Standard Chartered Bank: Women on Corporate Boards in India 2010

This first Standard Chartered Bank: Women on Corporate Boards in India 2010 report looks at the representation of women on the boards of India's leading companies on the Bombay Stock Exchange (BSE-100) . It ranks the companies in terms of the gender diversity of their boards, with those with the highest percentage of women on their boards appearing at the top. The report also examines the general topic of gender diversity on the boards of the BSE-100 by presenting the findings of interviews with 18 female directors of BSE-100 companies

Co-producing a Community University Knowledge Strategy

This community case study describes the process of developing a strategy for community-university engagement, as an example of co-production, and presents the strategy and early outcomes of the work. Based in London, the strategy and the process of co-production are of international relevance in supporting more productive relationships between universities and their cities, as a foundation for repurposing universities for sustainable human progress. The case study is presented in the context of literature related to community engagement with universities and co-production, an area of growing concern as universities seek to strengthen relationships and contribution to sustainable human progress in their home cities. London is one of the world’s great university cities, with more than 40 higher education institutions contributing ground-breaking research and educating students from across the globe. London is also home to vibrant local communities, with a strong tradition of grassroots action, community organization and citizen participation. Community groups and universities have a strong history of working together, often without formal recognition or resources. The Community university Knowledge Strategy for London, known as Collaborate!, was a collaboration between universities and grassroots community groups in London, co-convened by Just Space and University College London (UCL). A series of workshops, guided by two steering committees of community and university members, explored principles for working together, cultural and institutional barriers, decolonization, industrial strategies, community spaces and case studies of good practice. The final conference outlined the basis for a London-wide strategy to enable better engagement between universities and grassroots community groups. The strategy addresses core principles, curriculum, evaluation and evidence, resources, relationship building, governance and structures to support collaboration. Co-production ensured high levels of trust between participants and commitment to the outcomes. Implementation of the strategy actions requires ongoing resources to support intermediary structures to overcome misalignment between universities as large, hierarchical institutions and community groups as dynamic, informal, social organizations

Managing Fever in adults with possible or confirmed COVID-19 in Primary Care

The current evidence does not support routine antipyretic administration to treat fever in acute respiratory infections and COVID-19. Many protocols and professionals advise patients to self-medicate for Covid-19 using antipyretics (e.g. paracetamol and ibuprofen). The rapid and widespread purchase of antipyretic medication over-the-counter has led to temporary shortages

WASP 1628+10-an EL CVn-type binary with a very low mass stripped red giant star and multiperiodic pulsations

The star 1SWASP J162842.31+101416.7 (WASP 1628+10) is one of several EL CVn-type stars recently identified using the Wide Angle Search for Planets (WASP) data base, i.e. an eclipsing binary star in which an A-type dwarf star (WASP 1628+10 A) eclipses the remnant of a disrupted red giant star (WASP 1628+10 B). We have measured the masses, radii and luminosities of the stars in WASP 1628+10 using photometry obtained in three bands (u , g , r ) with the ULTRACAM instrument and medium-resolution spectroscopy. The properties of the remnant are well matched by models for stars in a rarely observed state evolving to higher effective temperatures at nearly constant luminosity prior to becoming a very low mass white dwarf composed almost entirely of helium, i.e. we confirm that WASP 1628+10 B is a precursor of a helium white dwarf (pre-He-WD). WASP 1628+10 A appears to be a normal A2 V star with a mass of 1.36 ± 0.05 M. By fitting models to the spectrum of this star around the Hγ line we find that it has an effective temperature Teff, A = 7500 ± 200 K and a metallicity [Fe/H] = −0.3 ± 0.3. The mass of WASP 1628+10 B is only 0.135 ± 0.02 M. The effective temperature of this pre-He-WD is approximately 9200 K. The ULTRACAM photometry of WASP 1628+10 shows variability at several frequencies around 40 cycles d−1, which is typical for δ Sct-type pulsations often observed in early A-type stars like WASP 1628+10 A. We also observe frequencies near 114 and 129 cycles d−1, much higher than the frequencies normally seen in δ Sct stars. Additional photometry through the primary eclipse will be required to confirm that these higher frequencies are due to pulsations in WASP 1628+10 B. If confirmed, this would be only the second known example of a pre-He-WD showing high-frequency pulsations

ELECTRIC BREAKDOWN AS A PROBABILITY PROCESS

ImportanceRecent estimates suggest that more than 26 million people worldwide have heart failure. The syndrome is associated with major symptoms, significantly increased mortality, and extensive use of health care. Evidence-based treatments influence all these outcomes in a proportion of patients with heart failure. Current management also often includes advice to reduce dietary salt intake, although the benefits are uncertain. ObjectiveTo systematically review randomized clinical trials of reduced dietary salt in adult inpatients or outpatients with heart failure. Evidence ReviewSeveral bibliographic databases were systematically searched, including the Cochrane Central Register of Controlled Trials, MEDLINE, Embase, and CINAHL. The methodologic quality of the studies was evaluated, and data associated with primary outcomes of interest (cardiovascular-associated mortality, all-cause mortality, and adverse events, such as stroke and myocardial infarction) and secondary outcomes (hospitalization, length of inpatient stay, change in New York Heart Association [NYHA] functional class, adherence to dietary low-salt intake, and changes in blood pressure) were extracted. FindingsOf 2655 retrieved references, 9 studies involving 479 unique participants were included in the analysis. None of the studies included more than 100 participants. The risks of bias in the 9 studies were variable. None of the included studies provided sufficient data on the primary outcomes of interest. For the secondary outcomes of interest, 2 outpatient-based studies reported that NYHA functional class was not improved by restriction of salt intake, whereas 2 studies reported significant improvements in NYHA functional class. Conclusions and RelevanceLimited evidence of clinical improvement was available among outpatients who reduced dietary salt intake, and evidence was inconclusive for inpatients. Overall, a paucity of robust high-quality evidence to support or refute current guidance was available. This review suggests that well-designed, adequately powered studies are needed to reduce uncertainty about the use of this intervention.</p

COVID-19 Vaccine Acceptance and Hesitancy among Ethnic Minorities in Hong Kong

Ethnic minorities account for 8% of the Hong Kong population, most are Filipino and Indonesian domestic helpers taking care of children and the elderly. To understand the COVID-19 vaccination rates and factors associated with vaccine acceptance of ethnic minorities, we performed a cross-sectional questionnaire study recruiting Hong Kong ethnic minorities aged ≥18 years between 1 July and 18 July 2021 in public areas. Demographics, knowledge about COVID-19, vaccination status, intention and reasons to receive the vaccine, and planning to be re-vaccinated were analyzed. Continuous and categorical variables were compared using unpaired t-test and Chi-square test, respectively. Potential confounders were adjusted using multiple logistic regression. 2,012 ethnic minorities participated, with a mean age of 39 years, of which 97.6% were female, 79.5% were Filipino, and 17.5% were Indonesian. 80.6% of participants were categorized as vaccine acceptance, and 69.2% were willing to be re-vaccinated. There were significantly more Filipinos than Indonesians in the vaccine acceptance group (p < .001). Subjects in the vaccine acceptance group were more likely to have higher education (p < .001), a higher COVID-19 knowledge score (p < .001), received information from the Government website (p = .003) and not from their friends or family members (p = .02), and were more confident in judging the accuracy of the information (p < .001). Logistic regression showed the mean knowledge score (β = 3.07, p < .001) and receiving information from official Government websites (adjusted OR = 1.37, p = .03) were significant factors that positively influenced vaccine acceptance. The Hong Kong Government should improve COVID-19 vaccination acceptance among ethnic minorities through public education using official channels

Case-based review and olinical guidance on the use of genomic assays for early-stage breast cancer: Breast Cancer Therapy Expert Group (BCTEG)

In addition to classical clinicopathologic factors, such as hormone receptor positivity, human epidermal growth factor receptor 2 (HER2) status, and tumor size, grade, and lymph node status, a number of commercially available genomic tests may be used to help inform treatment decisions for early breast cancer patients. Although these tests improve our understanding of breast cancer and help to individualize treatment decisions, clinicians face challenges when deciding on the most appropriate test to order, and the advantages, if any, of one test over another. The Breast Cancer Therapy Expert Group (BCTEG) recently convened a roundtable meeting to discuss issues surrounding the use of genomic testing in early breast cancer, with the goal of providing practical guidance on the use of these tests by the community oncologist, for whom breast cancer may be only one of many tumor types they treat. The group recognizes that genomic testing can provide important prognostic (eg, risk for recurrence), and in some cases predictive, information (eg, benefit of chemotherapy, or extended adjuvant endocrine therapy), which can be used to help guide treatment decisions in breast cancer. The available tests differ in the types of information they provide, and in the patient populations and clinical trials that were conducted to validate them. We summarize the discussion of the BCTEG on this topic, and we also consider several patient cases and clinical scenarios in which genomic testing may, or may not, be useful to guide treatment decisions for the practicing community oncologist

Transseptal puncture for left atrial ablation: Risk factors for cardiac tamponade and a proposed causative classification system

AIMS: Cardiac tamponade is a high morbidity complication of transseptal puncture (TSP). We examined the associations of TSP‐related cardiac tamponade (TRCT) for all patients undergoing left atrial ablation at our center from 2016 to 2020. METHODS AND RESULTS: Patient and procedural variables were extracted retrospectively. Cases of cardiac tamponade were scrutinized to adjudicate TSP culpability. Adjusted multivariate analysis examined predictors of TRCT. A total of 3239 consecutive TSPs were performed; cardiac tamponade occurred in 51 patients (incidence: 1.6%) and was adjudicated as TSP‐related in 35 (incidence: 1.1%; 68.6% of all tamponades). Patients of above‐median age [odds ratio (OR): 2.4 (1.19–4.2), p = .006] and those undergoing re‐do procedures [OR: 1.95 (1.29–3.43, p = .042] were at higher risk of TRCT. Of the operator‐dependent variables, choice of transseptal needle (Endrys vs. Brockenbrough, p > .1) or puncture sheath (Swartz vs. Mullins vs. Agilis vs. Vizigo vs. Cryosheath, all p > .1) did not predict TRCT. Adjusting for operator, equipment and demographics, failure to cross the septum first pass increased TRCT risk [OR: 4.42 (2.45–8.2), p = .001], whilst top quartile operator experience [OR: 0.4 (0.17–0.85), p = .002], transoesophageal echocardiogram [TOE prevalence: 26%, OR: 0.51 (0.11–0.94), p = .023], and use of the SafeSept transseptal guidewire [OR: 0.22 (0.08–0.62), p = .001] reduced TRCT risk. An increase in transseptal guidewire use over time (2016: 15.6%, 2020: 60.2%) correlated with an annual reduction in TRCT (R (2) = 0.72, p < .001) and was associated with a relative risk reduction of 70%. CONCLUSIONS: During left atrial ablation, the risk of TRCT was reduced by operator experience, TOE‐guidance, and use of a transseptal guidewire, and was increased by patient age, re‐do procedures, and failure to cross the septum first pass

Critical thinking in healthcare and education

Imagine you are a primary care doctor. A patient comes into your office with acute, atypical chest pain. Immediately you consider the patient’s sex and age, and you begin to think about what questions to ask and what diagnoses and diagnostic tests to consider. You will also need to think about what treatments to consider and how to communicate with the patient and potentially with the patient’s family and other healthcare providers. Some of what you do will be done reflexively, with little explicit thought, but caring for most patients also requires you to think critically about what you are going to do. Critical thinking, the ability to think clearly and rationally about what to do or what to believe, is essential for the practice of medicine. Few doctors are likely to argue with this. Yet, until recently, the UK regulator the General Medical Council and similar bodies in North America did not mention “critical thinking” anywhere in their standards for licensing and accreditation,1 and critical thinking is not explicitly taught or assessed in most education programmes for health professionals. Moreover, although more than 2800 articles indexed by PubMed have “critical thinking” in the title or abstract, most are about nursing. We argue that it is important for clinicians and patients to learn to think critically and that the teaching and learning of these skills should be considered explicitly. Given the shared interest in critical thinking with broader education, we also highlight why healthcare and education professionals and researchers need to work together to enable people to think critically about the health choices they make throughout life.</p

Understanding and Improving Older People’s Well-Being through Social Prescribing Involving the Cultural Sector: Interviews from a Realist Evaluation

doi: 10.1177/07334648231154043Social prescribing is a non-clinical approach to addressing social, environmental, and economic factors affecting how people feel physical and/or emotionally. It involves connecting people to ?community assets? (e.g., local groups, organizations, and charities) that can contribute to positive well-being. We sought to explain in what ways, for whom, and why the cultural sector can support social prescribing with older people. We conducted semi-structured interviews with 28 older people (aged 60+) and 25 cultural sector staff. The following nine concepts, developed from interview data, progressed the understanding of tailoring cultural offers, which came from our previous realist review?immersion, buddying, café culture, capacity, emotional involvement, perseverance, autonomy, elitism, and virtual cultural offers. Through tailoring, we propose that older people might experience one or more of the following benefits from engaging with a cultural offer as part of social prescribing?being immersed, psychological holding, connecting, and transforming through self-growth