1,823,219 research outputs found
The Women's international study of long-duration oestrogen after menopause (WISDOM): a randomised controlled trial
Full text linkBackground: At the time of feasibility work and final design of the trial there was no randomised control trial evidence for the long-term risks and benefits of hormone replacement therapy. Observational studies had suggested that long term use of estrogen was likely to be associated, amongst other things, with reduced risks of osteoporosis and ischaemic heart disease and increased risks of breast and endometrial cancer. Concomitant use of progestogens had been shown to protect against endometrial cancer, but there were few data showing how progestogen might affect estrogen actions on other conditions. Disease specific risks from observational studies suggested that, overall, long-term HRT was likely to be beneficial. Several studies showed that mortality from all causes was lower in HRT users than in non-users. Some secondary cardiovascular prevention trials were ongoing but evidence was also required for a range of outcomes in healthy women. The WISDOM trial was designed to compare combined estrogen and progestogen versus placebo, and estrogen alone versus combined estrogen and progestogen. During the development of WISDOM the Women's Health Initiative trial was designed, funded and started in the US. Design: Randomised, placebo, controlled, trial. Methods: The trial was set in general practices in the UK (384), Australia (94), and New Zealand (24). In these practices 284175 women aged 50–69 years were registered with 226282 potentially eligible. We sought to randomise 22300 postmenopausal women aged 50 – 69 and treat for ten years. The interventions were: conjugated equine estrogens, 0.625 mg orally daily; conjugated equine estrogens plus medroxyprogesterone acetate 2.5/5.0 mg orally daily; matched placebo. Primary outcome measures were: major cardiovascular disease, osteoporotic fractures, breast cancer and dementia. Secondary outcomes were: other cancers, all cause death, venous thromboembolism and cerebro-vascular disease. Results: The trial was prematurely closed during recruitment following publication of early results from the Women's Health Initiative. At the time of closure, 56583 had been screened, 8980 entered run-in, and 5694 (26% of target of 22,300) randomised. Those women randomised had received a mean of one year of therapy, mean age was 62.8 years and total follow-up time was 6491 person years. Discussion: The WISDOM experience leads to some simple messages. The larger a trial is the more simple it needs to be to ensure cost effective and timely delivery. When a trial is very costly and beyond the resources of one country, funders and investigators should make every effort to develop international collaboration with joint funding
The ecology of wisdom
Full text linkThis is the first of two papers concerning wisdom as an ecosystem appearing in sequential editions of Management & Marketing journal. The notion of wisdom as an ecosystem, or “the wisdom ecology,” builds on work by Hays (2007) who first identified wisdom as an organisational construct and proposed a dynamic model of it. The centrepiece of this paper and the companion part to follow is a relationship map of the wisdom ecosystem (the Causal Loop Diagram at Figure 1). This first instalment provides background on wisdom and complex adaptive systems, and introduces the wisdom ecosystem model. The second instalment, “Mapping Wisdom as a Complex Adaptive System,” appearing in the next edition of Management & Marketing, explains systems dynamics modelling and discusses the wisdom ecosystem model in detail. It covers the four domains, or subsystems, of the wisdom ecosystem, Dialogue, Communal Mind, Collective Intelligence, and Wisdom, and walks readers through the model, exploring each of its 24 elements in turn. That second paper examines the relationships amongst system elements and illuminates important aspects of systems function.causal loop diagramming, complexity, dialogue, organisational learning, systems dynamics, wisdom.
What do managers’ know? Examining experienced managers’ wisdom
No full textPurpose: The paper critically examines the nature of managerial knowledge, highlights the limitations of formal managerial knowledge in informing managerial practice and demonstrates the role of alternative forms of knowledge, knowing and wisdom in informing the practice of a sample of middle-managers.
Design/Methodology/Approach: The literature of managerial knowledge and wisdom is critically reviewed and seven components of wisdom are identified and discussed. Empirically, a qualitative research approach was adopted which involved visual-elicitation interviews focused on the nature of the work and learning of nineteen later-career middle-managers. Interviews were transcribed and an inductive, thematic, analysis of the data undertaken.
Findings: The findings show the incidence and types and extent of wisdom evident in the managers’ accounts of their work. Extensive empirical evidence is interpreted in the light of an inductively derived analytical framework.
Research Limitations/Implications: Certain limitations of the research are acknowledged and practical suggestions developed for further research.
Practical Implications: Practical implications include the need for skepticism regarding the contributions of the corpus of formal management knowledge to managerial practice and the need to change the emphasis in manager development and education. Specific suggestions are developed for educational practices to cultivate wisdom.
Originality / Value: The paper consolidates disparate critiques of formal managerial knowledge, provides a useful analytical typology of managerial wisdom and presents sound evidence of the extent and nature of wisdom used in middle-managers’ practice
Arthur Godfrey's Talent Scout Show in New York City
No full textScrapbook by Diane Wisdom containing letters, telegrams, newspaper clippings, tickets, and other ephemera from the events of May 16, 1957 when Diane Wisdom is accepted into Arthur Godfrey's Talent Scout Show to fan mail postmarked August 02, 1957 after her return to Dallas
Thoughts from a Band Bus
No full textAutobiographical notes from Diane Wisdom regarding her interactions with various performers and celebrities
Mapping wisdom as a complex adaptive system
Full text linkThis is the second of two papers concerning wisdom as an ecosystem appearing in sequential editions of Management & Marketing journal. The notion of wisdom as an ecosystem, or "the wisdom ecology", builds on work by Hays (2007) who first identified wisdom as an organisational construct and proposed a dynamic model of it. The centrepiece of this and its former companion paper is a relationship map of the Wisdom Ecosystem (the Causal Loop Diagram at Figure 1). The first paper, "The Ecology of Wisdom", introduced readers to the topics of wisdom and complex adaptive systems, and presented a dynamic model of the Wisdom Ecosystem. This second paper discusses systems dynamics modelling (mapping systems) and covers the Wisdom Ecosystem model in detail. It describes the four domains, or subsystems, of the Wisdom Ecosystem, Dialogue, Communal Mind, Collective Intelligence, and Wisdom, and walks readers through the model, exploring each of its 25 elements in turn. It examines the relationships amongst system elements and illuminates important aspects of systems function, providing a rare tutorial on developing and using Causal Loop Diagrams.Causal Loop Diagramming, Complexity, Dialogue, Organisational Learning, Systems Dynamics, Wisdom.
[Diane's Note About Judy Holliday]
No full textImage of imprinted note from Diane Wisdom about her resemblance to Judy Holliday
[Request for Leave of Absence]
No full textLetter from Diane Wisdom to SMU Dean of Instruction Frederick D. Smith requesting a leave of absence to sing in Tommy Dorsey's Orchestra. The Dean's reply is appended
Hassell With Wisdom
No full textDocument describing the careers Diane Wisdom and Jimmy Hassell before uniting as the Hassell With Wisdom act
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