A Study to Evaluate the Attitude of Faculty Members of Public Universities of Pakistan towards Shared Governance

This paper is based on the evaluation of the attitude of faculty members toward shared governance. Four indicators were used for share governance: role of dean, role of faculty, role of board, and role of joint decision making. Five points liker scale questionnaire of Baker-Brown was used in this study. There were 90 samples for this study from all public universities of Pakistan. Two research questions were formulated for this study.  A multivariate analyses of variance (MANOVA) approach was used to answer research questions. SAS 9.3 software used to analyze the data.  A one-way MANOVA result indicates that there is a significant difference in the perception of shared governance in all four indicators by the faculty rank group at a=0.05 since F (12, 219.89) = 4.68, p <. 001 correspondence to Wilks’ ? = .548, partial eta squared = .182. Power to detect the effect was .99. There is 55% of variance for shared governance perception is accounted by faculty position. The gender group one-way MANOVA result also indicates that there is a significant difference in the perception of shared governance in all four indicators by gender group at a=0.05 since F (4, 85) = 5.97, p <. 001, correspondence to Wilks’ ? = .781, partial eta squared = .182. Power to detect the effect was .99. There is 55% of variance for shared governance perception is accounted by faculty position. Follow-up tests indicates that there was a significance difference in the dean role and join decision making role indicators of shared governance according to the faculty position. There was also significance difference found in the overall MANOVA when analyzed by gender group since Wilks’ ? = .781, F (4, 85) = 5.97, p <. 001, partial eta squared = .219. Power to detect the effect was .98. The result shows that there was 22% of variance for shared governance perception is accounted by male and female group. Keywords: shared governance, faculty role, university, decision making.

A Study to Evaluate the Attitude of Faculty Members of Public Universities of Pakistan towards Shared Governance

This paper is based on the evaluation of the attitude of faculty members toward shared governance. Four indicators were used for share governance: role of dean, role of faculty, role of board, and role of joint decision making. Five points liker scale questionnaire of Baker-Brown was used in this study. There were 90 samples for this study from all public universities of Pakistan. Two research questions were formulated for this study.  A multivariate analyses of variance (MANOVA) approach was used to answer research questions. SAS 9.3 software used to analyze the data.  A one-way MANOVA result indicates that there is a significant difference in the perception of shared governance in all four indicators by the faculty rank group at a=0.05 since F (12, 219.89) = 4.68, p <. 001 correspondence to Wilks’ ? = .548, partial eta squared = .182. Power to detect the effect was .99. There is 55% of variance for shared governance perception is accounted by faculty position. The gender group one-way MANOVA result also indicates that there is a significant difference in the perception of shared governance in all four indicators by gender group at a=0.05 since F (4, 85) = 5.97, p <. 001, correspondence to Wilks’ ? = .781, partial eta squared = .182. Power to detect the effect was .99. There is 55% of variance for shared governance perception is accounted by faculty position. Follow-up tests indicates that there was a significance difference in the dean role and join decision making role indicators of shared governance according to the faculty position. There was also significance difference found in the overall MANOVA when analyzed by gender group since Wilks’ ? = .781, F (4, 85) = 5.97, p <. 001, partial eta squared = .219. Power to detect the effect was .98. The result shows that there was 22% of variance for shared governance perception is accounted by male and female group. Keywords: shared governance, faculty role, university, decision making.

Antiplatelet therapy with aspirin, clopidogrel, and dipyridamole versus clopidogrel alone or aspirin and dipyridamole in patients with acute cerebral ischaemia (TARDIS): a randomised, open-label, phase 3 superiority trial

Background: Intensive antiplatelet therapy with three agents might be more effective than guideline treatment for preventing recurrent events in patients with acute cerebral ischaemia. We aimed to compare the safety and efficacy of intensive antiplatelet therapy (combined aspirin, clopidogrel, and dipyridamole) with that of guideline-based antiplatelet therapy. Methods: We did an international, prospective, randomised, open-label, blinded-endpoint trial in adult participants with ischaemic stroke or transient ischaemic attack (TIA) within 48 h of onset. Participants were assigned in a 1:1 ratio using computer randomisation to receive loading doses and then 30 days of intensive antiplatelet therapy (combined aspirin 75 mg, clopidogrel 75 mg, and dipyridamole 200 mg twice daily) or guideline-based therapy (comprising either clopidogrel alone or combined aspirin and dipyridamole). Randomisation was stratified by country and index event, and minimised with prognostic baseline factors, medication use, time to randomisation, stroke-related factors, and thrombolysis. The ordinal primary outcome was the combined incidence and severity of any recurrent stroke (ischaemic or haemorrhagic; assessed using the modified Rankin Scale) or TIA within 90 days, as assessed by central telephone follow-up with masking to treatment assignment, and analysed by intention to treat. This trial is registered with the ISRCTN registry, number ISRCTN47823388. Findings: 3096 participants (1556 in the intensive antiplatelet therapy group, 1540 in the guideline antiplatelet therapy group) were recruited from 106 hospitals in four countries between April 7, 2009, and March 18, 2016. The trial was stopped early on the recommendation of the data monitoring committee. The incidence and severity of recurrent stroke or TIA did not differ between intensive and guideline therapy (93 [6%] participants vs 105 [7%]; adjusted common odds ratio [cOR] 0·90, 95% CI 0·67–1·20, p=0·47). By contrast, intensive antiplatelet therapy was associated with more, and more severe, bleeding (adjusted cOR 2·54, 95% CI 2·05–3·16, p<0·0001). Interpretation: Among patients with recent cerebral ischaemia, intensive antiplatelet therapy did not reduce the incidence and severity of recurrent stroke or TIA, but did significantly increase the risk of major bleeding. Triple antiplatelet therapy should not be used in routine clinical practice

Antiplatelet therapy with aspirin, clopidogrel, and dipyridamole versus clopidogrel alone or aspirin and dipyridamole in patients with acute cerebral ischaemia (TARDIS): a randomised, open-label, phase 3 superiority trial

Background: Intensive antiplatelet therapy with three agents might be more effective than guideline treatment for preventing recurrent events in patients with acute cerebral ischaemia. We aimed to compare the safety and efficacy of intensive antiplatelet therapy (combined aspirin, clopidogrel, and dipyridamole) with that of guideline-based antiplatelet therapy.Methods: We did an international, prospective, randomised, open-label, blinded-endpoint trial in adult participants with ischaemic stroke or transient ischaemic attack (TIA) within 48 h of onset. Participants were assigned in a 1:1 ratio using computer randomisation to receive loading doses and then 30 days of intensive antiplatelet therapy (combined aspirin 75 mg, clopidogrel 75 mg, and dipyridamole 200 mg twice daily) or guideline-based therapy (comprising either clopidogrel alone or combined aspirin and dipyridamole). Randomisation was stratified by country and index event, and minimised with prognostic baseline factors, medication use, time to randomisation, stroke-related factors, and thrombolysis. The ordinal primary outcome was the combined incidence and severity of any recurrent stroke (ischaemic or haemorrhagic; assessed using the modified Rankin Scale) or TIA within 90 days, as assessed by central telephone follow-up with masking to treatment assignment, and analysed by intention to treat. This trial is registered with the ISRCTN registry, number ISRCTN47823388.Findings: 3096 participants (1556 in the intensive antiplatelet therapy group, 1540 in the guideline antiplatelet therapy group) were recruited from 106 hospitals in four countries between April 7, 2009, and March 18, 2016. The trial was stopped early on the recommendation of the data monitoring committee. The incidence and severity of recurrent stroke or TIA did not differ between intensive and guideline therapy (93 [6%] participants vs 105 [7%]; adjusted common odds ratio [cOR] 0·90, 95% CI 0·67–1·20, p=0·47). By contrast, intensive antiplatelet therapy was associated with more, and more severe, bleeding (adjusted cOR 2·54, 95% CI 2·05–3·16,

Using Climate-HIV to describe real-world clinical outcomes for people living with HIV taking dolutegravir-based regimens.

OBJECTIVES The objective of this study was to describe the real-world use and effectiveness of dolutegravir-based regimens (DBRs) in routine clinical practice in the United Kingdom. METHODS Retrospective analysis was conducted using data from four National Health Service trusts using Climate-HIV, an electronic case record system. Eligible patients were aged ≥18 years with HIV-1 infection who were prescribed a DBR from December 2012 to March 2018. Outcome measurements were accessed at DBR initiation and at weeks 24, 48 and 96 and the last recorded visit up to the extraction date (last measurement). The primary endpoint was the proportion of patients with HIV-1 RNA <50 copies/mL at Week 48. RESULTS The study cohort included 934 patients; 337 (36%) were female, 414 (47%) were white and 717 (77%) were treatment experienced (TE). The Kaplan-Meier estimated probability of achieving HIV-1 RNA <50 copies/mL at 48 weeks was 96% for treatment-naive (TN) patients and 86% for TE patients. Median times to viral suppression (<50 copies/mL) were 49 and 57 days for TN and TE patients with detectable baseline viral load, respectively, according to Kaplan-Meier analysis. Median follow-up time was 377 days (interquartile range: 131-683). At last measurement, 87% (809/934) of patients remained on a DBR; among those patients, 681 (84%) had HIV-1 RNA <50 copies/mL. CONCLUSIONS High levels of virologic suppression and low rates of discontinuation of DBRs were seen in a large, diverse, UK-based population with HIV-1 infection. These findings are broadly consistent with efficacy data from phase III studies

Mortality of treated HIV-1 positive individuals according to viral subtype in Europe and Canada: collaborative cohort analysis

Objectives:To estimate prognosis by viral subtype in HIV-1-infected individuals from start of antiretroviral therapy (ART) and after viral failure.Design:Collaborative analysis of data from eight European and three Canadian cohorts.Methods:Adults (N>20000) who started triple ART between 1996 and 2012 and had data on viral subtype were followed for mortality. We estimated crude and adjusted (for age, sex, regimen, CD4(+) cell count, and AIDS at baseline, period of starting ART, stratified by cohort, region of origin and risk group) mortality hazard ratios (MHR) by subtype. We estimated MHR subsequent to viral failure defined as two HIV-RNA measurements greater than 500 copies/ml after achieving viral suppression.Results:The most prevalent subtypes were B (15419; 74%), C (2091; 10%), CRF02AG (1057; 5%), A (873; 4%), CRF01AE (506; 2.4%), G (359; 1.7%), and D (232; 1.1%). Subtypes were strongly patterned by region of origin and risk group. During 104649 person-years of observation, 1172/20784 patients died. Compared with subtype B, mortality was higher for subtype A, but similar for all other subtypes. MHR for A versus B were 1.13 (95% confidence interval 0.85,1.50) when stratified by cohort, increased to 1.78 (1.27,2.51) on stratification by region and risk, and attenuated to 1.59 (1.14,2.23) on adjustment for covariates. MHR for A versus B was 2.65 (1.64,4.28) and 0.95 (0.57,1.57) for patients who started ART with CD4(+) cell count below, or more than, 100 cells/l, respectively. There was no difference in mortality between subtypes A, B and C after viral failure.Conclusion:Patients with subtype A had worse prognosis, an observation which may be confounded by socio-demographic factors. Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved