Investigating prescribers' experiences of direct-acting oral anticoagulants for the management of nonvalvular atrial fibrillation.

Direct-acting oral anticoagulants (DOACs) have relatively recently been licensed for stroke and systemic embolism prevention in patients with non-valvular atrial fibrillation (AF) and have replaced warfarin as the first line agent of choice. The aim of this research was to determine prescribers' views and experiences of the use of DOACs for the management of non-valvular AF. The first phase was a PROSPERO-registered systematic review of clinicians' views and experiences of DOACs for the management of non-valvular atrial fibrillation. Ten studies were identified. In those studies reporting clinician preference, DOACs were first choice over warfarin in naïve patients, based on perceptions of evidence that DOACs had effectiveness equivalent or superior to warfarin and were also superior in safety. Other advantageous factors were in those with an unstable International Normalized Ratio and who were likely to miss appointments. There were, however, concerns relating to management of over-anticoagulation and experiences of observed bleeding rates. In addition to the lack of studies, none of the studies had used theory in the development of the data collection tools or analysis, indicating a gap in the literature. The second phase was a cross-sectional survey of prescriber's views, behaviours and experiences related to prescribing DOACs for the management of non-valvular AF. The survey was conducted in NHS Highland, inviting all medical and non-medical prescribers to participate. Items on potential influences on DOAC prescribing were based on the Theoretical Domains Framework (TDF). Principal component analysis (PCA) of the TDF items gave four components. Component scores were positive for (i) role of professionals, their knowledge and skills and (ii) influences on prescribing. There did, however, appear to be issues in switching from warfarin to DOACs or from one DOAC to another. Scores were more neutral for (iii) consequences of prescribing and (iv) monitoring for safety and effectiveness. There were low levels of agreement for statements relating to DOACs being more effective, safer and cost-effective than warfarin. There were similar responses around the complexity of bleeding management and detection of over and under-anticoagulation. Less experienced prescribers were statistically significantly more positive than more experienced prescribers in terms of the consequences of prescribing (p < 0.05). Content analysis of the responses to the open questions identified that the overwhelming perceived benefit was the absence of need for INR monitoring, with the main limitations being the lack of a suitable reversal agent and ability to monitor anticoagulation status.Given the updated recommendations of Healthcare Improvement Scotland (HIS) to use edoxaban first line, the final phase was a cross-sectional survey of prescriber's views, behaviours and experiences related to prescribing edoxaban for the management of non-valvular AF. Responses were received from 103 prescribers in NHS Highland. While almost all respondents had been encouraged to implement this recommendation of prescribing edoxaban, less than one third had either switched patients from warfarin or other DOACs to edoxaban. The following three PCA components identified in the previous survey were applied to the TDF determinants: the role of professionals, their knowledge and skills; influences on prescribing; and consequences of prescribing. While component scores for the first two components were positive, the scores for consequences of prescribing were more neutral. Although a number of respondents described edoxaban (and other DOAC) related adverse drug reactions (ADRs), very few had submitted a Yellow Card report to the Medicines and Healthcare products Regulatory Agency (MHRA). Content analysis of the responses to the open questions identified benefits and limitations similar to the previous survey. This doctoral research has generated original findings in terms of DOACs views, experiences and behaviours related to management of non-valvular AF. There is merit in reviewing the local and national guidelines, particularly in relation to switching and awareness of the evidence base. Attention should be paid to the literature on guideline implementation

INNOVATIVE SOLUTIONS FOR BUILDING ENVELOPES OF BIOCLIMATICAL HIGH-RISE BUILDINGS

The paper examines innovative and promising trends in in the design of high-rise buildings that challenge traditional typologies and are adapted for specific climatic conditions. The purpose of the study is to investigate modern methods of designing building envelopes for bioclimatic skyscrapers taking into account heat impact of climate on the thermal balance of buildings. The research methodology is based on a systematic analysis of advanced world experience in constructing innovative buildings, "conquering" climate. The paper provides the basic principles of bioclimatic architecture. The issues of buildings’ forms and modes are considered. The authors analyze the efficiency of using double facades in different climatic conditions with account of their interaction with other technological, constructive and planning elements, such as "solar chimney", passive and active solar control systems, landscaping, intelligence control systems of temperature and humidity conditions in premises and buildings, etc. The paper highlights that unique objects of bioclimatic skyscrapers are moving now into new typologies of buildings and help form dense, comfortable and convenient urban environment using natural resources effectively. The research shows how prospects and relevance of a systemic approach to introducing the related and interdependent projects for energy saving activities at all levels, starting from town-planning and architectural models, and ending with engineering and constructive solutions

Constructive systems, load-bearing and enclosing structures of high-rise buildings

As the height of the building increases, loads on load-carrying structures increase dramatically, and as a result of the development of high-rise construction, several structural systems of such buildings have been developed: frame, frame-frame, cross-wall, barrel, box-type, box-to-wall ("pipe in pipe", "Trumpet in the farm"), etc. In turn, the barrel systems have their own versions: cantilever support of the ceilings on the trunk, suspension of the outer part of the overlap to the upper carrying console "hanging house" or its support by means of the walls on the lower bearing cantilever, intermediate position of the supporting cantilevers in height to the floor, from a part of floors. The object of the study are the structural solutions of high-rise buildings. The subject of the study is the layout of structural schemes of high-rise buildings, taking into account the main parameters - altitude (height), natural climatic conditions of construction, materials of structural elements and their physical and mechanical characteristics. The purpose of the study is to identify the features and systematization of structural systems of high-rise buildings and the corresponding structural elements. The results of the research make it possible, at the stage of making design decisions, to establish rational parameters for the correspondence between the structural systems of high-rise buildings and their individual elements

ИНТЕГРАТИВНЫЕ ХАРАКТЕРИСТИКИ СОВРЕМЕННОГО ПРОТЕСТА (НА МАТЕРИАЛЕ НЕМЕЦКОЯЗЫЧНОЙ ПОЛИТИЧЕСКОЙ БЛОГОСФЕРЫ)

Purpose of this study was to analyse the characteristics of the German political blogosphere based on the official platform https://www.cision.de/top-10-blogs-politik/, which determine the chronotope, content, as well as collective-personal systemic-communicative dimensions of protest. The author focuses on the specific expressions of Net-thinking and e-democracy as new forms of today political communication in the studied protest practices.The study reveals the complex nature of political blogs, determined by their multifunctionality, discursive hybridity and stylistic syncretism. It describes the bundle of components that characterize a political blog as a complex genre of online communication, relevant communicative strategies and tactics of the mass addressee, individual addressee and co-addressees. The parameters of the Internet communication environment are regarded, which determine the way of organizing the communicative interaction of the blogger and the potential recipient and the choice of language means necessary to implement the blogger’s intentions. The author’s attention is focused on the set of classifying features, which are manifested in the stylistic syncretism of political blogs.Method or methodology of the study. The study was conducted with the method of overall selection of empirical material from the official platform https://www.cision.de/top-10-blogs-politik. Research methods include general scientific methods of analysis and synthesis, an interpretive method, content analysis, a stylistic method used to analyse fragments of political blogs.Results. The study highlights the manifestations of mediatization as a tool of social interaction in the analysed protest practices that affect our consciousness and life. The results of the study encourage to rethink the interrelationship between network communication and sociocultural changes.Scope of the results. The research results can be used in the basic course of Applied Linguistics, Linguoculturology and Sociolinguistics.Цель. Статья посвящена анализу характеристик немецкоязычной политической блогосферы на официальной платформе https://www.cision.de/top-10-blogs-politik/, определяющих пространственно-временное, предметное, коллективно-личностное системно-коммуникативные измерения протеста; актуальных выражений Net-мышления и электронной демократии как новых особенных форм современной политической коммуникации в исследуемых практиках протеста. Раскрывается комплексная сущность политических блогов, детерминируемая их полифункциональностью, дискурсивной гибридностью и стилистическим синкретизмом. Описывается совокупность компонентов, характеризующих политический блог как комплексный жанр онлайн-коммуникации; релевантные коммуникативные стратегии и тактики массового адресата, индивидуального адресанта и со-адресантов. Определяются параметры среды интернет-коммуникации, обусловливающие способ организации коммуникативного взаимодействия блогера и потенциального адресата и выбор языковых средств, необходимых для реализации интенциональности блогера. Основное внимание сосредоточено на совокупности классифицирующих признаков, которые находят свое проявление в стилистическом синкретизме политических блогов.Метод или методология проведения работы. Эмпирический материал был отобран методом сплошной выборки на официальной платформе https://www.cision.de/top-10-blogs-politik. Методы исследования включают в себя общенаучные методы анализа и синтеза, интерпретативный метод, контент-анализ, стилистический метод, применяемый для анализа фрагментов политических блогов.Результаты. Выделены проявления медиатизации как инструмента общественного взаимодействия в анализируемых протестных практиках, воздействующих на сознание и жизнедеятельность индивида. Результаты исследования позволяют по – новому переосмыслить взаимосвязь между сетевой коммуникацией и социокультурными изменениями.Область применения результатов. Результаты исследования могут быть использованы в базовом курсе прикладной лингвистики, лингвокультурологии и социолингвистике.

Russia as Seen by Heine’s “La Mouche” (I. S. Turgenev and Camille Selden)

The article offers for the first time an analysis of a series of critiques written by the French author Camille Selden (pseudonym of Elise Krinitz) and devoted to I. S. Turgenev’s works. Published in 1879 by the Paris newspaper “Le XIXe siècle,” these articles were read and appreciated by the writer in a letter addressed to Selden that is being now introduced into scientific circulation. “La Mouche” is known in literary circles as Heinrich Heine’s last love: he dedicated six poems to her and addressed her at least two dozens of letters. It was from Heine that Eliza received the nickname “La Mouche.” Later, she turned out to be an insightful critic who highly appreciated the work of the Russian writer. Despite numerous flaws, and sometimes not a very careful reading of Turgenev’s texts, Selden showed wide familiarity with the writer’s works, although often her assessments look more exotic than deep. In general, Selden’s view of Russia caused Turgenev’s rejection

INVESTIGATING SOFTWARE TEST AUTOMATION: CASE STUDY

Many organizations see software test automation as a possibility to decrease testing costs and to reduce time for testing. However, this approach falls short under certain circumstances. Hence, there is still a need for deeper exploration of case studies from industry. In this paper when- and what-to-automate questions are discussed based on the analysis of many sources. Next step is to present implementation model of software automation

Actualization of Semantic Roles in Protest Communication (on Material of German Online Petitions)

This paper examines the linguistic representation of situations of online protest petitions. The specificity of the implementation of semantic roles in the semantic predicate of action expressed by potentially performative verbs, which names the corresponding intention, is considered. Attention is paid to the characteristic of online petitions as a genre of protest communication, performativity as a property of language expressions, determination of the categorical status of the semantic predicate and semantic case, participation of the significative interpretation in alternative perception and linguistic representation of situations. The relevance of the work is determined by the need to study the discursive specifics, pragmatic parameters of new online genres of protest communication, the possibility and prospects of studying universal conceptual categories on the example of the case system and their role in the formation of language categories, the importance of understanding the degree of influence of ontological factors on the formation of language consciousness. The results of the study of the set of semantic-syntactic relations and paradigm of means of expression of semantic roles in the framework of the three communicative-semantic groups of statements, implementing the basic text-forming intentions such as consent / support, disagreement / disapproval, requirement / request, are presented. Features of the implementation of performativity in the named genre of electronic democracy, determined by discourse, are identified. The means of grammaticalization of pragmatic parameters of performativity in the analyzed material are described

Prescribers' views and experiences of using direct acting oral anticoagulants in the management of nonvalvular atrial fibrillation: a survey in remote and rural Scotland.

A recent systematic review highlighted the lack of robust studies on prescribers' perspectives of direct-acting oral anticoagulants (DOACs) for non-valvular atrial fibrillation (AF). The aim was to determine prescribers' views and experiences of prescribing DOACs. A cross-sectional survey of prescribers in a remote and rural area of Scotland. Survey items were: demographics; prescribing of DOACs; views of potential influences on DOAC prescribing; knowledge of prescribing guidelines; and experiences. Items on potential influences were based on the Theoretical Domains Framework (TDF). Data were analysed using descriptive and inferential statistics, and content analysis of responses to open questions. Principal component analysis (PCA) was performed on the items of potential influences. One hundred and fifty-four responses were received, 120 (77.9%) from doctors, 18 (11.7%) from nurse prescribers and 10 (6.4%) from pharmacist prescribers (6 missing). PCA of the TDF items of potential influences gave four components. Component scores for (i) role of professionals, their knowledge and skills and (ii) influences on prescribing were positive. Those for (iii) consequences of prescribing and (iv) monitoring for safety and effectiveness were more neutral. There were low levels of agreement for statements relating to DOACs being more effective, safer and cost-effective than warfarin. There were similar responses around the complexity of bleeding management and detection of over and under-anticoagulation. This study has identified several key issues of DOAC prescribing (e.g. bleeding management) hence further emphasis is required in continuing professional development and during guideline implementation and evaluation