Transformational leadership, organizational justice and organizational outcomes

Purpose: The purpose of this paper is to examine the impact of transformational leadership (TL) on organizational commitment (OC) with the mediating role of organizational justice (OJ) in the higher education (HE) sector in Syria. Design/methodology/approach: The data were collected from 502 employees from six HE institutions. Two measures of organizational outcomes were selected for this study, namely, job satisfaction (JS) and OC. Using structural equation modelling (SEM), the authors tested four alternative models to indicate the relationship between leadership and organizational outcomes. Findings: TL has both direct and indirect effects on OC through interactional justice (IJ). TL has an impact on JS through procedural justice (PJ) and IJ as intermediate variables, while transactional leadership (TrL) has an impact on JS through distributive justice (DJ). The three types of OJ have an impact on OC through JS. The authors found that the national culture may not influence the impact of the leader in the current globalization context, as the results were similar to the Western studies. Practical implications: The findings of the study provide managers of the HE sector with insights into the formations of employees’ fairness perceptions, and with some guidelines for managing employees by documenting OJ to draw positive attitudinal and behavioral responses from employees. Originality/value: While most previous research has focused on exploring the relationship between leadership and OJ or between OJ and JS in the business sector, the study, however, seeks in addition, to pinpoint the effect of OJ as a mediate variable between the leadership and JS and OC in HE

The Changing Landscape for Stroke\ua0Prevention in AF: Findings From the GLORIA-AF Registry Phase 2

Background GLORIA-AF (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation) is a prospective, global registry program describing antithrombotic treatment patterns in patients with newly diagnosed nonvalvular atrial fibrillation at risk of stroke. Phase 2 began when dabigatran, the first non\u2013vitamin K antagonist oral anticoagulant (NOAC), became available. Objectives This study sought to describe phase 2 baseline data and compare these with the pre-NOAC era collected during phase 1. Methods During phase 2, 15,641 consenting patients were enrolled (November 2011 to December 2014); 15,092 were eligible. This pre-specified cross-sectional analysis describes eligible patients\u2019 baseline characteristics. Atrial fibrillation disease characteristics, medical outcomes, and concomitant diseases and medications were collected. Data were analyzed using descriptive statistics. Results Of the total patients, 45.5% were female; median age was 71 (interquartile range: 64, 78) years. Patients were from Europe (47.1%), North America (22.5%), Asia (20.3%), Latin America (6.0%), and the Middle East/Africa (4.0%). Most had high stroke risk (CHA2DS2-VASc [Congestive heart failure, Hypertension, Age  6575 years, Diabetes mellitus, previous Stroke, Vascular disease, Age 65 to 74 years, Sex category] score  652; 86.1%); 13.9% had moderate risk (CHA2DS2-VASc = 1). Overall, 79.9% received oral anticoagulants, of whom 47.6% received NOAC and 32.3% vitamin K antagonists (VKA); 12.1% received antiplatelet agents; 7.8% received no antithrombotic treatment. For comparison, the proportion of phase 1 patients (of N = 1,063 all eligible) prescribed VKA was 32.8%, acetylsalicylic acid 41.7%, and no therapy 20.2%. In Europe in phase 2, treatment with NOAC was more common than VKA (52.3% and 37.8%, respectively); 6.0% of patients received antiplatelet treatment; and 3.8% received no antithrombotic treatment. In North America, 52.1%, 26.2%, and 14.0% of patients received NOAC, VKA, and antiplatelet drugs, respectively; 7.5% received no antithrombotic treatment. NOAC use was less common in Asia (27.7%), where 27.5% of patients received VKA, 25.0% antiplatelet drugs, and 19.8% no antithrombotic treatment. Conclusions The baseline data from GLORIA-AF phase 2 demonstrate that in newly diagnosed nonvalvular atrial fibrillation patients, NOAC have been highly adopted into practice, becoming more frequently prescribed than VKA in Europe and North America. Worldwide, however, a large proportion of patients remain undertreated, particularly in Asia and North America. (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients With Atrial Fibrillation [GLORIA-AF]; NCT01468701

A Lethal Case of Acute Exacerbation of Rheumatoid Arthritis – Related Interstitial Lung Disease Induced by the COVID Vaccine.

Interstitial lung disease (ILD) exacerbation is a serious condition that can have a high morbidity and mortality. Identifying the triggers of ILD exacerbations is very challenging. Several case reports described COVID-19 vaccine-induced exacerbation of underlying interstitial lung disease, namely idiopathic interstitial pneumonias. The clinical implications of this adverse effect is underrecognized. We are reporting a case of fatal respiratory failure in a patient with rheumatoid arthritis Interstitial Lung disease few days following the second dose of COVID vaccine. Identifying risk factors of this complication is of utmost importance to aid in the rapid recognition and early initiation of treatment