Dialogic research in a diverse globalizing world: Ways of valuing local voices in multi-partner design research including both developing and developed countries

ABSTRACT: The science education literature is by and large limited to cases in individual countries of which the majority is Western. Consequently, little is known of the actual practice of doing research in the 21st century science education for a diverse global community which includes both developing and developed countries. By drawing on our experiences in a global research project entitled Science Education for Diversity we aim at concretizing this practice. The purpose of this collaborative research project between the UK, the Netherlands, Turkey, Lebanon, India and Malaysia was to (i) understand how the partner countries address the issue of diversity and (ii) use the results to improve science education in terms of responding more effectively to the new cultural diversity of students and benefit students in Western and non-Western countries involved in the project. Particularly, in this contribution, we highlight the dialogic way according to which the project was setup and by which we are currently collaborating, that is, by valuing the local voices as they are in a project with both developing and developed countries. Furthermore, we identify several successes and challenges in this kind of multi-partner global research, and how they are related to social, cultural, and practical aspects of our research. In so doing, we develop a number of principles for the practice of doing research in the 21st century science education for a diverse global community

Acute heart failure congestion and perfusion status – impact of the clinical classification on in-hospital and long-term outcomes; insights from the ESC-EORP-HFA Heart Failure Long-Term Registry

Aims: Classification of acute heart failure (AHF) patients into four clinical profiles defined by evidence of congestion and perfusion is advocated by the 2016 European Society of Cardiology (ESC)guidelines. Based on the ESC-EORP-HFA Heart Failure Long-Term Registry, we compared differences in baseline characteristics, in-hospital management and outcomes among congestion/perfusion profiles using this classification. Methods and results: We included 7865 AHF patients classified at admission as: ‘dry-warm’ (9.9%), ‘wet-warm’ (69.9%), ‘wet-cold’ (19.8%) and ‘dry-cold’ (0.4%). These groups differed significantly in terms of baseline characteristics, in-hospital management and outcomes. In-hospital mortality was 2.0% in ‘dry-warm’, 3.8% in ‘wet-warm’, 9.1% in ‘dry-cold’ and 12.1% in ‘wet-cold’ patients. Based on clinical classification at admission, the adjusted hazard ratios (95% confidence interval) for 1-year mortality were: ‘wet-warm’ vs. ‘dry-warm’ 1.78 (1.43–2.21) and ‘wet-cold’ vs. ‘wet-warm’ 1.33 (1.19–1.48). For profiles resulting from discharge classification, the adjusted hazard ratios (95% confidence interval) for 1-year mortality were: ‘wet-warm’ vs. ‘dry-warm’ 1.46 (1.31–1.63) and ‘wet-cold’ vs. ‘wet-warm’ 2.20 (1.89–2.56). Among patients discharged alive, 30.9% had residual congestion, and these patients had higher 1-year mortality compared to patients discharged without congestion (28.0 vs. 18.5%). Tricuspid regurgitation, diabetes, anaemia and high New York Heart Association class were independently associated with higher risk of congestion at discharge, while beta-blockers at admission, de novo heart failure, or any cardiovascular procedure during hospitalization were associated with lower risk of residual congestion. Conclusion: Classification based on congestion/perfusion status provides clinically relevant information at hospital admission and discharge. A better understanding of the clinical course of the two entities could play an important role towards the implementation of targeted strategies that may improve outcomes. © 2019 The Authors. European Journal of Heart Failure © 2019 European Society of Cardiolog