Boundary objects, power, and learning: The matter of developing sustainable practice in organizations

This article develops an understanding of the agential role of boundary objects in generating and politicizing learning in organizations, as it emerges from the entangled actions of humans and non-humans. We offer two empirical vignettes in which middle managers seek to develop more sustainable ways of working. Informed by Foucault’s writing on power, our work highlights how power relations enable and foreclose the affordances, or possibilities for action, associated with boundary objects. Our data demonstrate how this impacts the learning that emerges as boundary objects are configured and unraveled over time. In so doing, we illustrate how boundary objects are not fixed entities, but are mutable, relational, and politicized in nature. Connecting boundary objects to affordances within a Foucauldian perspective on power offers a more nuanced understanding of how ‘the material’ plays an agential role in consolidating and disrupting understandings in the accomplishment of learning

Ship-shape: materializing leadership in the British Royal Navy

In this article I contribute to posthumanist, actor-network influenced theories of leadership, drawing empirically on qualitative data collected at a Royal Navy shore establishment in Great Britain. I demonstrate how a fluid network of hybridized relationships between people and things affords shifting and multiple possibilities for making leadership matter. As configurations of actants evolve these affordances are altered, and the blackboxing processes hiding the material actants co-generating leadership effects are uncovered. A detailed explication of the politicised affordances within actor networks contributes to knowledge about how hybridized relationships co-enable possibilities for action that bring to life, reinforce, and call into question the human-centred, gendered, colonialist web of assumptions and practices through which Royal Naval personnel understand and enact leadership

Managing the monsters of doubt: liminality, threshold concepts and leadership learning

In this article we argue that management and business undergraduate students who are engaged in learning about leadership occupy a liminal space or state of between-ness. Drawing on anthropological conceptualizations of liminality in which those undergoing liminal rituals must grapple with symbolic monsters, we point to the experience of doubt and uncertainty as ‘monsters’ with which students must come to terms. We link this to scholarship that characterises dealing with uncertainty as a central element of leadership practice. Drawing on notions of ‘threshold concepts’, we suggest that students experience the monster of doubt as they progress in their learning experience and that there are a number of potential ways students might ‘think like a leadership scholar’. We set out some opportunities for leadership educators to engage students with threshold concepts as they seek to become familiar with ‘doubt’ as central to the study and practice of leadership. Applying a liminality framework to the understanding of threshold concepts helps to identify threshold concepts as crucial to learning, infused with cultural assumptions, and situated within an understanding of the student experience

Using DNA Metabarcoding to Identify the Floral Composition of Honey:A New Tool for Investigating Honey Bee Foraging Preferences

Identifying the floral composition of honey provides a method for investigating the plants that honey bees visit. We compared melissopalynology, where pollen grains retrieved from honey are identified morphologically, with a DNA metabarcoding approach using the rbcL DNA barcode marker and 454-pyrosequencing. We compared nine honeys supplied by beekeepers in the UK. DNA metabarcoding and melissopalynology were able to detect the most abundant floral components of honey. There was 92% correspondence for the plant taxa that had an abundance of over 20%. However, the level of similarity when all taxa were compared was lower, ranging from 22–45%, and there was little correspondence between the relative abundance of taxa found using the two techniques. DNA metabarcoding provided much greater repeatability, with a 64% taxa match compared to 28% with melissopalynology. DNA metabarcoding has the advantage over melissopalynology in that it does not require a high level of taxonomic expertise, a greater sample size can be screened and it provides greater resolution for some plant families. However, it does not provide a quantitative approach and pollen present in low levels are less likely to be detected. We investigated the plants that were frequently used by honey bees by examining the results obtained from both techniques. Plants with a broad taxonomic range were detected, covering 46 families and 25 orders, but a relatively small number of plants were consistently seen across multiple honey samples. Frequently found herbaceous species were Rubus fruticosus, Filipendula ulmaria, Taraxacum officinale, Trifolium spp., Brassica spp. and the non-native, invasive, Impatiens glandulifera. Tree pollen was frequently seen belonging to Castanea sativa, Crataegus monogyna and species of Malus, Salix and Quercus. We conclude that although honey bees are considered to be supergeneralists in their foraging choices, there are certain key species or plant groups that are particularly important in the honey bees environment. The reasons for this require further investigation in order to better understand honey bee nutritional requirements. DNA metabarcoding can be easily and widely used to investigate floral visitation in honey bees and can be adapted for use with other insects. It provides a starting point for investigating how we can better provide for the insects that we rely upon for pollination

Double agents: gendered organizational culture, control and resistance

Author's pre-publication draft. Final version of the article published in Sociology; available online on http://online.sagepub.com/This article presents ethnographic data showing how recruitment consultants negotiate managerial attempts to control workforce culture. I suggest the values which senior managers encourage consultants to embody prioritize so-called`masculine' attributes over `feminine' ones. I attempt to demonstrate the limits of cultural control by outlining three ways in which the consultants engage with this imposed culture: defiance, parody and ritual. These activities contain gendered assumptions similar to those embedded in corporate culture. I discuss the potential such practices have for resisting corporate culture and the gender within it, suggesting that one source of ambiguity within workplace `control' and `resistance' practices is that they employ overlapping cultural resources and assumptions

Concurrent Oral 1 - Therapy of rheumatic disease: OP4. Effectiveness of Rituximab in Rheumatoid Arthritis: Results from the British Society for Rheumatology Biologics Register (BSRBR)

Background: Rituximab (RTX) in combination with methotrexate (MTX) has been licensed since 2006 for the management of severe active rheumatoid arthritis (RA) in patients who have failed at least one anti-tumour necrosis factor (anti-TNF) therapy. Published clinical trials have demonstrated the efficacy of RTX in improving both clinical symptoms and patients' physical function. This study aimed to assess the effectiveness of RTX in RA patients treated in routine clinical practice by examining clinical and patient reported outcomes six months after receiving a first course of RTX. Methods: The analysis involved 550 RA patients registered with the BSRBR, who were starting RTX and were followed up for at least 6 months. Change in Disease Activity Score (DAS28) and European League Against Rheumatism (EULAR) response were used to assess the clinical response while change in Health Assessment Questionnaire (HAQ) score was used to assess the physical function of the patients 6 months after starting RTX. The change in DAS28 and HAQ was compared between seronegative and seropositive patients and anti-TNF naïve patients versus anti-TNF failures. The response was also compared between patients receiving RTX in combination with MTX, other non-biologic disease modifying anti-rheumatic drugs (nbDMARDs) or no nbDMARDs. Results: The mean (s.d.) age of the cohort was 59 (12) years and 78% of the patients were females. The patients had a mean (s.d.) of 15 (10) years of disease duration. 16% were biologic naïve while 84% were anti-TNF failures. 32% of the patients were seronegative and 68% were seropositive. The mean (95% CI) DAS28 at baseline was 6.2 (6.1, 6.3) which decreased to 4.8 (4.7, 4.9) at 6 months of follow up. 16% were EULAR good responders, 43% were moderate responders and 41% were non responders. The mean (95% CI) change in HAQ was −0.1 (−0.2, −0.1) (Table 1). The mean change in DAS28 was similar in seropositive and seronegative patients (p = 0.18) while the anti-TNF naïve patients showed a greater reduction in DAS28 scores than anti-TNF failures (p = 0.05). Patients receiving RTX in combination with MTX showed similar changes in DAS28 and HAQ compared to patients receiving RTX alone or with other nbDMARDs. Conclusions: RTX has proven to be effective in the routine clinical practice. Anti-TNF naïve patients seem to benefit more from RTX treatment than anti-TNF failures. Disclosure statement: The authors have declared no conflicts of interes

Emerging signals of climate change from the equator to the poles: new insights into a warming world

The reality of human-induced climate change is unequivocal and exerts an ever-increasing global impact. Access to the latest scientific information on current climate change and projection of future trends is important for planning adaptation measures and for informing international efforts to reduce emissions of greenhouse gases (GHGs). Identification of hazards and risks may be used to assess vulnerability, determine limits to adaptation, and enhance resilience to climate change. This article highlights how recent research programs are continuing to elucidate current processes and advance projections across major climate systems and identifies remaining knowledge gaps. Key findings include projected future increases in monsoon rainfall, resulting from a changing balance between the rainfall-reducing effect of aerosols and rainfall-increasing GHGs; a strengthening of the storm track in the North Atlantic; an increase in the fraction of precipitation that falls as rain at both poles; an increase in the frequency and severity of El Niño Southern Oscillation (ENSO) events, along with changes in ENSO teleconnections to North America and Europe; and an increase in the frequency of hazardous hot-humid extremes. These changes have the potential to increase risks to both human and natural systems. Nevertheless, these risks may be reduced via urgent, science-led adaptation and resilience measures and by reductions in GHGs

Polymorphisms in the WNK1 gene are associated with blood pressure variation and urinary potassium excretion.

WNK1--a serine/threonine kinase involved in electrolyte homeostasis and blood pressure (BP) control--is an excellent candidate gene for essential hypertension (EH). We and others have previously reported association between WNK1 and BP variation. Using tag SNPs (tSNPs) that capture 100% of common WNK1 variation in HapMap, we aimed to replicate our findings with BP and to test for association with phenotypes relating to WNK1 function in the British Genetics of Hypertension (BRIGHT) study case-control resource (1700 hypertensive cases and 1700 normotensive controls). We found multiple variants to be associated with systolic blood pressure, SBP (7/28 tSNPs min-p = 0.0005), diastolic blood pressure, DBP (7/28 tSNPs min-p = 0.002) and 24 hour urinary potassium excretion (10/28 tSNPs min-p = 0.0004). Associations with SBP and urine potassium remained significant after correction for multiple testing (p = 0.02 and p = 0.01 respectively). The major allele (A) of rs765250, located in intron 1, demonstrated the strongest evidence for association with SBP, effect size 3.14 mmHg (95%CI:1.23-4.9), DBP 1.9 mmHg (95%CI:0.7-3.2) and hypertension, odds ratio (OR: 1.3 [95%CI: 1.0-1.7]).We genotyped this variant in six independent populations (n = 14,451) and replicated the association between rs765250 and SBP in a meta-analysis (p = 7 x 10(-3), combined with BRIGHT data-set p = 2 x 10(-4), n = 17,851). The associations of WNK1 with DBP and EH were not confirmed. Haplotype analysis revealed striking associations with hypertension and BP variation (global permutation p10 mmHg reduction) and risk for hypertension (OR<0.60). Our data indicates that multiple rare and common WNK1 variants contribute to BP variation and hypertension, and provide compelling evidence to initiate further genetic and functional studies to explore the role of WNK1 in BP regulation and EH

Effect of Hydrocortisone on Mortality and Organ Support in Patients With Severe COVID-19: The REMAP-CAP COVID-19 Corticosteroid Domain Randomized Clinical Trial.

Importance: Evidence regarding corticosteroid use for severe coronavirus disease 2019 (COVID-19) is limited. Objective: To determine whether hydrocortisone improves outcome for patients with severe COVID-19. Design, Setting, and Participants: An ongoing adaptive platform trial testing multiple interventions within multiple therapeutic domains, for example, antiviral agents, corticosteroids, or immunoglobulin. Between March 9 and June 17, 2020, 614 adult patients with suspected or confirmed COVID-19 were enrolled and randomized within at least 1 domain following admission to an intensive care unit (ICU) for respiratory or cardiovascular organ support at 121 sites in 8 countries. Of these, 403 were randomized to open-label interventions within the corticosteroid domain. The domain was halted after results from another trial were released. Follow-up ended August 12, 2020. Interventions: The corticosteroid domain randomized participants to a fixed 7-day course of intravenous hydrocortisone (50 mg or 100 mg every 6 hours) (n = 143), a shock-dependent course (50 mg every 6 hours when shock was clinically evident) (n = 152), or no hydrocortisone (n = 108). Main Outcomes and Measures: The primary end point was organ support-free days (days alive and free of ICU-based respiratory or cardiovascular support) within 21 days, where patients who died were assigned -1 day. The primary analysis was a bayesian cumulative logistic model that included all patients enrolled with severe COVID-19, adjusting for age, sex, site, region, time, assignment to interventions within other domains, and domain and intervention eligibility. Superiority was defined as the posterior probability of an odds ratio greater than 1 (threshold for trial conclusion of superiority >99%). Results: After excluding 19 participants who withdrew consent, there were 384 patients (mean age, 60 years; 29% female) randomized to the fixed-dose (n = 137), shock-dependent (n = 146), and no (n = 101) hydrocortisone groups; 379 (99%) completed the study and were included in the analysis. The mean age for the 3 groups ranged between 59.5 and 60.4 years; most patients were male (range, 70.6%-71.5%); mean body mass index ranged between 29.7 and 30.9; and patients receiving mechanical ventilation ranged between 50.0% and 63.5%. For the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively, the median organ support-free days were 0 (IQR, -1 to 15), 0 (IQR, -1 to 13), and 0 (-1 to 11) days (composed of 30%, 26%, and 33% mortality rates and 11.5, 9.5, and 6 median organ support-free days among survivors). The median adjusted odds ratio and bayesian probability of superiority were 1.43 (95% credible interval, 0.91-2.27) and 93% for fixed-dose hydrocortisone, respectively, and were 1.22 (95% credible interval, 0.76-1.94) and 80% for shock-dependent hydrocortisone compared with no hydrocortisone. Serious adverse events were reported in 4 (3%), 5 (3%), and 1 (1%) patients in the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively. Conclusions and Relevance: Among patients with severe COVID-19, treatment with a 7-day fixed-dose course of hydrocortisone or shock-dependent dosing of hydrocortisone, compared with no hydrocortisone, resulted in 93% and 80% probabilities of superiority with regard to the odds of improvement in organ support-free days within 21 days. However, the trial was stopped early and no treatment strategy met prespecified criteria for statistical superiority, precluding definitive conclusions. Trial Registration: ClinicalTrials.gov Identifier: NCT02735707