Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.

BACKGROUND: The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. METHODS AND RESULTS: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012-2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3-2.3) versus 2.3 (IQR 1.8-2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32-9.35) vs 4.34 (4.16-4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. CONCLUSION: Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

Shared leadership: leading through polylogue

Purpose – To examine the leadership requirements and challenges that need to be considered for future organizational sustainability. Design/methodology/approach – The approach adopted focuses on the pool of talent available and required within the organization and how a philosophy of shared responsibility and commitment can be engendered on behalf of the organization. Findings – A model is provided outlining how multiple conversations, namely a practice of polylogue, can be effectively pursued. Practical implications – The benefits of polylogue are outlined in terms of future leader development and staff retention through accommodating a co-operative working environment. Originality/value – Pursuing multiple “fierce conversations”; through polylogue, but in a constructive manner, is positioned to effectively realize competitive advantag

Considering context in psychological leadership research

Despite Lewin's identification of the importance of context in behavioral research over 70 years ago, leadership psychology tended to ignore the context. Only in the past 10 years has the context been more routinely included in psychological leadership research. We provide examples of leadership research that has explored the context, introduce the special issue articles, and provide suggestions for future research on the context of leadership

Principal's Leader Power, Teacher Empowerment, Teacher Compliance and Conflict

This paper reports on a study which investigated the relationship among the principal's bases of leader power, teacher empowerment, teacher compliance, and the amount of conflict within self, with peers and with the principal. Factor analysis and regression analysis revealed a strong association for expert power and referent power with each conflict dimension and teacher empowerment. Teacher compliance and teacher empowerment were strongly associated with all three conflict dimensions. Implications were derived for the preservice and inservice education of school principals and their evaluation.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/68275/2/10.1177_0263211X98262004.pd