'The thieving magpie'? No evidence for attraction to shiny objects.

It is widely accepted in European culture that magpies (Pica pica) are unconditionally attracted to shiny objects and routinely steal small trinkets such as jewellery, almost as a compulsion. Despite the long history of this folklore, published accounts of magpies collecting shiny objects are rare and empirical evidence for the behaviour is lacking. The latter is surprising considering that an attraction to bright objects is well documented in some bird species. The present study aims to clarify whether magpies show greater attraction to shiny objects than non-shiny objects when presented at the same time. We did not find evidence of an unconditional attraction to shiny objects in either captive or free-living birds. Instead, all objects elicited responses indicating neophobia in free-living birds. We suggest that humans notice when magpies occasionally pick up shiny objects because they believe the birds find them attractive, while it goes unnoticed when magpies interact with less eye-catching items. The folklore may therefore result from observation bias and cultural inflation of orally transmitted episodic events.

Establishment of primary stroke centers: a survey of physician attitudes and hospital resources.

OBJECTIVES: To survey US physicians involved in acute stroke care to determine the proportion of hospitals that currently meet the recommended Brain Attack Coalition (BAC) criteria for Primary Stroke Centers (PSC) and obtain opinions regarding the value of stroke centers. METHODS: A survey regarding the BAC guidelines for the establishment of stroke centers was mailed to 3,245 US neurologists, neurosurgeons, and emergency physicians. RESULTS: A total of 1,032 responses were received. Seventy-nine percent (range by specialty 58 to 98%) of respondents believed there was a need for stroke centers. If formal stroke center designation were established, 81% (range 72 to 90%) would like their hospital to become a PSC. Although 77% of respondents believed that their hospital currently met recommended criteria for a PSC, only 7% actually meet all recommended elements. However, 44% of hospitals already provide most acute stroke services. The BAC criteria most frequently lacking were continuing medical education for professional stroke center staff, stroke training for emergency department staff, formal establishment of a stroke unit, and designation of a stroke center director. CONCLUSIONS: The majority of emergency medicine and neuroscience physician respondents involved in acute stroke care support the designation of primary stroke centers. Although respondents globally overestimated the extent to which their facilities currently meet BAC recommended criteria for PSC, detailed responses suggested that over 40% of hospitals possess substantial existing acute stroke care resources and are poised to function as PSC with modest additional administrative and financial commitment.

Recommendations for the establishment of primary stroke centers. Brain Attack Coalition.

OBJECTIVE: To develop recommendations for the establishment and operation of primary stroke centers as an approach to improve the medical care of patients with stroke. PARTICIPANTS: Members of the Brain Attack Coalition (BAC), a multidisciplinary group of representatives from major professional organizations involved with delivering stroke care. Supplemental input was obtained from other experts involved in acute stroke care. EVIDENCE: A review of literature published from 1966 to March 2000 was performed using MEDLINE. More than 600 English-language articles that had evidence from randomized clinical trials, meta-analyses, care guidelines, or other appropriate methods supporting specific care recommendations for patients with acute stroke that could be incorporated into a stroke center model were selected. CONSENSUS PROCESS: Articles were reviewed initially by 1 author (M.J.A.). Members of the BAC reviewed each recommendation in the context of current practice parameters, with special attention to improving the delivery of care to patients with acute stroke, cost-effectiveness, and logistical issues related to the establishment of primary stroke centers. Consensus was reached among all BAC participants before an element was added to the list of recommendations. CONCLUSIONS: Randomized clinical trials and observational studies suggest that several elements of a stroke center would improve patient care and outcomes. Key elements of primary stroke centers include acute stroke teams, stroke units, written care protocols, and an integrated emergency response system. Important support services include availability and interpretation of computed tomography scans 24 hours everyday and rapid laboratory testing. Administrative support, strong leadership, and continuing education are also important elements for stroke centers. Adoption of these recommendations may increase the use of appropriate diagnostic and therapeutic modalities and reduce peristroke complications. The establishment of primary stroke centers has the potential to improve the care of patients with stroke. JAMA. 2000.

Neurologic mechanisms in psychoneuroimmunology.

Synthesizing the neurologic mechanisms of psychoneuroimmunology (PNI) into a schematic model serves as a basis to enhance understanding of the complex interactions within the PNI framework. The examination of current research in physiology, neurotransmission, hormonal mechanisms, immunologic function and stress allows for the creation of a neurological model to depict hypothetical interactions of these systems. This model of neurological mechanisms in PNI can serve as the basis for integrating PNI in nursing practice. It is hoped that the model will serve as a bridge to understanding the neuroscience component of PNI and stimulate further research.

Precipitous decrease in blood pressure in acute ischemic stroke patients during transesophageal echocardiography: a case study from the adult brain attack database.

Transesophageal echocardiography is often the diagnostic modality used for evaluation of cardiovascular sources of cerebral emboli. While invasive, TEE has proven to be a safe diagnostic method. However, TEE may have hemodynamic consequences within the procedure that are potentially hazardous to the specific population of acute ischemic stroke patients. As the case study and resultant discussion illustrated, specific interventions may theoretically interrupt the possible mechanisms responsible for the precipitous decrease in blood pressure. Further investigation of methods to prevent precipitous decrease in blood pressure and to identify potential negative outcomes for ischemic stroke patients must continue within the clinical setting.

Assessment and management of hypertension in the acute ischemic stroke patient.

The assessment and treatment of hypertension in the patient with acute ischemic stroke is a controversial issue in the overall management of such patients. The primary physiologic and pathologic concepts at the core of the issue are autoregulatory failure and shift, cytotoxic and vasogenic edema, vascular pathology and hemorrhage. Clues about the interrelationships of these factors to hypertension in the acute stroke patient are available to the nurse. By integrating pathophysiologic concepts with knowledge gained during assessment of stroke onset, patient history and clinical presentation, the nurse is better prepared to monitor and provide care for the acute stroke patient.