461 research outputs found
Plasmid-mediated colistin resistance among human clinical Enterobacterales isolates: national surveillance in the Czech Republic
The occurrence of colistin resistance has increased rapidly among Enterobacterales around the world. We performed a national survey of plasmid-mediated colistin resistance in human clinical isolates through a retrospective analysis of samples from 2009 to 2017 and a prospective sampling in 2018–2020. The aim of this study was to identify and characterize isolates with mcr genes from various regions of the Czech Republic using whole genome sequencing (WGS). Of all 1932 colistin-resistant isolates analyzed, 73 (3.8%) were positive for mcr genes. Most isolates carried mcr-1 (48/73) and were identified as Escherichia coli (n = 44) and Klebsiella pneumoniae (n = 4) of various sequence types (ST). Twenty-five isolates, including Enterobacter spp. (n = 24) and Citrobacter freundii (n = 1) carrying the mcr-9 gene were detected; three of them (Enterobacter kobei ST54) co-harbored the mcr-4 and mcr-9 genes. Multi-drug resistance phenotype was a common feature of mcr isolates and 14% (10/73) isolates also co-harbored clinically important beta-lactamases, including two isolates with carbapenemases KPC-2 and OXA-48. Phylogenetic analysis of E. coli ST744, the dominant genotype in this study, with the global collection showed Czech isolates belonged to two major clades, one containing isolates from Europe, while the second composed of isolates from diverse geographical areas. The mcr-1 gene was carried by IncX4 (34/73, 47%), IncHI2/ST4 (6/73, 8%) and IncI2 (8/73, 11%) plasmid groups. Small plasmids belonging to the ColE10 group were associated with mcr-4 in three isolates, while mcr-9 was carried by IncHI2/ST1 plasmids (4/73, 5%) or the chromosome (18/73, 25%). We showed an overall low level of occurrence of mcr genes in colistin-resistant bacteria from human clinical samples in the Czech Republic
Death and organization: Heidegger’s thought on death and life in organizations
Mortality has not been given the attention it deserves within organization studies. Even when it has been considered, it is not usually in terms of its implications for own lives and ethical choices. In particular, Heidegger’s writing on death has been almost entirely ignored both in writing on death and writing on organizational ethics, despite his insights into how our mortality and the ethics of existence are linked. In this paper, we seek to address this omission by arguing that a consideration of death may yield important insights about the ethics of organizational life. Most important of these is that a Heideggerian approach to death brings us up against fundamental ethical questions such as what our lives are for, how they should be lived and how we relate to others. Heideggerarian thought also reconnects ethics and politics, as it is closely concerned with how we can collectively make institutions that support our life projects rather than thwart or diminish them
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Beyond dis-identification: A discursive approach to self-alienation in contemporary organizations
Dis-identification has become a key research area in organization studies, demonstrating how employees subjectively distance themselves from managerial domination by protecting/constructing their more ‘authentic’ identities. But how should we understand situations where even these ‘real’ selves are experienced as alien and foreign? We revise the theory of self-alienation to explain cases beyond disidentification, where even back-stage identities (‘who we really are’) are considered something polluted, objectified and foreign. Drawing on an illustrative empirical vignette of a consultant, we demonstrate how a revised version of self-alienation might usefully capture experiences of work where the back-stage/front-stage boundary breaks down. We tentatively posit three causes of this self-alienation in relation to contemporary organizations, and discuss their significance in the context of organizational dis identification
2024 European Society of Hypertension clinical practice guidelines for the management of arterial hypertension
Practice Guidelines: 2024 European Society of Hypertension clinical practice guidelines for the management ofarterial hypertension. Endorsed by the European Federation of Internal Medicine (EFIM), European Renal Association (ERA), and International Society ofHypertension (ISH)</p
Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries
Abstract
Background
Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres.
Methods
This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries.
Results
In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia.
Conclusion
This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries
The Bored Self in Knowledge Work
This article draws attention to reported experiences of boredom in knowledge work. Drawing on extensive qualitative data gathered at two management consultancy firms, we analyze these experiences as a particular interaction with identity regulation and work experiences. We conceptualize the reports of the bored self as a combination of unfilled aspirations and the sense of stagnation, leading to an arrested identity. Our contribution is to expand extant conceptualizations of employee interactions with identity regulation, in particular relating to identity work and identification. The findings provide a critical rendering of the glamourized image of knowledge work
Secrecy and communication:towards a research agenda
Purpose
The purpose of this paper is to identify possible lines of research relating to communication and secrecy.
Design/methodology/approach
This paper is a conceptual essay drawing on recent research on secrecy.
Findings
The findings suggest that secrecy entails the communication of rules about communication, and that secrecy can play a role in the communicative constitution of organizations.
Originality/value
The paper is innovative in configuring secrecy as a form of communication rather than being the opposite of communication, and in showing the linkages between what are normally two separate domains of research
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