The relationship between the perception of distributed leadership in secondary schools and teachers' and teacher leaders' job satisfaction and organizational commitment

This study investigates the relation between distributed leadership, the cohesion of the leadership team, participative decision-making, context variables, and the organizational commitment and job satisfaction of teachers and teacher leaders. A questionnaire was administered to teachers and teacher leaders (n=1770) from 46 large secondary schools. Multiple regression analyses and path analyses revealed that the study variables explained significant variance in organizational commitment. The degree of explained variance for job satisfaction was considerably lower compared to organizational commitment. Most striking was that the cohesion of the leadership team and the amount of leadership support was strongly related to organizational commitment, and indirectly to job satisfaction. Decentralization of leadership functions was weakly related to organizational commitment and job satisfaction

Studies on Lake Erie's littoral algae; Host specificity and temporal periodicity of epiphytic diatoms

Substratum specificity and temporal periodicity of the attached diatom flora upon three aquatic vascular plants and an artificial substratum were examined in three Lake Erie marshes. No qualitative or quantitative specificity for substrata was observed. Variability of diatom assemblage structure within replicate samples of a particular substratum type was as great as, or greater than, variability between substrata. Diatom assemblages upon dowel rod displayed a mid to late summer density maximum. Variability of density maxima upon natural substrata was attributed to different growth rates of the host macrophytes. Diatom assemblages within each sampling site possessed a distinct temporal periodicity indicating that factors affecting diatom growth are heterogeneous in distribution throughout Lake Erie's littoral zone.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/42923/1/10750_2004_Article_BF00013712.pd

Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial

Background: Many patients with COVID-19 have been treated with plasma containing anti-SARS-CoV-2 antibodies. We aimed to evaluate the safety and efficacy of convalescent plasma therapy in patients admitted to hospital with COVID-19. Methods: This randomised, controlled, open-label, platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]) is assessing several possible treatments in patients hospitalised with COVID-19 in the UK. The trial is underway at 177 NHS hospitals from across the UK. Eligible and consenting patients were randomly assigned (1:1) to receive either usual care alone (usual care group) or usual care plus high-titre convalescent plasma (convalescent plasma group). The primary outcome was 28-day mortality, analysed on an intention-to-treat basis. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936. Findings: Between May 28, 2020, and Jan 15, 2021, 11558 (71%) of 16287 patients enrolled in RECOVERY were eligible to receive convalescent plasma and were assigned to either the convalescent plasma group or the usual care group. There was no significant difference in 28-day mortality between the two groups: 1399 (24%) of 5795 patients in the convalescent plasma group and 1408 (24%) of 5763 patients in the usual care group died within 28 days (rate ratio 1·00, 95% CI 0·93–1·07; p=0·95). The 28-day mortality rate ratio was similar in all prespecified subgroups of patients, including in those patients without detectable SARS-CoV-2 antibodies at randomisation. Allocation to convalescent plasma had no significant effect on the proportion of patients discharged from hospital within 28 days (3832 [66%] patients in the convalescent plasma group vs 3822 [66%] patients in the usual care group; rate ratio 0·99, 95% CI 0·94–1·03; p=0·57). Among those not on invasive mechanical ventilation at randomisation, there was no significant difference in the proportion of patients meeting the composite endpoint of progression to invasive mechanical ventilation or death (1568 [29%] of 5493 patients in the convalescent plasma group vs 1568 [29%] of 5448 patients in the usual care group; rate ratio 0·99, 95% CI 0·93–1·05; p=0·79). Interpretation: In patients hospitalised with COVID-19, high-titre convalescent plasma did not improve survival or other prespecified clinical outcomes. Funding: UK Research and Innovation (Medical Research Council) and National Institute of Health Research

Tocilizumab in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Background: In this study, we aimed to evaluate the effects of tocilizumab in adult patients admitted to hospital with COVID-19 with both hypoxia and systemic inflammation. Methods: This randomised, controlled, open-label, platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing several possible treatments in patients hospitalised with COVID-19 in the UK. Those trial participants with hypoxia (oxygen saturation <92% on air or requiring oxygen therapy) and evidence of systemic inflammation (C-reactive protein ≥75 mg/L) were eligible for random assignment in a 1:1 ratio to usual standard of care alone versus usual standard of care plus tocilizumab at a dose of 400 mg–800 mg (depending on weight) given intravenously. A second dose could be given 12–24 h later if the patient's condition had not improved. The primary outcome was 28-day mortality, assessed in the intention-to-treat population. The trial is registered with ISRCTN (50189673) and ClinicalTrials.gov (NCT04381936). Findings: Between April 23, 2020, and Jan 24, 2021, 4116 adults of 21 550 patients enrolled into the RECOVERY trial were included in the assessment of tocilizumab, including 3385 (82%) patients receiving systemic corticosteroids. Overall, 621 (31%) of the 2022 patients allocated tocilizumab and 729 (35%) of the 2094 patients allocated to usual care died within 28 days (rate ratio 0·85; 95% CI 0·76–0·94; p=0·0028). Consistent results were seen in all prespecified subgroups of patients, including those receiving systemic corticosteroids. Patients allocated to tocilizumab were more likely to be discharged from hospital within 28 days (57% vs 50%; rate ratio 1·22; 1·12–1·33; p<0·0001). Among those not receiving invasive mechanical ventilation at baseline, patients allocated tocilizumab were less likely to reach the composite endpoint of invasive mechanical ventilation or death (35% vs 42%; risk ratio 0·84; 95% CI 0·77–0·92; p<0·0001). Interpretation: In hospitalised COVID-19 patients with hypoxia and systemic inflammation, tocilizumab improved survival and other clinical outcomes. These benefits were seen regardless of the amount of respiratory support and were additional to the benefits of systemic corticosteroids. Funding: UK Research and Innovation (Medical Research Council) and National Institute of Health Research

Febrile Neutropenia in women treated for early breast cancer

This article presents guidelines on preventing and managing febrile neutropenia in women receiving docetaxel-based chemotherapy to treat early-stage breast cancer. The recommendations, developed by a consensus group of senior oncology nurses, take account of breast cancer epidemiology, practice, guidelines and perceived barriers to the routine implementation of good practice. They consider the changes required in the governance of patient care, the education of health professionals, patients and carers, and the way information is communicated across the NHS

Muted diatom responses to recent environmental change on the southeast Tibetan Plateau during the last two centuries.

A general mean annual temperature increase accompanied with substantial glacial retreat has been noted on the Tibetan Plateau during the last two centuries but most significantly since the mid 1950s. These climate trends are particularly apparent on the southeastern Tibetan Plateau. However, the Tibetan Plateau (due to its heterogeneous mountain landscape) has very complex and spatially differing temperature and precipitations patterns. As a result, intensive palaeolimnological investigations are necessary to decipher these climatic patterns and to understand ecological responses to recent environmental change. Here we present palaeolimnological results from a Pb-210/Cs-137-dated sediment core spanning approximately the last 200 years from a remote high-mountain lake (LC6 Lake, working name) on the southeastern Tibetan Plateau. Sediment profiles of diatoms, organic variables (TOC, C:N) and grain size were investigated. The Pb-210 record suggests a period of rapid sedimentation, which might be linked to major tectonic events in the region ca. 1950. Furthermore, unusually high Pb-210 supply rates over the last 50 years suggest that the lake has possibly been subjected to increasing precipitation rates, sediment focussing and/or increased spring thaw. The majority of diatom taxa encountered in the core are typical of slightly acidic to circumneutral, oligotrophic, electrolyte-poor lakes. Diatom species assemblages were rich, and dominated by Cyclotella sp., Achnanthes sp., Aulacoseira sp. and fragilarioid taxa. Diatom compositional change was minimal over the 200-year period (DCCA = 0.85 SD, p = 0.59); only a slightly more diverse but unstable diatom assemblage was recorded during the past 50 years. The results indicate that large-scale environmental changes recorded in the twentieth century (i.e. increased precipitation and temperatures) are likely having an affect on the LC6 Lake, but so far these impacts are more apparent on the lake geochemistry than on the diatom flora. Local and/or regional peculiarities, such as increasing precipitation and cloud cover, or localized climatic phenomena, such as negative climate feedbacks, might have offset the effects of increasing mean surface temperatures