Prospective areas of didactic research: А problem statement.

Introduction. Current educational practice largely functions independently of didactics: decisions on the selection of content, the methods and forms of instruction are often made at different levels and in different areas of education without a conceptual substantiation. This does not necessarily mean the educators’ lack of knowledge, it rather points at the urgency of updating didactic research, including objects and phenomena that are relevant and have not been extensively studied yet.The aim of the present publication is to pose relevant problems of didactic research, based on the challenges rooted in the development of educational practice.Methodology and research methods. This research is based on systemic, interdisciplinary, and anthropological approaches. Research methods include analysis, synthesis, systematisation, modelling, idealisation, forecasting.Results. The authors state the need to expand the range of issues covered by didactic research. Additionally, the authors highlighted didactic research problems related to learning across all levels of the educational ladder, to a wide range of contexts of educational practice: psychological and didactic characteristics of a modern agent of learning; didactic foundations for the selection of educational content in the context of the transformation of the educational environment of the digital era; the expansion of conceptual and terminological toolbox of didactics; contextual features of didactic principles in diverse areas of educational practice; didactical aims and functions of non-traditional learning formats; didactic foundations and the range of the teacher’s roles in various learning formats; the development of didactics for teacher training.The directions of promising didactic research are identified. The authors conclude the necessity for broadening research area to cover problems facing didactics: inclusion of phenomena and processes that were left out of the scope of traditional didactic research; enhancing the role of interdisciplinary research on learning, enhancing the versatility of didactic concepts and their scientific validity; a didactic study of specific innovative educational practices, identifying the feasibility and possibilities of their dissemination in different areas of education.Scientific novelty. The article describes educational practices, which are not covered by didactic studies. The authors identify and present conceptual gaps, which challenge didactics to expand and enrich its conceptual toolkit. Several paradoxes are highlighted as conceptual contradictions, which indicate the gaps in modern didactic knowledge: paradoxes of the learning actor, of learning outcomes, of teacher expertise. These paradoxes prompt to update didactics as the theory of education.Practical significance. The development of didactics in the areas considered in the article will make it possible to improve the educational process on a theoretically verified basis, enhance opportunities, to reduce the risks, and to increase the effectiveness of innovations.Введение. Современная образовательная практика во многом «обходится» без дидактики: решения об отборе содержания, методов и форм обучения нередко принимаются на разных уровнях и в разных сферах образования без концептуального обоснования. Это не обязательно говорит о неосведомленности участников данного процесса, но скорее обнаруживает острую необходимость актуализировать дидактические исследования, включить в сферу их охвата те значимые объекты и явления в области образования, которые пока не получили должного внимания. Цель работы состоит в обозначении проблематики дидактических исследований исходя из вызовов, которые ставит перед дидактикой развитие образовательной практики.Методология и методики. Основой исследования служат системный, междисциплинарный, антропологический подходы; к его методам относятся анализ, синтез, систематизация, моделирование, идеализация, прогнозирование. Результаты исследования. Обоснована необходимость расширения проблематики дидактических исследований. Выделены сквозные дидактические проблемы, которые касаются обучения на всех ступенях образовательной лестницы, широкого диапазона контекстов образовательной практики: психолого-дидактические характеристики современного субъекта обучения; дидактические основы отбора содержания образования в условиях трансформации образовательной среды цифровой эпохи; уточнение концептуально-терминологического аппарата дидактики; контекстные особенности дидактических принципов применительно к каждой сфере образовательной практики; задачи и функции нетрадиционных форматов обучения; дидактические основы использования этих форматов и диапазон ролей педагога в соответствующих условиях; разработка дидактики подготовки педагогов.Выявлены перспективные направления дидактических исследований. Сделан вывод о расширении пространства проблем, стоящих перед дидактикой, посредством включения объектов и процессов, которые обычно находились вне сферы внимания; повышения роли междисциплинарных исследований обучения, усиливающих многогранность дидактических представлений и их на-учную обоснованность; изучения локальных инновационных образовательных практик, выявления целесообразности и возможностей их распространения в разных сферах образования. Научная новизна. Охарактеризованы области образовательной практики, которые недостаточно охвачены дидактическими исследованиями или находятся вне исследовательского поля дидактики; обозначены концептуальные разрывы, для заполнения которых необходимо расширение и обогащение концептуального аппарата этой науки. Освещен ряд парадоксов как концептуальных противоречий, которые указывают на пробелы в современном дидактическом знании (парадоксы субъекта обучения, целей-результатов обучения, экспертности педагога) и побуждают к обновлению дидактики как теории обучения. Практическая значимость. Развитие дидактики в рассмотренных направлениях позволит совершенствовать образовательный процесс на теоретически выверенной основе, расширить возможности, сократить риски и повысить эффективность нововведений.The publication was prepared under the support of the Russian Foundation for Basic Research (RFBR) in the framework of the research project No. 20-013-00248 “Prospective Areas of Didactic Research in Russia”.Публикация подготовлена в рамках поддержанного Российским фондом фундаментальных исследований (РФФИ) научного проекта № 20-013-00248 «Перспективные направления дидактических исследований в России»

Inappropriate prescribing and adverse drug events in older people

Inappropriate prescribing (IP) in older patients is highly prevalent and is associated with an increased risk of adverse drug events (ADEs), morbidity, mortality and healthcare utilisation. Consequently, IP is a major safety concern and with changing population demographics, it is likely to become even more prevalent in the future. IP can be detected using explicit or implicit prescribing indicators. Theoretically, the routine clinical application of these IP criteria could represent an inexpensive and time efficient method to optimise prescribing practice. However, IP criteria must be sensitive, specific, have good inter-rater reliability and incorporate those medications most commonly associated with ADEs in older people. To be clinically relevant, use of prescribing appropriateness tools must translate into positive patient outcomes, such as reduced rates of ADEs. To accurately measure these outcomes, a reliable method of assessing the relationship between the administration of a drug and an adverse clinical event is required. The Naranjo criteria are the most widely used tool for assessing ADE causality, however, they are often difficult to interpret in the context of older patients. ADE causality criteria that allow for the multiple co-morbidities and prescribed medications in older people are required. Ultimately, the current high prevalence of IP and ADEs is unacceptable. IP screening criteria need to be tested as an intervention to assess their impact on the incidence of ADEs in vulnerable older patients. There is a role for IP screening tools in everyday clinical practice. These should enhance, not replace good clinical judgement, which in turn should be based on sound pharmacogeriatric training

Strategic Sensemaking and Political Connections in Unstable Institutional Contexts

Emerging economies are often characterized by pervasive institutional changes and resultant institutional voids. In the absence of strong formal institutions, firms rely on informal institutions to fill these voids. This article argues that the process of sensemaking for firms in turbulent environments is continuous and dependent on cyclical adjustments connecting performance via a feedback loop to scanning and interpretation. Far from being a one-time occurrence, environmental sensemaking is a process operating in accord with continuous environmental changes. This study’s findings derive from an in-depth analysis of a Russian pharmaceutical firm and an Indian telecommunications firm, and demonstrate that entrepreneurs make sense and gain legitimacy through political connections. The study further finds that improvements in institutional environments reduce the salience of political networks, thereby creating a choice for firms to rely on formed market mechanisms or continue along the path of political connections that evolve to public–private partnerships

Are sedatives and hypnotics associated with increased suicide risk of suicide in the elderly?

<p>Abstract</p> <p>Background</p> <p>While antidepressant-induced suicidality is a concern in younger age groups, there is mounting evidence that these drugs may reduce suicidality in the elderly. Regarding a possible association between other types of psychoactive drugs and suicide, results are inconclusive. Sedatives and hypnotics are widely prescribed to elderly persons with symptoms of depression, anxiety, and sleep disturbance. The aim of this case-control study was to determine whether specific types of psychoactive drugs were associated with suicide risk in late life, after controlling for appropriate indications.</p> <p>Methods</p> <p>The study area included the city of Gothenburg and two adjacent counties (total 65+ population 210 703 at the start of the study). A case controlled study of elderly (65+) suicides was performed and close informants for 85 suicide cases (46 men, 39 women mean age 75 years) were interviewed by a psychiatrist. A population based comparison group (n = 153) was created and interviewed face-to-face. Primary care and psychiatric records were reviewed for both suicide cases and comparison subjects. All available information was used to determine past-month mental disorders in accordance with DSM-IV.</p> <p>Results</p> <p>Antidepressants, antipsychotics, sedatives and hypnotics were associated with increased suicide risk in the crude analysis. After adjustment for affective and anxiety disorders neither antidepressants in general nor SSRIs showed an association with suicide. Antipsychotics had no association with suicide after adjustment for psychotic disorders. Sedative treatment was associated with an almost fourteen-fold increase of suicide risk in the crude analyses and remained an independent risk factor for suicide even after adjustment for any DSM-IV disorder. Having a current prescription for a hypnotic was associated with a four-fold increase in suicide risk in the adjusted model.</p> <p>Conclusion</p> <p>Sedatives and hypnotics were both associated with increased risk for suicide after adjustment for appropriate indications. Given the extremely high prescription rates, a careful evaluation of the suicide risk should always precede prescribing a sedative or hypnotic to an elderly individual.</p

Genetic and clinical determinants of abdominal aortic diameter: genome-wide association studies, exome array data and Mendelian randomization study

Progressive dilation of the infrarenal aortic diameter is a consequence of the ageing process and is considered the main determinant of abdominal aortic aneurysm (AAA). We aimed to investigate the genetic and clinical determinants of abdominal aortic diameter (AAD). We conducted a meta-analysis of genome-wide association studies in 10 cohorts (n = 13 542) imputed to the 1000 Genome Project reference panel including 12 815 subjects in the discovery phase and 727 subjects [Partners Biobank cohort 1 (PBIO)] as replication. Maximum anterior–posterior diameter of the infrarenal aorta was used as AAD. We also included exome array data (n = 14 480) from seven epidemiologic studies. Single-variant and gene-based associations were done using SeqMeta package. A Mendelian randomization analysis was applied to investigate the causal effect of a number of clinical risk factors on AAD. In genome-wide association study (GWAS) on AAD, rs74448815 in the intronic region of LDLRAD4 reached genome-wide significance (beta = −0.02, SE = 0.004, P-value = 2.10 × 10(−8)). The association replicated in the PBIO1 cohort (P-value = 8.19 × 10(−4)). In exome-array single-variant analysis (P-value threshold = 9 × 10(−7)), the lowest P-value was found for rs239259 located in SLC22A20 (beta = 0.007, P-value = 1.2 × 10(−5)). In the gene-based analysis (P-value threshold = 1.85 × 10(−6)), PCSK5 showed an association with AAD (P-value = 8.03 × 10(−7)). Furthermore, in Mendelian randomization analyses, we found evidence for genetic association of pulse pressure (beta = −0.003, P-value = 0.02), triglycerides (beta = −0.16, P-value = 0.008) and height (beta = 0.03, P-value < 0.0001), known risk factors for AAA, consistent with a causal association with AAD. Our findings point to new biology as well as highlighting gene regions in mechanisms that have previously been implicated in the genetics of other vascular diseases

Gene-gene Interaction Analyses for Atrial Fibrillation

Atrial fibrillation (AF) is a heritable disease that affects more than thirty million individuals worldwide. Extensive efforts have been devoted to the study of genetic determinants of AF. The objective of our study is to examine the effect of gene-gene interaction on AF susceptibility. We performed a large-scale association analysis of gene-gene interactions with AF in 8,173 AF cases, and 65,237 AF-free referents collected from 15 studies for discovery. We examined putative interactions between genome-wide SNPs and 17 known AF-related SNPs. The top interactions were then tested for association in a