Preventable stroke and stroke prevention

Stroke is a major cause of death and disability in the world. The main causes of stroke are atherothromboembolism and cardiogenic embolism. The main causal and treatable risk factors for atherothromboembolic ischemic stroke are increasing blood pressure (BP), increasing cholesterol, cigarette smoking and diabetes; and the main risk factors for cardiogenic ischemic stroke are atrial fibrillation (AF) and ischemic heart disease. Strategies to reduce the incidence of stroke include prevention of first-ever and recurrent stroke, and treatment of patients with acute stroke to reduce death and disability. The two main strategies of stroke prevention are the 'population' (or 'mass') approach and the 'high risk' approach. The 'population' approach aims to reduce stroke by lowering the prevalence and mean level of causal risk factors in the community, by means of public education and government legislation. The 'high risk' approach aims to reduce stroke by identifying individuals at high risk of stroke, and lowering their risk by means of optimal medical therapies. Level 1 evidence from randomized controlled trials indicates that effective treatments for high risk patients include control of causal risk factors (lowering BP, lowering blood cholesterol), antithrombotic therapy (antiplatelet therapy with aspirin, clopidogrel, or the combination of aspirin and dipyridamole for patients in sinus rhythm, and anticoagulation with warfarin or ximelagatran for patients in AF) and, where appropriate, carotid revascularization for patients with severe carotid stenosis.     

Investigating rating scale category utility

Eight guidelines are suggested to aid the analyst in investigating whether rating scales categories are cooperating to produce observations on which valid measurement can be based. These guidelines are presented within the context of Rasch analysis. They address features of rating-scale-based data such as category frequency, ordering, rating-to-measure inferential coherence, and the quality of the scale from measurement and statistical perspectives. The manner in which the guidelines prompt recategorization or reconceptualization of the rating scale is indicated. Utilization of the guidelines is illustrated through their application to two published data sets.     

Investigating change in a nursing context

This paper focuses on 'why', 'what' and 'how' issues as they relate to the investigation of change in a nursing context. The why issues revolve around the need for change, and evolutionary and revolutionary change are discussed. Next the what issues are discussed and some variables involved in the change process are identified, and the role of change agents is outlined. Change strategies such as the power-coercive, the rational-empirical and the normative-re-education are discussed. Finally, the potential of action research in the context of bringing about change is advanced.     

Investigating the removal of body piercings

Although body piercing procurement continues to increase, 13% to 18% of them are removed. Reasons for piercing removal in college students were examined with three groups: (a) those who kept all their piercings, (b) those who removed some, or (c) those who removed all of their body piercings. Of the sample, 41% were still pierced; 50% in their lifetime. Their major purpose for the body piercing was "helped them feel unique." Females obtained more (in high school) and then removed more, usually as upperclassmen. Males and females reported themselves as risk takers at procedure time and currently; however, only 10% cited deviancy as a reason for the body piercing(s). Only removal elements of "I just got tired of it" and "I just decided to remove it" were present, especially with the Some Removed Group. Further examination of body piercing building personal distinctiveness and self-identity to promote their need of uniqueness is suggested.     

Investigating perfluorohexane particles with high-frequency ultrasound

Submicron particles filled with liquid perfluorocarbon are currently being studied as a potential ultrasound-targeted contrast agent. The objective of this study was to evaluate the scattering properties of these particles. Sets of perfluorohexane-filled particles of different average sizes (300 nm to 1000 nm) were produced with a constant total volume fraction. The attenuation coefficient was measured in the 15- to 50-MHz frequency range and was found to increase smoothly with frequency and to be independent of the amplitude and bandwidth of the transmitted pulse. The values range from 0.31 to 0.64 dB/mm at 30 MHz for mean particle size ranging from 970 to 310 nm, respectively. The backscattering spectra of the particle solutions were measured and showed no sign of nonlinear scattering. The backscattering coefficient increased with the power 3.9 +/- 0.3 of the frequency. These results confirm that liquid perfluorocarbon droplets behave as linear Rayleigh scatterers.