Ambiguity and Freedom of Dissent in Post-Incident Discussion

The after-action review (AAR) is a discussion technique some high-reliability organizations employ to encourage learning via collective retrospection. AARs are an effective communication tool for promoting reliability if they are held regularly. One way to encourage frequent AARs is to increase participants’ satisfaction with these meetings. This study examined the impact of post-incident, pre-discussion ambiguity and freedom of dissent on participant satisfaction with AARs. Firefighters (N = 119) completed a survey on their most recent AAR. As predicted, the level of post-incident, pre-discussion ambiguity was negatively related to AAR satisfaction. Freedom of dissent, however, attenuated the negative influence of ambiguity on AAR satisfaction

Representación de la distribución diatópica de algunos procesos fonológicos del español de Colombia según el ALEC

Este artículo presenta la distribución diatópica de los procesos fonológicos de elisión, debucalización, velarización y deslateralización de la palatal que afectan a los fonemas /s/, /r/, /n/, /ʝ/ y /ʎ/ en una selección de mapas fonéticos del Atlas Lingüístico-Etnográfico de Colombia, ALEC. El objetivo principal es proponer una discusión con los estudios más recientes acerca de la distribución de dichos procesos fonológicos en el país, para así establecer un estado del arte que sirva de insumo para el diseño del cuestionario fonético del Nuevo Atlas Lingüístico-Antropológico de Colombia (NALAC). Como resultados se especifican las zonas exactas de distribución de los fenómenos en cuestión, mientras que la literatura al respecto tendía a la generalización de zonas dialectales más amplias

Outcomes for patients with severe chronic neutropenia treated with granulocyte colony-stimulating factor

Severe chronic neutropenia (SCN), defined as blood neutrophils \u3c0.5 × 109/L for \u3e3 months, is an uncommon hematological condition associated with recurrent and severe bacterial infections. After short-term clinical trials showed the benefits of granulocyte colony-stimulating factor (G-CSF) treatment for SCN, SCNIR (Severe Chronic Neutropenia International Registry) opened to determine the long-term benefits and safety of this treatment. This report summarizes findings from more than 16 000 patient-years of prospective observations for patients with congenital and acquired SCN. We observed that adverse outcomes depend on the underlying etiology. Myelodysplasia (MDS) and acute myeloid leukemia (AML) occur infrequently and largely in patients with congenital neutropenias. Having cyclic or chronic autoimmune/ idiopathic neutropenia portends a favorable prognosis. A few patients with idiopathic neutropenia evolve to develop lymphoid malignancies, but they do not appear to be at increased risk of myeloid malignancies, even with very long-term G-CSF therapy. Progression to systemic autoimmune diseases, bone marrow (BM) failure, aplastic anemia, or nonmyeloid malignancies are not expected consequences of SCN or treatment with G-CSF

Long-Term Effects of G-CSF Therapy in Cyclic Neutropenia

Cyclic neutropenia is a rare hematologic disease that is characterized by regular oscillations in blood neutrophil counts from normal levels (absolute neutrophil count [ANC], \u3e1.5×109 per liter) to severe neutropenia (ANC, \u3c0.2×109 per liter), usually with a cycle length of about 21 days.When patients with this disorder have neutropenia, they often have fever and mouth ulcers and are at risk for severe infections. Cyclic neutropenia is usually an autosomal dominant disorder caused by mutations in the gene encoding neutrophil elastase (ELANE)

Stable long-term risk of leukaemia in patients with severe congenital neutropenia maintained on G-CSF therapy

In severe congenital neutropenia (SCN), long-term therapy with granulocyte colony-stimulating factor (G-CSF) has reduced mortality from sepsis, revealing an underlying predisposition to myelodysplastic syndrome and acute myeloid leukaemia (MDS/AML). We have reported the early pattern of evolution to MDS/AML, but the long-term risk remains uncertain. We updated a prospective study of 374 SCN patients on long-term G-CSF enrolled in the Severe Chronic Neutropenia International Registry. Long-term, the annual risk of MDS/AML attained a plateau (2·3%/year after 10 years). This risk now appears similar to, rather than higher than, the risk of AML in Fanconi anaemia and dyskeratosis congenita.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/79264/1/j.1365-2141.2010.08216.x.pd