THE MEDIATING EFFECT OF CONTEXTUAL CHARACTERISTICS ON COLLECTIVIST DYNAMICS AND ENTITY BASED CREATIVITY AMONG FACULTY IN HIGHER EDUCATION

This study examines the mediating effect of the entity based creativity on the interaction between complexity theory and creativity among faculty members in higher education organizations. The purpose of study was to investigate how mechanisms for intellectual productivity and creativity foster intellectual and disciplinary interactions among faculty members in higher education. The theoretical framework of complexity theory and KEYS model constructs were employed in order to examine how complexity dynamics, motivation, stimulants and inhibitors foster faculty creativity in higher education. The Partial Least Square of Structural Equation Model (PLS-SEM) was used to analyze data using the PLS algorithm, bootstrapping and predictive relevance (Q2 ) to assess the predictive accuracy on creativity among 73 tenure and tenure-track faculty members in south east research based university in the United States. The result showed that stimulant resource, inhibitors and stimulant new-thinking was identified as constructs with the strongest effect on creativity. The findings also reveal that indicator types like organizational impediments, psychological safety, organizational encouragement, freedom, organizational pressure, fun and novelty/ originality had the greatest impact on faculty creativity in higher education. These outcomes suggest implications for faculty members, research, policy, practice. Finding in this study is consistent with complexity theorists arguments that appropriate amounts of pressure encourages workers to seek creative solutions to challenges in an effort to control that pressure and the issues of trust, confidence and organizational encouragement are important in fostering creativity

The Influence of Creativity Inhibitors and Collectivist Dynamics

This study examines the mediating influence of creativity inhibitors on collectivist dynamics and faculty creativity in higher education organizations. Complexity theory was employed to frame how collectivist dynamic (Complexity Interaction) and creativity inhibitor foster faculty creativity in higher education. The Partial Least Square of Structural Equation Model (PLS-SEM) was used to analyze data using the PLS algorithm, and mediating effect to assess the predictive accuracy on creativity among 73 tenure and tenure-track faculty members in a south east research-based university in the United States. The result showed that creativity inhibitors have positive influence on the interaction between complexity interaction (collectivist) and faculty creativity. Additionally, indicator-types like organizational impediments, psychological safety, organizational encouragement, freedom, organizational pressure, fun and novelty/ originality had the greatest impact on faculty creativity in higher education. These findings are consistent with the argument that appropriate amount of pressure encourages workers to seek creative solutions to challenges in an effort to control that pressur

Safety, Quality, and Acceptability of Contraceptive Implant Provision by Community Health Extension Workers versus Nurses and Midwives in Two States in Nigeria.

Task sharing is a strategy with potential to increase access to effective modern contraceptive methods. This study examines whether community health extension workers (CHEWs) can insert contraceptive implants to the same safety and quality standards as nurse/midwives. We analyze data from 7,691 clients of CHEWs and nurse/midwives who participated in a noninferiority study conducted in Kaduna and Ondo States, Nigeria. Adverse events (AEs) following implant insertions were compared. On the day of insertion AEs were similar among CHEW and nurse/midwife clients-0.5 percent and 0.4 percent, adjusted odds ratio (aOR) 0.92 (95 percent CI 0.38-2.23)-but noninferiority could not be established. At follow-up 6.6 percent of CHEW clients and 2.1 percent of nurse/midwife clients experienced AEs. There was strong evidence of effect modification by State. In the final adjusted model, odds of AEs for CHEW clients in Kaduna was 3.34 (95 percent CI 1.53-7.33) compared to nurse/midwife clients, and 0.72 (95 percent CI 0.19-2.72]) in Ondo. Noninferiority could not be established in either State. Implant expulsions were higher among CHEW clients (142/2987) compared to nurse/midwives (40/3517). Results show the feasibility of training CHEWs to deliver implants in remote rural settings but attention must be given to provider selection, training, supervision, and follow-up to ensure safety and quality of provision

Stroke genetics informs drug discovery and risk prediction across ancestries

Previous genome-wide association studies (GWASs) of stroke — the second leading cause of death worldwide — were conducted predominantly in populations of European ancestry1,2. Here, in cross-ancestry GWAS meta-analyses of 110,182 patients who have had a stroke (five ancestries, 33% non-European) and 1,503,898 control individuals, we identify association signals for stroke and its subtypes at 89 (61 new) independent loci: 60 in primary inverse-variance-weighted analyses and 29 in secondary meta-regression and multitrait analyses. On the basis of internal cross-ancestry validation and an independent follow-up in 89,084 additional cases of stroke (30% non-European) and 1,013,843 control individuals, 87% of the primary stroke risk loci and 60% of the secondary stroke risk loci were replicated (P < 0.05). Effect sizes were highly correlated across ancestries. Cross-ancestry fine-mapping, in silico mutagenesis analysis3, and transcriptome-wide and proteome-wide association analyses revealed putative causal genes (such as SH3PXD2A and FURIN) and variants (such as at GRK5 and NOS3). Using a three-pronged approach4, we provide genetic evidence for putative drug effects, highlighting F11, KLKB1, PROC, GP1BA, LAMC2 and VCAM1 as possible targets, with drugs already under investigation for stroke for F11 and PROC. A polygenic score integrating cross-ancestry and ancestry-specific stroke GWASs with vascular-risk factor GWASs (integrative polygenic scores) strongly predicted ischaemic stroke in populations of European, East Asian and African ancestry5. Stroke genetic risk scores were predictive of ischaemic stroke independent of clinical risk factors in 52,600 clinical-trial participants with cardiometabolic disease. Our results provide insights to inform biology, reveal potential drug targets and derive genetic risk prediction tools across ancestries

Hypolipidemic effects of lactic acid bacteria fermented cereal in rats

<p>Abstract</p> <p>Background</p> <p>The objectives of the present study were to investigate the efficacy of the mixed culture of <it>Lactobacillus acidophilus</it> (DSM 20242), <it>Bifidobacterium bifidum</it> (DSM 20082) <it>and Lactobacillus helveticus</it> (CK60) in the fermentation of maize and the evaluation of the effect of the fermented meal on the lipid profile of rats.</p> <p>Methods</p> <p>Rats were randomly assigned to 3 groups and each group placed on a Diet A (high fat diet into which a maize meal fermented with a mixed culture of <it>Lb acidophilus</it> (DSM 20242)<it>, B bifidum</it> (DSM 20082) and <it>Lb helveticus</it> (CK 60) was incorporated), B (unfermented high fat diet) or C (commercial rat chow) respectively after the first group of 7 rats randomly selected were sacrificed to obtain the baseline data. Thereafter 7 rats each from the experimental and control groups were sacrificed weekly for 4 weeks and the plasma, erythrocytes, lipoproteins and organs of the rats were assessed for cholesterol, triglyceride and phospholipids.</p> <p>Results</p> <p>Our results revealed that the mixed culture of <it>Lb acidophilus</it> (DSM 20242)<it>, B bifidum</it> (DSM 20082) and <it>Lb helveticus</it> (CK 60) were able to grow and ferment maize meal into ‘ogi’ of acceptable flavour. In addition to plasma and hepatic hypercholesterolemia and hypertriglyceridemia, phospholipidosis in plasma, as well as cholesterogenesis, triglyceride constipation and phospholipidosis in extra-hepatic tissues characterized the consumption of unfermented hyperlipidemic diets. However, feeding the animals with the fermented maize diet reversed the dyslipidemia.</p> <p>Conclusion</p> <p>The findings of this study indicate that consumption of mixed culture lactic acid bacteria (<it>Lb acidophilus</it> (DSM 20242)<it>, Bifidobacterium bifidum</it> (DSM 20082) <it>and Lb helveticus</it> (CK 60) fermented food results in the inhibition of fat absorption. It also inhibits the activity of HMG CoA reductase. This inhibition may be by feedback inhibition or repression of the transcription of the gene encoding the enzyme via activation of the sterol regulatory element binding protein (SREBP) transcription factor. It is also possible that consumption of fermented food enhances conversion of cholesterol to bile acids by activating cholesterol-7α-hydroxylase.</p

Prospective observational cohort study on grading the severity of postoperative complications in global surgery research

Background The Clavien–Dindo classification is perhaps the most widely used approach for reporting postoperative complications in clinical trials. This system classifies complication severity by the treatment provided. However, it is unclear whether the Clavien–Dindo system can be used internationally in studies across differing healthcare systems in high- (HICs) and low- and middle-income countries (LMICs). Methods This was a secondary analysis of the International Surgical Outcomes Study (ISOS), a prospective observational cohort study of elective surgery in adults. Data collection occurred over a 7-day period. Severity of complications was graded using Clavien–Dindo and the simpler ISOS grading (mild, moderate or severe, based on guided investigator judgement). Severity grading was compared using the intraclass correlation coefficient (ICC). Data are presented as frequencies and ICC values (with 95 per cent c.i.). The analysis was stratified by income status of the country, comparing HICs with LMICs. Results A total of 44 814 patients were recruited from 474 hospitals in 27 countries (19 HICs and 8 LMICs). Some 7508 patients (16·8 per cent) experienced at least one postoperative complication, equivalent to 11 664 complications in total. Using the ISOS classification, 5504 of 11 664 complications (47·2 per cent) were graded as mild, 4244 (36·4 per cent) as moderate and 1916 (16·4 per cent) as severe. Using Clavien–Dindo, 6781 of 11 664 complications (58·1 per cent) were graded as I or II, 1740 (14·9 per cent) as III, 2408 (20·6 per cent) as IV and 735 (6·3 per cent) as V. Agreement between classification systems was poor overall (ICC 0·41, 95 per cent c.i. 0·20 to 0·55), and in LMICs (ICC 0·23, 0·05 to 0·38) and HICs (ICC 0·46, 0·25 to 0·59). Conclusion Caution is recommended when using a treatment approach to grade complications in global surgery studies, as this may introduce bias unintentionally

The surgical safety checklist and patient outcomes after surgery: a prospective observational cohort study, systematic review and meta-analysis

© 2017 British Journal of Anaesthesia Background: The surgical safety checklist is widely used to improve the quality of perioperative care. However, clinicians continue to debate the clinical effectiveness of this tool. Methods: Prospective analysis of data from the International Surgical Outcomes Study (ISOS), an international observational study of elective in-patient surgery, accompanied by a systematic review and meta-analysis of published literature. The exposure was surgical safety checklist use. The primary outcome was in-hospital mortality and the secondary outcome was postoperative complications. In the ISOS cohort, a multivariable multi-level generalized linear model was used to test associations. To further contextualise these findings, we included the results from the ISOS cohort in a meta-analysis. Results are reported as odds ratios (OR) with 95% confidence intervals. Results: We included 44 814 patients from 497 hospitals in 27 countries in the ISOS analysis. There were 40 245 (89.8%) patients exposed to the checklist, whilst 7508 (16.8%) sustained ≥1 postoperative complications and 207 (0.5%) died before hospital discharge. Checklist exposure was associated with reduced mortality [odds ratio (OR) 0.49 (0.32–0.77); P\u3c0.01], but no difference in complication rates [OR 1.02 (0.88–1.19); P=0.75]. In a systematic review, we screened 3732 records and identified 11 eligible studies of 453 292 patients including the ISOS cohort. Checklist exposure was associated with both reduced postoperative mortality [OR 0.75 (0.62–0.92); P\u3c0.01; I2=87%] and reduced complication rates [OR 0.73 (0.61–0.88); P\u3c0.01; I2=89%). Conclusions: Patients exposed to a surgical safety checklist experience better postoperative outcomes, but this could simply reflect wider quality of care in hospitals where checklist use is routine

Critical care admission following elective surgery was not associated with survival benefit: prospective analysis of data from 27 countries

This was an investigator initiated study funded by Nestle Health Sciences through an unrestricted research grant, and by a National Institute for Health Research (UK) Professorship held by RP. The study was sponsored by Queen Mary University of London