Categorizing stroke prognosis using different stroke scales

<p><b>Background and Purpose</b>: Stroke severity and dependency are often categorized to allow stratification for randomization or analysis. However, there is uncertainty whether the categorizations used for different stroke scales are equivalent. We investigated the amount of information retained by categorizing severity and dependency, and whether the currently used cut-offs are equivalent across different stroke scales.</p> <p><b>Methods</b>: Stroke severity and dependency have been categorized as mild, moderate, or severe. We studied 2 acute stroke unit cohorts, measuring Scandinavian Stroke Scale (SSS), modified Rankin Scale (mRS), Barthel Index (BI), and modified National Institutes of Health Stroke Scale (mNIHSS). Receiver operating characteristic (ROC) curves were examined to determine the ability of full and categorized scales to predict death and dependency. A weighted kappa analysis assessed agreement between the categorized scales.</p> <p><b>Results</b>: When scales are categorized, the area under the ROC curve is significantly reduced; however, the differences are small and may not be practically important. BI, mRS, and SSS all have excellent agreement with each other when categorized, whereas mNIHSS has substantial agreement with mRS and BI.</p> <p><b>Conclusions</b>: Little predictive information is lost when stroke scales are categorized. There is substantial to almost perfect agreement among categorized scales. Therefore the use and categorization of a variety of stroke severity or dependency scales is acceptable in analyses.</p&gt

Annotated bibliography on socio-economic and ecological impacts of marine protected areas in Pacific Island countries

This bibliography highlights impacts on fisheries and livelihoods attributed to coral reef marine protected areas in Pacific Island countries and territories. Included in this collection is literature that reports various forms of reef area management practiced in Pacific Island countries: reserves, sanctuaries, permanent or temporary closed areas, community and traditional managed areas.Marine parks, Environmental impact, Socioeconomic aspects, I, Pacific,

Solomon Islands national situation analysis

The CGIAR Research Program on Aquatic Agricultural Systems (CRP AAS) was approved by the CGIAR Fund Council in July, 2011. Solomon Islands, one of five countries targeted by the program, began its rollout with a five month planning phase between August and December of 2011. Subsequent steps of the Program rollout include scoping, diagnosis and design. This report is the first to be produced during the scoping phase in Solomon Islands; it addresses the national setting and provides basic information on the context within which the AAS Program will operate. The macro level subjects of analysis provide initial baselines of national level indicators, policy context, power relationships and other factors relevant to the Program

Annotated bibliography on socio-economic and ecological impacts of marine protected areas in Pacific Island countries

The bibliography is to highlight impacts on fisheries and livelihoods attributed to coral reef marine protected areas in Pacific Island countries and territories. Included in this collection is literature that reports various forms of reef area management practiced in Pacific Island countries: reserves, sanctuaries, permanent or temporary closed areas, community and traditional managed areas. (Document contains 36 pages

How do diabetes models measure up? A review of diabetes economic models and ADA guidelines

Introduction: Economic models and computer simulation models have been used for assessing short-term cost-effectiveness of interventions and modelling long-term outcomes and costs. Several guidelines and checklists have been published to improve the methods and reporting. This article presents an overview of published diabetes models with a focus on how well the models are described in relation to the considerations described by the American Diabetes Association (ADA) guidelines. Methods: Relevant electronic databases and National Institute for Health and Care Excellence (NICE) guidelines were searched in December 2012. Studies were included in the review if they estimated lifetime outcomes for patients with type 1 or type 2 diabetes. Only unique models, and only the original papers were included in the review. If additional information was reported in subsequent or paired articles, then additional citations were included. References and forward citations of relevant articles, including the previous systematic reviews were searched using a similar method to pearl growing. Four principal areas were included in the ADA guidance reporting for models: transparency, validation, uncertainty, and diabetes specific criteria. Results: A total 19 models were included. Twelve models investigated type 2 diabetes, two developed type 1 models, two created separate models for type 1 and type 2, and three developed joint type 1 and type 2 models. Most models were developed in the United States, United Kingdom, Europe or Canada. Later models use data or methods from earlier models for development or validation. There are four main types of models: Markov-based cohort, Markov-based microsimulations, discrete-time microsimulations, and continuous time differential equations. All models were long-term diabetes models incorporating a wide range of compilations from various organ systems. In early diabetes modelling, before the ADA guidelines were published, most models did not include descriptions of all the diabetes specific components of the ADA guidelines but this improved significantly by 2004. Conclusion: A clear, descriptive short summary of the model was often lacking. Descriptions of model validation and uncertainty were the most poorly reported of the four main areas, but there exist conferences focussing specifically on the issue of validation. Interdependence between the complications was the least well incorporated or reported of the diabetes-specific criterion

Towards integrated island management: lessons from Lau, Malaita, for the implementation of a national approach to resource management in Solomon Islands: final report

Solomon Islands has recently developed substantial policy aiming to support inshore fisheries management, conservation, climate change adaptation and ecosystem approaches to resource management. A large body of experience in community based approaches to management has developed but “upscaling” and particularly the implementation of nation-wide approaches has received little attention so far. With the emerging challenges posed by climate change and the need for ecosystem wide and integrated approaches attracting serious donor attention, a national debate on the most effective approaches to implementation is urgently needed. This report discusses potential implementation of “a cost-effective and integrated approach to resource management that is consistent with national policy and needs” based on a review of current policy and institutional structures and examination of a recent case study from Lau, Malaita using stakeholder, transaction and financial cost analyses

Solomon Islands: Malaita Hub scoping report

The CGIAR Research Program (CRP) Aquatic Agricultural Systems (AAS) will target five countries, including Solomon Islands. The proposed hubs for Solomon Islands were to cover most provinces, referencing the Western, Central and Eastern regions. Scoping of the initial ‘Central’ hub was undertaken in Guadalcanal, Malaita and Central Islands provinces and this report details findings from all three. As scoping progressed however, it was agreed that, based on the AAS context and priority needs of each province and the Program’s capacity for full implementation, the Central Hub would be restricted to Malaita Province only and renamed “Malaita Hub”. Consistent in each AAS country, there are four steps in the program rollout: planning, scoping, diagnosis and design. Rollout of the Program in Solomon Islands began with a five month planning phase between August and December 2011, and scoping of the first hub began in January 2012. This report, the second to be produced during rollout, describes the findings from the scoping process between January and June 2012. This report marks the transition from the scoping phase to the diagnosis phase in which output from scoping was used to develop a hub level theory of change for identifying research opportunities. Subsequent reports detail in-depth analyses of gender, governance, nutrition and partner activities and discuss Program engagement with community members to identify grass-roots demand for research