Biolimus-eluting biodegradable polymer versus sirolimus-eluting permanent polymer stent performance in long lesions: results from the LEADERS multicentre trial substudy

AIMS: Lesion length remains a predictor of target lesion revascularisation and results of long lesion stenting remain poor. Sirolimus-eluting stents have been shown to perform better than paclitaxel eluting stents in long lesions. In this substudy of the LEADERS trial, we compared the performance of biolimus biodegradable polymer (BES) and sirolimus permanent polymer stents (SES) in long lesions. METHODS AND RESULTS: A total of 1,707 'all-comer' patients were randomly allocated to treatment with BES and SES. A stratified analysis of angiographic and clinical outcomes at nine months and one year, respectively was performed for vessels with lesion length <20 mm versus >20 mm (as measured by quantitative angiography).Of 1,707 patients, 592 BES patients with 831 lesions and 619 SES patients with 876 lesions had only short lesions treated. One hundred and fifty-three BES patients with 166 lesions and 151 SES patients with 162 lesions had long lesions. There were no significant differences in baseline clinical characteristics, except for higher number of patients with long lesions presenting with acute myocardial infarction in both stent groups. Long lesions tended to have lower MLD and greater percent diameter stenosis at baseline than short lesions. Late loss was greater for long lesions than short lesions. There was no statistically significant difference in late loss between BES and SES stents (0.32+/-0.69 vs 0.24+/-0.57, p=0.59). Binary in-segment restenosis was present in 23.2% versus 13.1% of long lesions treated with BES and SES, respectively (p=0.042). In patients with long lesions, the overall MACE rate was similar for BES and SES (17% vs 14.6%; p=0.62). There was a trend towards higher overall TLR rate with BES (12.4 % vs 6.0%; HR=2.06; p=0.07) and clinically driven TLR (10.5% vs 5.3%: HR 1.94; p=0.13). Rates of definite stent thrombosis were 3.3% in the long lesion group and 1.3-1.7 % in the short lesion group. CONCLUSIONS: BES and SES appear similar with respect to MACE in long lesions in this "all-comer" patient population. However, long lesions tended to have a higher rate of binary in-segment restenosis and TLR following BES than SES treatment.

First generation versus second generation drug-eluting stents for the treatment of bifurcations: 5-year follow-up of the LEADERS all-comers randomized trial.

BACKGROUND Historically, percutaneous coronary intervention (PCI) of bifurcation lesions was associated with worse procedural and clinical outcomes when compared with PCI of non-bifurcation lesions. Newer generation drug-eluting stents (DES) might improve long-term clinical outcomes after bifurcation PCI. METHODS AND RESULTS The LEADERS trial was a 10-center, assessor-blind, non-inferiority, all-comers trial, randomizing 1,707 patients to treatment with a biolimus A9(TM) -eluting stent (BES) with an abluminal biodegradable polymer or a sirolimus-eluting stent (SES) with a durable polymer (ClinicalTrials.gov Identifier: NCT00389220). Five-year clinical outcomes were compared between patients with and without bifurcation lesions and between BES and SES in the bifurcation lesion subgroup. There were 497 (29%) patients with at least 1 bifurcation lesion (BES = 258; SES = 239). At 5-year follow-up, the composite endpoint of cardiac death, myocardial infarction (MI) and clinically-indicated (CI) target vessel revascularization (TVR) was observed more frequently in the bifurcation group (26.6% vs. 22.4%, P = 0.049). Within the bifurcation lesion subgroup, no differences were observed in (cardiac) death or MI rates between BES and SES. However, CI target lesion revascularization (TLR) (10.1% vs. 15.9%, P = 0.0495), and CI TVR (12.0% vs. 19.2%, P = 0.023) rates were significantly lower in the BES group. Definite/probable stent thrombosis (ST) rate was numerically lower in the BES group (3.1% vs. 5.9%, P = 0.15). Very late (>1 year) definite/probable ST rates trended to be lower with BES (0.4% vs. 3.1%, P = 0.057). CONCLUSIONS In the treatment of bifurcation lesions, use of BES led to superior long-term efficacy compared with SES. Safety outcomes were comparable between BES and SES, with an observed trend toward a lower rate of very late definite/probable ST between 1 and 5 years with the BES. © 2015 Wiley Periodicals, Inc.

Effects of a health advocacy program to promote physical activity and nutrition behaviors among adolescents: An evaluation of the Young Leaders for Healthy Change program

Background. This study was designed to evaluate the effects of the Young Leaders for Healthy Change program, an internet-delivered program in the school setting that emphasized health advocacy skills-development, on nutrition and physical activity behaviors among older adolescents (13–18 years). The program consisted of online curricular modules, training modules, social media, peer and parental support, and a community service project. Module content was developed based on Social Cognitive Theory and known determinants of behavior for older adolescents. ^ Methods. Of the 283 students who participated in the fall 2011 YL program, 38 students participated in at least ten of the 12 weeks and were eligible for this study. This study used a single group-only pretest/posttest evaluation design. Participants were 68% female, 58% white/Caucasian, 74% 10th or 11th graders, and 89% mostly A and/or B students. The primary behavioral outcomes for this analysis were participation in 60-minutes of physical activity per day, 20-minutes of vigorous- or moderate- intensity physical activity (MVPA) participation per day, television and computer time, fruit and vegetable (FV) intake, sugar-sweetened beverage intake, and consumption of breakfast, home-cooked meals, and fast food. Other outcomes included knowledge, beliefs, and attitudes related to healthy eating, physical activity, and advocacy skills. ^ Findings. Among the 38 participants, no significant changes in any variables were observed. However, among those who did not previously meet behavioral goals there was an 89% increase in students who participated in more than 20 minutes of MVPA per day and a 58% increase in students who ate home-cooked meals 5–7 days per week. The majority of participants met program goals related to knowledge, beliefs, and attitudes prior to the start of the program. Participants reported either maintaining or improving to the goal at posttest for all items except FV intake knowledge, taste and affordability of healthy foods, interest in teaching others about being healthy, and ease of finding ways to advocate in the community. ^ Conclusions. The results of this evaluation indicated that promoting healthy behaviors requires different strategies than maintaining healthy behaviors among high school students. In the school setting, programs need to target the promotion and maintenance of health behaviors to engage all students who participate in the program as part of a class or club activity. Tailoring the program using screening and modifying strategies to meet the needs of all students may increase the potential reach of the program. The Transtheoretical Model may provide information on how to develop a tailored program. Additional research on how to utilize the constructs of TTM effectively among high school students needs to be conducted. Further evaluation studies should employ a more expansive evaluation to assess the long-term effectiveness of health advocacy programming.^

Group growth and educational dynamics /

Cover title.

Listening to young people's voices: Youth sports leaders' advice on facilitating participation in sport

This article reports on a study that accepts the proposal that we listento the voices of young people in relation to sport and physical recreation.The study sought the advice of young sports leaders on what can be done to facilitate young people’s involvement in sport. The study used group interviews (Nominal Group Technique) with over 600 14–18-year-olds toelicit responses to a single question, ‘What can be done to help young people participate in sport?’ This article focuses on young people’s views on issues to do with climate and conditions. We argue that, while their advice offers support for some current initiatives in youth sport, it also provides new insights and challenges and suggests a reordering of existing priorities for youth sport and leisure provision.

Productive leaders and productive leadership: Schools as learning organisations

This paper draws on a three-year study of 24 schools involving classroom observations and interviews with teachers and principals. Through an examination of three cases, sets of leadership practices that focus on the learning of both students and teachers are described. This set of practices is called productive leadership and how these practices are dispersed among productive leaders in three schools is described. This form of leadership supports the achievement of both academic and social outcomes through a focus on pedagogy, a culture of care and related organizational processes. The concepts of learning organisations and teacher professional learning communities as ways of framing relationships in schools, in which ongoing teacher learning is complementary to student learning, are espoused.

Social identity, self-categorization, and the communication of group norms

We articulate the role of norms within the social identity perspective as a basis for theorizing a number of manifestly communicative phenomena. We describe how group norms are cognitively represented as context-dependent prototypes that capture the distinctive properties of groups. The same process that governs the psychological salience of different prototypes, and thus generates group normative behavior, can be used to understand the formation, perception, and diffusion of norms, and also how some group members, for example, leaders, have more normative influence than others. life illustrate this process across a number of phenomena and make suggestions for future interfaces between the social identity perspective and communication research. We believe that the social identity approach represents a truly integrative force for the communication discipline.

The role of self-regulation as a meta-competency in developing leaders: a longitudinal field experimental study

The question of how to develop leaders so that they are more effective in a variety of situations, roles and levels has inspired a voluminous amount of research. While leader development programs such as executive coaching and 360-degree feedback have been widely practiced to meet this demand within organisations, the research in this area has only scratched the surface. Drawing from the past literature and leadership practices, the current research conceptualised self-regulation, as a metacompetency that would assist leaders to further develop the specific competencies needed to perform effectively in their leadership role, leading to an increased rating of leader effectiveness and to enhanced group performance. To test this conceptualisation, a longitudinal field experimental study was conducted across ten months with a pre- and two post-test intervention designs with a matched control group. This longitudinal field experimental compared the difference in leader and team performance after receiving self-regulation intervention that was delivered by an executive coach. Leaders in experimental group also received feedback reports from 360-degree feedback at each stage. Participants were 40 leaders, 155 followers and 8 supervisors. Leaders’ performance was measured using a multi-source perceptual measure of leader performance and objective measures of team financial and assessment performance. Analyses using repeated measure of ANCOVA on pre-test and two post-tests responses showed a significant difference between leader and team performance between experimental and control group. Furthermore, leader competencies mediated the relationship between self-regulation and performance. The implications of these findings for the theory and practice of leadership development training programs and the impact on organisational performance are discussed.

Experiential learning:inspiring the business leaders of tomorrow

Purpose: The complex challenges of sustainable development and the need to embed these issues effectively into the education of future business leaders has never been more urgent. The purpose of this paper is to discuss different approaches taken by two UK signatories to the UN Principles for Responsible Management Education (PRME). Design/methodology/approach: The two approaches examined are: MSc Entrepreneurship students opting for placements with social enterprises; and MBA students undertaking workshops using "live" case studies. A content analysis of the experiences of students from their written reflective narratives is presented. This is supplemented by reflections of the facilitators and tutors. Findings: The analysis reveals that the opportunity to work with social entrepreneurs and/or "responsible" business professionals provides the business students with inspirational role models and positive social learning opportunities. Research limitations/implications: This paper suggests that experiential learning is an effective way of integrating ethics, responsibility and sustainability into the curriculum but the research draws on the experience of two schools. Further research is important to explore these findings in other contexts. Practical implications: The authors argue that direct exposure to a business culture (and/or behaviour) that is predicated upon ethical/social responsibility and sustainability is an effective means to embed these values in the curriculum. Originality/value: This paper contributes by drawing on social psychological research related to behaviour change to examine how experiential learning on traditional Business Masters programmes can provide students with the knowledge, motivation and skills to contribute positively to society, in a way that more traditional pedagogies cannot. © Emerald Group Publishing Limited.

Contesting gender stereotypes stimulates generalized fairness in the selection of leaders

Exposure to counter-stereotypic gender role models (e.g., a woman engineer) has been shown to successfully reduce the application of biased gender stereotypes. We tested the hypothesis that such efforts may more generally lessen the application of stereotypic knowledge in other (non-gendered) domains. Specifically, based on the notion that counter-stereotypes can stimulate a lesser reliance on heuristic thinking, we predicted that contesting gender stereotypes would eliminate a more general group prototypicality bias in the selection of leaders. Three studies supported this hypothesis. After exposing participants to a counter-stereotypic gender role model, group prototypicality no longer predicted leadership evaluation and selection. We discuss the implications of these findings for groups and organizations seeking to capitalize on the benefits of an increasingly diverse workforce.

Investigation of Group Leadership in a Fission-Fusion Species, the Bottlenose Dolphin

Consistent leadership of group travel by specific individuals has been documented in many animals. Most species exhibiting this type of leadership have relatively stable group membership. Animals using fission-fusion grouping are not expected to use specific leaders because associations would not be frequent. Certain conditions, however, may allow this type of control over group travel to occur. First, a population would need to be small enough to allow regular associations between individuals. Second, leadership may be useful if the environment where the population in question lives is complex and requires learning to access the resources efficiently. To determine whether fission-fusion species existing under these conditions utilize specific individual leadership, I examined a small residential population of bottlenose dolphins (Tursiops truncatus) in the Lower Florida Keys (LFK) where the benthic habitat is highly complex. My goals were to (1) determine whether specific individuals in this population led group travel more often than expected; (2) determine whether certain factors predicted which animals would lead most often and (3) investigate the benefits of leading to leaders and to followers in a fission-fusion society. Multiple types of data were collected to answer questions posed including dolphin behavior (for leadership analyses), fish sampling (to examine dolphin habitat use under leadership), and dolphin biopsy sampling (for genetic analyses). Results of analyses provided strong evidence for consistent leadership in this population. Leaders were female, most were mothers and on average they had larger measures of centrality within the LFK population. Leaders benefited by leading individuals who were more closely related than expected. Followers benefited from efficient access to profitable habitat. Results build on previous leadership research by expanding our knowledge about the type of species in which specific individuals lead and predictors for what types of individuals may lead. Additionally, results provide the first detailed information about benefits group members obtain by both leading and following.^

Developing a leadership identity: A case study exploring a select group of Hispanic women at a Hispanic serving institution

Leadership is a socially constructed concept shaped by the context, values and experiences of society (Klenke, 1996); the historical context of gender and ethnicity in society affects views about leadership and who merits a leadership role. Therefore, developing an understanding of Hispanic women students’ leadership identity development is critical in broadening how we define leadership and develop leadership education. The purpose of this qualitative case study was to explore and describe the leadership identity development of a select group of women leaders at a Hispanic Serving Institution (HSI) in the southeast. A psychosocial approach to the study was utilized. In-depth interviews and focus groups were conducted with 11 self-identified Hispanic women students of sophomore, junior or senior standing with varying degrees of involvement in leadership activities at Florida International University. Participants were asked questions related to four topics; (a) leadership, (b) gender, (c) ethnic identity, and (d) influences that contributed to their understanding of self as leader. Five topics emerged from the data presented by the participants’: (a) encouraging relationships, (b) meaningful experiences, (c) self development, (d) the role of gender, and (e) impact of ethnicity. These themes contributed to the leadership identity development of the participants. Findings indicate that leadership identity development for Hispanic women college students at this HSI is complex. The concept of leadership identity development presented in the literature was challenged as findings indicate that the participants’ experiences living and attending a school in a majority-minority city influenced their development of a leadership identity. The data indicate that leadership is not gender or ethnicity neutral as differences exist in expectations of men and women in leadership roles. Gender expectations posed particular challenges for these women student leaders. The prescriptive nature of stage-based models was problematic as findings indicated leadership identity development a complicated and continuing process influenced strongly by relationships and experiences. This study enhanced knowledge of the ways that Hispanic women students become leaders and the influences that shape their leadership experiences which can assist higher education professionals in developing leadership programs and courses that address gender, multiculturalism and awareness of self as leader.