. For the analysis both deductive and abductive approach has been used. With the help of theoretical framework and empirical data, conclusions drown for better understanding of the concept. Findings The author has divided the search in two main segments, communicational effects on cross-functional team performance and effectiveness of particular communicational tools used by team members and team leaders. Empirical findings shows that without proper communication, cross-functional team are less tend to perform well to achieve set goals as well as face to face communications are more effective than other communicational tools.  Research limitations The research work is limited to Scandinavian countries. Organizational communicational structures are not studied due to time factor. Other limitation of this research work is effect of cultural differences on communication. Implications The research work provides deep understanding of the different communicational effects on cross-functional team performance. The choice of communicational tool and proportional importance for the team members will help managers while selecting the tools of communication with the team members. Originality / value During the literature studies, author determined that there is potential of research for the communicational tools used in cross-functional team communications. The social media is taking over the traditional communicational tools which provide value for findings. 

A test of basic psychological needs theory in young soccer players: Time-lagged design at the individual and team levels

Within the framework of basic psychological needs theory (Deci & Ryan, 2000), multilevel structural equation modeling (MSEM) with a time-lagged design was used to test a mediation model examining the relationship between perceptions of coaches’ interpersonal styles (autonomy supportive and controlling), athletes’ basic psychological needs (satisfaction and thwarting), and indicators of well-being (subjective vitality) and ill-being (burnout), estimating separately between and within effects. The participants were 597 Spanish male soccer players aged between 11 and 14 years (M = 12.57, SD = 0.54) from 40 teams who completed a questionnaire package at two time points in a competitive season. Results revealed that at the individual level, athletes’ perceptions of autonomy support positively predicted athletes’ need satisfaction (autonomy, competence, and relatedness), whereas athletes’ perceptions of controlling style positively predicted athletes’ need thwarting (autonomy, competence, and relatedness). In turn, all three athletes’ need satisfaction dimensions predicted athletes’ subjective vitality and burnout (positively and negatively, respectively), whereas competence thwarting negatively predicted subjective vitality and competence and relatedness positively predicted burnout. At the team level, team perceptions of autonomy supportive style positively predicted team autonomy and relatedness satisfaction. Mediation effects only appeared at the individual level.

Nordic policy lessons for Australia

This report considers public debate on Scandinavian and Finnish policy ideas of possible relevance to Australia since the publication in November 2014 by an Australian university press of Andrew Scott’s book Northern Lights: The Positive Policy Example of Sweden, Finland, Denmark and Norway. Two years on from the book’s publication, the report considers the varying reception in Australia of propositions advanced in Northern Lights for: expansion of public early childhood education and care and extension of paid parental leave, as well as properly enshrining children’s rights and other actions to reduce child poverty and improve children’s wellbeing (learning from Sweden); more equitable schools funding, better valuing of a quality teaching profession and more effective provision of vocational education in schools (learning from Finland); enhancement of support and skills retraining for mature-age workers displaced by job losses (learning from Denmark); and increasing revenue including through greater taxation and regulation of natural resource wealth (learning from Norway). The report then considers the main priority areas of Nordic achievement nominated by policy actors for additional consideration for Australia to now learn from. These are: better, healthier and more natural urban design, together with more balanced regional development; better workplace design – specifically the importance of taking into account aesthetics, ergonomics and nature in people’s workplace environments; and greater emphasis on both the prevention of crime and the rehabilitation of persons convicted of crimes. Sweden and Norway’s continuing leadership in the provision of quality foreign aid and other foreign policy initiatives such as Sweden's current “feminist foreign policy” are also discussed. Objections raised to the book’s premises, including to the possibility of policy transfer to Australia from nations presumed to be less multicultural, are evaluated.

The subjunctive mood in Late Middle English adverbial clauses: the interaction of form and function

This thesis focuses on the history of the inflexional subjunctive and its functional substitutes in Late Middle English. To explore why and how the inflexional subjunctive declined in the history of English language, I analysed 2653 examples of three adverbial clauses introduced by if (1882 examples), though (305 examples) and lest (466 examples). Using a corpus-based approach, this thesis argues that linguistic change in subjunctive constructions did not happen suddenly but rather gradually, and the way it changed was varied , and that different constructions changed at different speeds in different environments. It is well known that the inflexional subjunctive declined in the history of English, mainly because of inflexional loss. Strangely however this topic has been comparatively neglected in the scholarly literature, especially with regard to the Middle English period, probably due to the limitations of data and also because study of this development requires very cumbersome textual research. This thesis has derived and analysed the data from three large corpora in the public domain: the Middle English Grammar Corpus (MEG-C for short), the Innsbruck Computer Archive of Machine-Readable English Texts (ICAMET for short), and some selected texts from The Corpus of Middle English Prose and Verse, part of the Middle English Compendium that also includes the Middle English Dictionary. The data were analysed from three perspectives: 1) clausal type, 2) dialect, and 3) textual genre. The basic methodology for the research was to analyse the examples one by one, with special attention being paid to the peculiarities of each text. In addition, this thesis draw on some complementary – indeed overlapping -- linguistic theories for further discussion: 1) Biber’s multi-dimensional theory, 2) Ogura and Wang’s (1994) S-curve or ‘diffusion’ theory, 3) Kretzchmar’s (2009) linguistics of speech, and 4) Halliday’s (1987) notion of language as a dynamic open system. To summarise the outcomes of this thesis: 1) On variation between clausal types, it was shown that the distributional tendencies of verb types (sub, ind, mod) are different between the three adverbial clauses under consideration. 2) On variation between dialects, it has been shown that the northern area, i.e. the so-called Great Scandinavian Belt, displays an especially high comparative ratio of the inflexional subjunctive construction compared to the other areas. This thesis suggests that this result was caused by the influence of Norse, relating the finding to the argument of Samuels (1989) that the present tense -es ending in the northern dialect was introduced by the influence of the Scandinavians. 3) On variation between genres, those labelled Science, Documents and Religion display relatively high ratio of the inflexional subjunctive, while Letter, Romance and History show relatively low ratio of the inflexional subjunctive. This results are explained by Biber’s multi-dimensional theory, which shows that the inflexional subjunctive can be related to the factors ‘informational’, ‘non-narrative’, ‘persuasive’ and ‘abstract’. 4) Lastly, on the inflexional subjunctive in Late Middle English, this thesis concludes that 1) the change did not happen suddenly but gradually, and 2) the way language changes varies. Thus the inflexional subjunctive did not disappear suddenly from England, and there was a time lag among the clausal types, dialects and genres, which can be related to Ogura and Wang’s S-curve (“diffusion”) theory and Kretzchmars’s view of “linguistic continuum”. This thesis has shown that the issues with regard to the inflexional subjunctive are quite complex, so that research in this area requires not only textual analysis but also theoretical analysis, considering both intra- and extra- linguistic factors.

Evaluación del desempeño de pruebas diagnósticas de tuberculosis en pacientes VIH positivo en dos hospitales públicos de Bogotá

La tuberculosis TB es una de las principales causas de muerte en el mundo en individuos con infección por VIH. En Colombia esta coinfección soporta una carga importante en la población general convirtiéndose en un problema de salud pública. En estos pacientes las pruebas diagnósticas tienen sensibilidad inferior y la enfermedad evoluciona con mayor frecuencia hacia formas diseminadas y rápidamente progresivas y su diagnóstico oportuno representa un reto en Salud. El objetivo de este proyecto es evaluar el desempeño de las pruebas diagnósticas convencionales y moleculares, para la detección de TB latente y activa pacientes con VIH, en dos hospitales públicos de Bogotá. Para TB latente se evaluó la concordancia entre las pruebas QuantiFERON-TB (QTF) y Tuberculina (PPD), sugiriendo superioridad del QTF sobre la PPD. Se evaluaron tres pruebas diagnósticas por su sensibilidad y especificidad, baciloscopia (BK), GenoType®MTBDR plus (Genotype) y PCR IS6110 teniendo como estándar de oro el cultivo. Los resultados de sensibilidad (S) y especificidad (E) de cada prueba con una prevalencia del 19,4 % de TB pulmonar y extrapulmonar en los pacientes que participaron del estudio fue: BK S: 64% E: 99,1%; Genotype S: 77,8% E: 94,5%; PCRIS6110 S: 73% E: 95,5%, de la misma forma se determinaron los valores predictivos positivos y negativos (VPP y VPN) BK: 88,9% y 94,8%, Genotype S: 77,8% E: 94,5%; PCRIS6110 S: 90% y 95,7%. Se concluyó bajo análisis de curva ROC que las pruebas muestran un rendimiento diagnóstico similar por separado en el diagnóstico de TB en pacientes con VIH, aumentando su rendimiento diagnostico cuando se combinan