Outflow graft stenosis and the role of unintended consequences

Author(s):  
Paul Kurlansky
2020 ◽  
pp. 101269022097920
Author(s):  
Gareth Wiltshire ◽  
Nicola J Clarke ◽  
Cassandra Phoenix ◽  
Carl Bescoby

In the context of an increasing clinical need to better support self-managemt for people living with long-term health conditions an interest in the role of social networks has emerged. Given that sport participation often provides opportunities for social engagement, a space to explore Self-managemt at the intersection of medical sociology and the sociology of sport has opened up. This article presents findings from an exploratory qualitative study with organ transplant recipients who have participated in Transplant Games events – national and international multi-sport competitions for organ transplant recipients. Our findings illustrate how sport-based Social networks serve as resources for health-related knowledge, provide participants with additional affective support and help shape health expectations for the future. Although sport-based Social networks were seen as an overwhelmingly positive resource for our participants, it is plausible that harmful unintended consequences could arise for patients with existing Self-managemt issues. As such, it is recommended that people seeking to use sport as a tool to enhance illness Self-managemt should consider the various and powerful ways that Social networks can be impactful and anticipate the potential consequences accordingly.


ASAIO Journal ◽  
2018 ◽  
Vol 64 (1) ◽  
pp. e3-e7 ◽  
Author(s):  
Dominik Wiedemann ◽  
Thomas Schlöglhofer ◽  
Thomas Haberl ◽  
Julia Riebandt ◽  
Kamen Dimitrov ◽  
...  

Author(s):  
Gosia Klatt ◽  
Marcella Milana

This paper considers the changing modes of governance of education policy in the European Union (EU) and Australia through a lens of ‘soft governance’. It considers the increased use of ‘policy instruments’ such as benchmarking, targets, monitoring, data-generation in policy-making in recent decades. It considers the roles these policy instruments play in coordinating education policy in the EU and Australia as well as their intended and unintended consequences. It shows that in the EU, these instruments played a role in strengthening the coordination through the links between individuals and programs, and networking, which is seen as resulting in enhanced creativity in policy solutions, development of new norms and new means for achieving policy goals. While in Australia it seems that the role of these instruments is focused on consolidating the role of the Commonwealth’s oversight and control over what constitutionally is a responsibility of States which adds to several policy tensions already existing in the federal coordination of education.


Author(s):  
Alasdair Roberts

This chapter assesses the role of planning in the design of governance strategies. Enthusiasm for large-scale planning—also known as overall, comprehensive, long-term, economic, or social planning—boomed and collapsed in twentieth century. At the start of that century, progressive reformers seized on planning as the remedy for the United States' social and economic woes. By the end of the twentieth century, enthusiasm for large-scale planning had collapsed. Plans could be made, but they were unlikely to be obeyed, and even if they were obeyed, they were unlikely to work as predicted. The chapter then explains that leaders should make plans while being realistic about the limits of planning. It is necessary to exercise foresight, set priorities, and design policies that seem likely to accomplish those priorities. Simply by doing this, leaders encourage coordination among individuals and businesses, through conversation about goals and tactics. Neither is imperfect knowledge a total barrier to planning. There is no “law” of unintended consequences: it is not inevitable that government actions will produce entirely unexpected results. The more appropriate stance is modesty about what is known and what can be achieved. Plans that launch big schemes on brittle assumptions are more likely to fail. Plans that proceed more tentatively, that allow room for testing, learning, and adjustment, are less likely to collapse in the face of unexpected results.


Author(s):  
Frédéric Volpi

This chapter introduces the ‘eventful sociology’ that characterizes the emergence of protest episodes in the four North African countries. Events are non-routine sequences of actions that reshape the routine forms of governance (and opposition) structuring everyday social and political life. Transformative events initiate a transformation of behaviors that is both strategic and reactive, and that reshapes social and political life first at the local level. This chapter qualifies the emergence of new causal processes and how they interact with preexisting practices of governance. The narrative places side by side the views and strategies of different pro- and anti-regime actors in the face of unexpected events and their consequences. The chapter outlines how sequences of events produced new practices, arenas and actors of contestations, often as unintended consequences of interactions. This event-centric account of protest episodes highlights the transformative role of protest in the construction of newly effective forms of political behaviors.


2019 ◽  
Vol 11 (5) ◽  
pp. 1478 ◽  
Author(s):  
Şebnem Feriver ◽  
Refika Olgan ◽  
Gaye Teksöz ◽  
Matthias Barth

This study presents an attempt to contribute to the field of Education for Sustainable Development (ESD) by conceptualizing systems thinking skills of four- to six-year-old preschool children with the role of age in this particular skill. For this purpose, we developed and tested a method and instruments to assess and conceptualize systems thinking skills of 52 preschool children in early childhood education contexts from Turkey and Germany. By employing qualitative case study research, we concluded that the young children showed some signs of complex understanding regarding systems thinking in terms of detecting obvious gradual changes and two-step domino and/or multiple one-way causalities, as well as describing behavior of a balancing loop. However, their capacity was found to be limited when it comes to detecting a reinforcing loop, understanding system mechanisms by acknowledging the unintended consequences, detecting hidden components and processes, demonstrating multi-dimensional perspective, solving problems through high-leverage interventions, and predicting the future behavior of the system. Age had a notable effect on the total systems thinking mean scores of the participants.


2020 ◽  
Vol 22 (1) ◽  
pp. 387
Author(s):  
Zhongyan Wang ◽  
Megan Snyder ◽  
Jessica E. Kenison ◽  
Kangkang Yang ◽  
Brian Lara ◽  
...  

For decades, the aryl hydrocarbon receptor (AHR) was studied for its role in environmental chemical toxicity i.e., as a quirk of nature and a mediator of unintended consequences of human pollution. During that period, it was not certain that the AHR had a “normal” physiological function. However, the ongoing accumulation of data from an ever-expanding variety of studies on cancer, cancer immunity, autoimmunity, organ development, and other areas bears witness to a staggering array of AHR-controlled normal and pathological activities. The objective of this review is to discuss how the AHR has gone from a likely contributor to genotoxic environmental carcinogen-induced cancer to a master regulator of malignant cell progression and cancer aggression. Particular focus is placed on the association between AHR activity and poor cancer outcomes, feedback loops that control chronic AHR activity in cancer, and the role of chronically active AHR in driving cancer cell invasion, migration, cancer stem cell characteristics, and survival.


2018 ◽  
Vol 38 (7) ◽  
pp. 1519-1539 ◽  
Author(s):  
Torsten Steinbach ◽  
Carl Marcus Wallenburg ◽  
Kostas Selviaridis

Purpose This research focuses on the role of customer behavior in service outsourcing relationships that are governed by outcome-oriented contracts. The purpose of this paper is to explain how non-collaborative customer behavior impedes the effectiveness of outcome-oriented contracts to align the goals and incentives of the customer and service provider, and leads to service provider opportunism. Design/methodology/approach Nine hypotheses are developed regarding customer behavior and the reaction of the service provider to this. These are tested using structural equation modeling with data from 213 service outsourcing relationships. Findings Outcome-orientated contracts in service outsourcing may have unintended consequences because they create value attribution ambiguity. This ambiguity induces non-collaborative customer behavior, which, in turn, results in service provider opportunism. This reveals a paradox, where customer behavior aimed at curbing service provider opportunism instead induces such opportunism. This chain of effects can be counteracted by increased outcome attributability, which reduces the ambiguity and, thus, the motivation for non-collaborative customer behavior. Originality/value This research extends the existing literature by stressing that non-collaborative customer behavior is a key reason why outcome-oriented contracts fail in effectively governing outsourcing relationships, and that this can be counteracted by increased outcome attributability.


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