Dialogue and professionalism in the contemporary organization

The dynamic changes as an integral part of everyday life are highly characteristic for the workplace. On the other hand, differences in cultural norms and values affect the changes specifically and add a different dimension to the processes that form the individual professionalism and the new reality in organizations expressed through collective intelligence. One of the resources for their formation is the dialogue. According to the varieties of dialogic interaction there are three types of dialogic subject and according to the prevailing type of individuals - three types of organizationsyesBelgorod State Universit

Extended Thromboprophylaxis with Betrixaban in Acutely Ill Medical Patients

Background Patients with acute medical illnesses are at prolonged risk for venous thrombosis. However, the appropriate duration of thromboprophylaxis remains unknown. Methods Patients who were hospitalized for acute medical illnesses were randomly assigned to receive subcutaneous enoxaparin (at a dose of 40 mg once daily) for 10±4 days plus oral betrixaban placebo for 35 to 42 days or subcutaneous enoxaparin placebo for 10±4 days plus oral betrixaban (at a dose of 80 mg once daily) for 35 to 42 days. We performed sequential analyses in three prespecified, progressively inclusive cohorts: patients with an elevated d-dimer level (cohort 1), patients with an elevated d-dimer level or an age of at least 75 years (cohort 2), and all the enrolled patients (overall population cohort). The statistical analysis plan specified that if the between-group difference in any analysis in this sequence was not significant, the other analyses would be considered exploratory. The primary efficacy outcome was a composite of asymptomatic proximal deep-vein thrombosis and symptomatic venous thromboembolism. The principal safety outcome was major bleeding. Results A total of 7513 patients underwent randomization. In cohort 1, the primary efficacy outcome occurred in 6.9% of patients receiving betrixaban and 8.5% receiving enoxaparin (relative risk in the betrixaban group, 0.81; 95% confidence interval [CI], 0.65 to 1.00; P=0.054). The rates were 5.6% and 7.1%, respectively (relative risk, 0.80; 95% CI, 0.66 to 0.98; P=0.03) in cohort 2 and 5.3% and 7.0% (relative risk, 0.76; 95% CI, 0.63 to 0.92; P=0.006) in the overall population. (The last two analyses were considered to be exploratory owing to the result in cohort 1.) In the overall population, major bleeding occurred in 0.7% of the betrixaban group and 0.6% of the enoxaparin group (relative risk, 1.19; 95% CI, 0.67 to 2.12; P=0.55). Conclusions Among acutely ill medical patients with an elevated d-dimer level, there was no significant difference between extended-duration betrixaban and a standard regimen of enoxaparin in the prespecified primary efficacy outcome. However, prespecified exploratory analyses provided evidence suggesting a benefit for betrixaban in the two larger cohorts. (Funded by Portola Pharmaceuticals; APEX ClinicalTrials.gov number, NCT01583218. opens in new tab.

NON-MOTOR VISUAL DISORDERS IN KAZAKHTAN PATIENTS WITH PARKINSON'S DISEASE

We observed 106 Parkinson’s patients in Almaty city to detect non-motor visual disorders. Among non-motor symptoms in patients with Parkinson’s disease (PD), visual symptoms are becoming increasingly important. Visual impairments cause severe disability, reduce compensatory ability and adaptation of the patient to motor impairments and reduce life expectancy. Many neurologists do not take into serious consideration the importance of visual disorders in PD. This type of research has never been carried out in Kazakhstan or indeed the rest of Central Asia. To study visual non-motor disorders in PD patients in Almaty to help optimize diagnosis and evaluate their correlation with disease duration and severity.  The diagnosis included the following elements: patient’s complaints and history, a general physical examination, a neurological examination with auxiliary assessment scales. The study confirmed that non-motor manifestations are common in PD patients. Research to date has confirmed the predictive value of non-motor PD manifestations. Non-motor visual impairments are important to the overall quality of life of Parkinson’s patients as well its motor manifestation, and require a very careful approach and considerable effort for early detection by a physician, medical personnel and caregivers, including relatives

NON-MOTOR VISUAL DISORDERS IN KAZAKHTAN PATIENTS WITH PARKINSON'S DISEASE

We observed 106 Parkinson’s patients in Almaty city to detect non-motor visual disorders. Among non-motor symptoms in patients with Parkinson’s disease (PD), visual symptoms are becoming increasingly important. Visual impairments cause severe disability, reduce compensatory ability and adaptation of the patient to motor impairments and reduce life expectancy. Many neurologists do not take into serious consideration the importance of visual disorders in PD. This type of research has never been carried out in Kazakhstan or indeed the rest of Central Asia. To study visual non-motor disorders in PD patients in Almaty to help optimize diagnosis and evaluate their correlation with disease duration and severity.  The diagnosis included the following elements: patient’s complaints and history, a general physical examination, a neurological examination with auxiliary assessment scales. The study confirmed that non-motor manifestations are common in PD patients. Research to date has confirmed the predictive value of non-motor PD manifestations. Non-motor visual impairments are important to the overall quality of life of Parkinson’s patients as well its motor manifestation, and require a very careful approach and considerable effort for early detection by a physician, medical personnel and caregivers, including relatives

Origin and history of Phoxinus (Cyprinidae) introductions in the Douro basin (Iberian Peninsula): an update inferred from genetic data

The number of non-native freshwater fishes in the Iberian Peninsula has been greatly increasing. In this study, individuals of the genus Phoxinus were detected in 18 out of 138 stream sites sampled across the Douro Basin in 2017 and 2018. A total of 26 individuals were barcoded using partial cytochrome c oxidase subunit I (COI) and cytochrome b (cytb) genes for species identification and determination of geographical origin. Molecular data provided the first record of a second Phoxinus species in western Douro (Portugal, Iberian Peninsula), with haplotypes closely matching those found in the Charente River (southern France). This species is suspected to be a recent introduction associated with the use of minnows as live bait by freshwater anglers, which was facilitated by human movements between France and Portugal. Individuals from watercourses in eastern Douro (Spain) were genetically assigned to Phoxinus bigerri, an introduced species previously known for that region, which confirms reports of introduction events from Ebro to Douro Basin probably also related to freshwater angling and facilitated by geographic proximity. The potential ecological impacts of this genus in the region are unknown and need further investigation.We acknowledge Fernando Teixeira, Fernando Miranda, Mario Ferreira, Sara Carona, Jose Pedro RamiAo and Francisco Carvalho for the valuable assistance during fieldwork. We specially thank Maria Filomena MagalhAes for previous fruitful discussions and logistic support. We are grateful to Matthias F. Geiger and Andrea Corral Lou for facilitating genetic data and coordinates of sampling sites. Finally, we appreciate the comments of the three anonymous reviewers that improved the quality of the manuscript. AFF and AGR were supported by the project FRESHING founded by the Portuguese Foundation for Science and Technology (FCT) and COMPETE (PTDC/AAGMAA/2261/2014 - POCI-01-0145-FEDER-356016824). FMSM was supported by the FCT PhD grant SFRH/BD/104703/2014. This study was conducted as part of the projects FRESHING and FRESHCO. The latter is also supported by FCT and COMPETE (PTDC/AGR-FOR/1627/2014 - 04/SAICT/2015) and UID/AGR/04033/2019. Logistic support was also facilitated by the ENVMETAGEN - Capacity Building at InBIO for Research and Innovation Using Environmental Metagenomics project at CIBIO laboratories (668981; EUH2020-WIDESPREAD-2014-2)

Finding purpose through altruism: The potential of ‘doing for others’ during asylum

Refugees are increasingly acknowledged as facing significant occupational injustice, and they experience multiple barriers to finding meaningful occupational opportunities. Occupation has enormous potential for enhancing the post migratory experience, but choice of occupation is important. People strive to move beyond simply ‘keeping busy’ to find occupations of real meaning that meet personal and cultural needs. This paper reports selected findings from a phenomenological study exploring the occupational experiences of people seeking asylum in the United Kingdom. Data were gathered through a series of in-depth interviews with 10 participants. The findings reveal that participants held a preference for altruistic occupations, where altruism is the principle or practice of doing for others, which was expressed through, or a motivation for, a range of occupations. These occupational choices were prompted by kinship, empathy, learned behaviour and moral principles. The occupations appeared to promote connectivity, positive sense of self and a connection between past and present occupations, called here ‘occupational constancy’. In seeking occupations rich with meaning and purpose, the drive to ‘do for others’ might provide individuals with opportunities to live well in the here and now, and rise above the hardship and marginalisation of asylum and forced migration. In conclusion, I assert that doing of others can be particularly meaningful, and may provide opportunities for personal, social and cultural rewards

Location of studies and evidence of effects of herbivory on Arctic vegetation : a systematic map

Background: Herbivores modify the structure and function of tundra ecosystems. Understanding their impacts is necessary to assess the responses of these ecosystems to ongoing environmental changes. However, the effects of herbivores on plants and ecosystem structure and function vary across the Arctic. Strong spatial variation in herbivore effects implies that the results of individual studies on herbivory depend on local conditions, i.e., their ecological context. An important first step in assessing whether generalizable conclusions can be produced is to identify the existing studies and assess how well they cover the underlying environmental conditions across the Arctic. This systematic map aims to identify the ecological contexts in which herbivore impacts on vegetation have been studied in the Arctic. Specifically, the primary question of the systematic map was: "What evidence exists on the effects of herbivores on Arctic vegetation?". Methods: We used a published systematic map protocol to identify studies addressing the effects of herbivores on Arctic vegetation. We conducted searches for relevant literature in online databases, search engines and specialist websites. Literature was screened to identify eligible studies, defined as reporting primary data on herbivore impacts on Arctic plants and plant communities. We extracted information on variables that describe the ecological context of the studies, from the studies themselves and from geospatial data. We synthesized the findings narratively and created a Shiny App where the coded data are searchable and variables can be visually explored. Review findings We identified 309 relevant articles with 662 studies (representing different ecological contexts or datasets within the same article). These studies addressed vertebrate herbivory seven times more often than invertebrate herbivory. Geographically, the largest cluster of studies was in Northern Fennoscandia. Warmer and wetter parts of the Arctic had the largest representation, as did coastal areas and areas where the increase in temperature has been moderate. In contrast, studies spanned the full range of ecological context variables describing Arctic vertebrate herbivore diversity and human population density and impact. Conclusions: The current evidence base might not be sufficient to understand the effects of herbivores on Arctic vegetation throughout the region, as we identified clear biases in the distribution of herbivore studies in the Arctic and a limited evidence base on invertebrate herbivory. In particular, the overrepresentation of studies in areas with moderate increases in temperature prevents robust generalizations about the effects of herbivores under different climatic scenarios.Peer reviewe

Emerging priorities in terrestrial herbivory research in the Arctic

Herbivores are an integral part of Arctic terrestrial ecosystems, driving ecosystem functioning and sustaining local livelihoods. In the context of accelerated climate warming and land use changes, understanding how herbivores contribute to the resilience of Arctic socio-ecological systems is essential to guide sound decision-making and mitigation strategies. While research on Arctic herbivory has a long tradition, recent literature syntheses highlight important geographical, taxonomic, and environmental knowledge gaps on the impacts of herbivores across the region. At the same time, climate change and limited resources impose an urgent need to prioritize research and management efforts. We conducted a horizon scan within the Arctic herbivory research community to identify emerging scientific and management priorities for the next decade. From 288 responses received from 85 participants in two online surveys and an in-person workshop, we identified 8 scientific and 8 management priorities centred on (a) understanding and integrating fundamental ecological processes across multiple scales from individual herbivore–plant interactions up to regional and decadal scale vegetation and animal population effects; (b) evaluating climate change feedbacks; and (c) developing new research methods. Our analysis provides a strategic framework for broad, inclusive, interdisciplinary collaborations to optimise terrestrial herbivory research and sustainable management practices in a rapidly changing Arctic

Association between loop diuretic dose changes and outcomes in chronic heart failure: observations from the ESC-EORP Heart Failure Long-Term Registry

[Abstract] Aims. Guidelines recommend down-titration of loop diuretics (LD) once euvolaemia is achieved. In outpatients with heart failure (HF), we investigated LD dose changes in daily cardiology practice, agreement with guideline recommendations, predictors of successful LD down-titration and association between dose changes and outcomes. Methods and results. We included 8130 HF patients from the ESC-EORP Heart Failure Long-Term Registry. Among patients who had dose decreased, successful decrease was defined as the decrease not followed by death, HF hospitalization, New York Heart Association class deterioration, or subsequent increase in LD dose. Mean age was 66±13 years, 71% men, 62% HF with reduced ejection fraction, 19% HF with mid-range ejection fraction, 19% HF with preserved ejection fraction. Median [interquartile range (IQR)] LD dose was 40 (25–80) mg. LD dose was increased in 16%, decreased in 8.3% and unchanged in 76%. Median (IQR) follow-up was 372 (363–419) days. Diuretic dose increase (vs. no change) was associated with HF death [hazard ratio (HR) 1.53, 95% confidence interval (CI) 1.12–2.08; P = 0.008] and nominally with cardiovascular death (HR 1.25, 95% CI 0.96–1.63; P = 0.103). Decrease of diuretic dose (vs. no change) was associated with nominally lower HF (HR 0.59, 95% CI 0.33–1.07; P = 0.083) and cardiovascular mortality (HR 0.62 95% CI 0.38–1.00; P = 0.052). Among patients who had LD dose decreased, systolic blood pressure [odds ratio (OR) 1.11 per 10 mmHg increase, 95% CI 1.01–1.22; P = 0.032], and absence of (i) sleep apnoea (OR 0.24, 95% CI 0.09–0.69; P = 0.008), (ii) peripheral congestion (OR 0.48, 95% CI 0.29–0.80; P = 0.005), and (iii) moderate/severe mitral regurgitation (OR 0.57, 95% CI 0.37–0.87; P = 0.008) were independently associated with successful decrease. Conclusion. Diuretic dose was unchanged in 76% and decreased in 8.3% of outpatients with chronic HF. LD dose increase was associated with worse outcomes, while the LD dose decrease group showed a trend for better outcomes compared with the no-change group. Higher systolic blood pressure, and absence of (i) sleep apnoea, (ii) peripheral congestion, and (iii) moderate/severe mitral regurgitation were independently associated with successful dose decrease