The following study tries to establish whether it is possible to ascertain participation as an important factor of vulnerability to climate change. The thesis is therefore: the quality of ...participation influences vulnerability to climate change. In order to examine the thesis, vulnerability to climate change is defined, and the quality of participation is operationalised with the five most important dimensions. This model is then applied to a case study of a decision-making process on flood protection measures for south-west Ljubljana. Semi- -structured in-depth interviews and an analysis of written communication sources are used. Important deficiencies regarding all five of the most important dimensions of participation are discovered and, therefore, it can be concluded that in the analysed case a low quality of participation enabled the vulnerability to remain high.
Pričujoča študija poizkuša ugotoviti, ali lahko med dejavnike ranljivosti na podnebne spremembe štejemo tudi participacijo. Teza članka se glasi: kakovost participacije vpliva na ranljivost na ...podnebne spremembe. Za preverjanje teze je opredeljena ranljivost na podnebne spremembe in operacionalizirana kakovost participacije s pomočjo petih najpomembnejših dimenzij. Ta model je nato preverjen na odločevalskem postopku zagotavljanja poplavne varnosti jugozahodnega dela Ljubljane z uporabo poglobljenih polstrukturiranih intervjujev in analizo pisnih komunikacijskih virov. Ugotovljene so pomembne pomanjkljivosti v upoštevanju vseh petih najpomembnejših opredeljenih dimenzij participacije, zaradi česar je mogoče sklepati, da je nizka kakovost participacije omogočila ohranjanje visoke ranljivosti.
Background
The neurotrophic drug Cerebrolysin accelerated recovery and prevented acute neuronal damage in preclinical models of ischaemia. Previous clinical trials support therapeutic effects in ...stroke patients. The study investigated whether the combination with alteplase and Cerebrolysin is safe and can further reduce disability after acute ischaemic stroke.
Methods
This placebo-controlled, double-blind trial involved 119 patients with acute ischaemic hemispheric stroke, randomly assigned to a combined treatment with alteplase plus Cerebrolysin or placebo (administered 1 h after thrombolytic treatment) starting within three-hours after onset of symptoms. A daily i.v. infusion of 30 ml Cerebrolysin or placebo was given for 10 consecutive days. Primary outcome was the modified Rankin Scale at day 90. A sequential design with interim analyses was applied.
Results
The third interim analysis did not show a benefit in the modified Rankin Scale for Cerebrolysin on day 90 compared to placebo and the study was stopped. The National Institutes of Health Stroke Scale responder analysis (secondary outcome measure) showed significantly more patients with an improvement of 6 or more points (or a total score of 0 or 1) after two-, five-, 10, and 30 days in the Cerebrolysin group. Similar trends were observed for the modified Rankin Scale responder analysis without achieving statistical significance. There was no difference between treatment groups regarding adverse events.
Conclusions
The combination of Cerebrolysin with recombinant tissue-Plasminogen Activator is safe for treatment of acute ischaemic stroke but did not improve outcome at day 90. During the treatment period with Cerebrolysin (10 days), significantly more patients had a favourable response in neurological outcome measures (National Institutes of Health Stroke Scale) as compared to the placebo group.
