ICAR: endoscopic skull‐base surgery

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The Changing Landscape for Stroke\ua0Prevention in AF: Findings From the GLORIA-AF Registry Phase 2

Background GLORIA-AF (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation) is a prospective, global registry program describing antithrombotic treatment patterns in patients with newly diagnosed nonvalvular atrial fibrillation at risk of stroke. Phase 2 began when dabigatran, the first non\u2013vitamin K antagonist oral anticoagulant (NOAC), became available. Objectives This study sought to describe phase 2 baseline data and compare these with the pre-NOAC era collected during phase 1. Methods During phase 2, 15,641 consenting patients were enrolled (November 2011 to December 2014); 15,092 were eligible. This pre-specified cross-sectional analysis describes eligible patients\u2019 baseline characteristics. Atrial fibrillation disease characteristics, medical outcomes, and concomitant diseases and medications were collected. Data were analyzed using descriptive statistics. Results Of the total patients, 45.5% were female; median age was 71 (interquartile range: 64, 78) years. Patients were from Europe (47.1%), North America (22.5%), Asia (20.3%), Latin America (6.0%), and the Middle East/Africa (4.0%). Most had high stroke risk (CHA2DS2-VASc [Congestive heart failure, Hypertension, Age  6575 years, Diabetes mellitus, previous Stroke, Vascular disease, Age 65 to 74 years, Sex category] score  652; 86.1%); 13.9% had moderate risk (CHA2DS2-VASc = 1). Overall, 79.9% received oral anticoagulants, of whom 47.6% received NOAC and 32.3% vitamin K antagonists (VKA); 12.1% received antiplatelet agents; 7.8% received no antithrombotic treatment. For comparison, the proportion of phase 1 patients (of N = 1,063 all eligible) prescribed VKA was 32.8%, acetylsalicylic acid 41.7%, and no therapy 20.2%. In Europe in phase 2, treatment with NOAC was more common than VKA (52.3% and 37.8%, respectively); 6.0% of patients received antiplatelet treatment; and 3.8% received no antithrombotic treatment. In North America, 52.1%, 26.2%, and 14.0% of patients received NOAC, VKA, and antiplatelet drugs, respectively; 7.5% received no antithrombotic treatment. NOAC use was less common in Asia (27.7%), where 27.5% of patients received VKA, 25.0% antiplatelet drugs, and 19.8% no antithrombotic treatment. Conclusions The baseline data from GLORIA-AF phase 2 demonstrate that in newly diagnosed nonvalvular atrial fibrillation patients, NOAC have been highly adopted into practice, becoming more frequently prescribed than VKA in Europe and North America. Worldwide, however, a large proportion of patients remain undertreated, particularly in Asia and North America. (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients With Atrial Fibrillation [GLORIA-AF]; NCT01468701

International Consensus Statement on Rhinology and Allergy: Rhinosinusitis

Background: The 5 years since the publication of the first International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR‐RS) has witnessed foundational progress in our understanding and treatment of rhinologic disease. These advances are reflected within the more than 40 new topics covered within the ICAR‐RS‐2021 as well as updates to the original 140 topics. This executive summary consolidates the evidence‐based findings of the document. Methods: ICAR‐RS presents over 180 topics in the forms of evidence‐based reviews with recommendations (EBRRs), evidence‐based reviews, and literature reviews. The highest grade structured recommendations of the EBRR sections are summarized in this executive summary. Results: ICAR‐RS‐2021 covers 22 topics regarding the medical management of RS, which are grade A/B and are presented in the executive summary. Additionally, 4 topics regarding the surgical management of RS are grade A/B and are presented in the executive summary. Finally, a comprehensive evidence‐based management algorithm is provided. Conclusion: This ICAR‐RS‐2021 executive summary provides a compilation of the evidence‐based recommendations for medical and surgical treatment of the most common forms of RS

Supports and constraints to middle leadership development in higher education: a Q-methodology study

Middle leadership development in a Higher Education context can be understood as a complex endeavor, influenced by interactions and interrelations within multiple systems. We explored the perspectives of thirty-five male and female middle leaders on the conditions influencing their leadership development at one university in Qatar. Q methodology was applied to collect and analyze data quantitatively and qualitatively. A 40-statement Q-sample was developed based on a proposed conceptual framework inspired by complexity thinking, and consisting of three dimensions; intrapersonal, relational and institutional. Q factor analysis revealed four significantly different viewpoints regarding the conditions that participants perceived were most influential for their leadership development, namely (1) institutional goals, (2) a culture of trust, (3) senior leadership support, and (4) personal ambitions. Despite the differences in viewpoints, three common constraints to leadership development were also identified. The study has implications for middle leadership development, with its distinctive methodological, theoretical and contextual contributions

An integrated systems model for understanding experiences of academic leadership development in Qatar

While leadership development is acknowledged as essential for institutional growth in the higher education sector, it remains poorly understood and under researched both empirically and theoretically. Although knowledge in this area is growing in western contexts, there is little published data from the Arabic speaking world. This article addresses this gap by reporting on a Qatar National Research Fund (QNRF) funded research project which aimed to explore academic middle leaders’ experiences of leadership and leadership development in Qatar. Drawing on semi structured interviews with 17 academic middle leaders, an integrated systems model for understanding leadership development in Qatar is proposed, based on three inter-related systems: intrapersonal, relational, and institutional. This model has clear implications for future leadership development policy and practice, which it is argued needs to acknowledge the nuanced and complex leadership behaviours and interactions that are required to run academic departments successfully

The role identities of women middle management academic leaders in STEM Higher Education

Despite a growing number of women entering STEM-related professions and higher education, they remain underrepresented in taking up the role of middle management leaders. Once in their roles, they face multiple challenges in their attempt to balance numerous demands on their time and efforts. Working in a male-dominated culture increases the pressure on women middle management leaders to perform at a similarly high caliber. This study adopted a life history approach to narrative inquiry to explore the role identities of three female middle management leaders in one university in Qatar. Using the Dynamic Systems Model of Role Identity as a theoretical model, participants took part in a semi-structured interview during which they recounted their stories of past, present, and future. The findings of this study captured the rich, complex, dynamic, and contextualized nature of how the participants negotiated their identity formation in their academic leadership roles through their discursive practices of gender and leadership highlighting the values and beliefs of motherly care, trust and respect. With the self-perception of goal orientation, they engaged themselves in actions that enabled collegial support and encouraged colleagues to act. Despite a lack of structured professional training for leadership preparation, they generally replied on their prior experiences and efforts as strategies for leadership in doing. Family support was also considered a resource for balancing heavy workload for academic leadership and life commitments. The study concludes with ways to better support women academic leaders