The period following heart failure hospitalization (HFH) is a vulnerable time with high rates of death or recurrent HFH.OBJECTIVE To evaluate clinical characteristics, outcomes, and treatment response to vericiguat according to prespecified index event subgroups and time from index HFH in the Vericiguat Global Study in Subjects With Heart Failure With Reduced Ejection Fraction (VICTORIA) trial. DESIGN, SETTING, AND PARTICIPANTSAnalysis of an international, randomized, placebo-controlled trial. All VICTORIA patients had recent (<6 months) worsening HF (ejection fraction <45%). Index event subgroups were less than 3 months after HFH (n = 3378), 3 to 6 months after HFH (n = 871), and those requiring outpatient intravenous diuretic therapy only for worsening HF (without HFH) in the previous 3 months (n = 801). Data were analyzed between May 2, 2020, and May 9, 2020.INTERVENTION Vericiguat titrated to 10 mg daily vs placebo. MAIN OUTCOMES AND MEASURESThe primary outcome was time to a composite of HFH or cardiovascular death; secondary outcomes were time to HFH, cardiovascular death, a composite of all-cause mortality or HFH, all-cause death, and total HFH. RESULTS Among 5050 patients in the VICTORIA trial, mean age was 67 years, 24% were women, 64% were White, 22% were Asian, and 5% were Black. Baseline characteristics were balanced between treatment arms within each subgroup. Over a median follow-up of 10.8 months, the primary event rates were 40.9, 29.6, and 23.4 events per 100 patient-years in the HFH at less than 3 months, HFH 3 to 6 months, and outpatient worsening subgroups, respectively. Compared with the outpatient worsening subgroup, the multivariable-adjusted relative risk of the primary outcome was higher in HFH less than 3 months (adjusted hazard ratio, 1.48; 95% CI, 1.27-1.73), with a time-dependent gradient of risk demonstrating that patients closest to their index HFH had the highest risk. Vericiguat was associated with reduced risk of the primary outcome overall and in all subgroups, without evidence of treatment heterogeneity. Similar results were evident for all-cause death and HFH. Addtionally, a continuous association between time from HFH and vericiguat treatment showed a trend toward greater benefit with longer duration since HFH. Safety events (symptomatic hypotension and syncope) were infrequent in all subgroups, with no difference between treatment arms.CONCLUSIONS AND RELEVANCE Among patients with worsening chronic HF, those in closest proximity to their index HFH had the highest risk of cardiovascular death or HFH, irrespective of age or clinical risk factors. The benefit of vericiguat did not differ significantly across the spectrum of risk in worsening HF.

Purpose-The purpose of this paper is to ask: what effect does moving from individual to collective understandings of the entrepreneur in enterprising education have on the student's learning? And given this shift in understanding, is there a need for a new paradigm in entrepreneurship learning? Design/methodology/approach-This paper draws on ethnographic data from entrepreneurship education (EEd) at a summer school in Denmark. The purpose of the summer school was to bring the students from an awareness of their own competences to a shared understanding of resources, relationships, and opportunities for becoming enterprising. Findings-Drawing on the recent developments in understanding creativity, the authors' explore the potential for similarities between becoming an entrepreneur in collaboration with others and being creative in collaboration with others. The authors' found that a focus on the collaborative and distributed character of entrepreneurship, as within the We-paradigm from creativity, does not exclude the importance of perceptions of individuals' self-images as part of a course in entrepreneurship. Yet, a reformulation of these could be an entry point for richer group work and articulation of diverse group potential. Research limitations/implications-This study suggests that it is possible to take at least one step further in what can be achieved during an EEd course. Rather than remain a focus on individual learning and treating group work a didactics instrument, team formation processes can be used as a pedagogy/andragogy experiential tool in the classroom with its own learning outcomes, as presented and discussed above. For educators, this means that they have an additional tool to aid the complicated task of bringing EEd to students across campus. For students, this new approach means that the often dreaded and frustrating process of classroom team formation can become a positive experience of purposeful team assembly and collaboration. Two possible limitations regarding the findings of this paper can be identified: for students with extensive experience in forming teams and working in groups, taking them through this process may not have the desired effect as they may rely on habits and known mechanism without much reflection; it may be difficult to achieve the desired effect with students that know each other well before the course starts, as they may have too strong hidden agendas about who they want to work with and who they do not want to work with that this will overpower the idea/opportunity/subject-matter driven approach (Aldrich and Kim, 2007). Educators should consider if they may be subject to these limitations as this may have an effect on the use of active, opportunity-driven team formation in practice. To counter the second limitation, educators may want to consider how far into a course they want to facilitate the team formation; especially for courses running over significantly longer periods than two weeks. Future research may be able to assess the significance of these limitation...

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This article presents a phenomenological study that was conducted as a series of semi-structured qualitative research interviews with eight student therapists, just two months after their debut in this role. Thematically, the interviews focused on specific examples of good and bad supervisory events. Also included were the importance of peers in the supervision group and the organisational setting of the supervision. The objective was to give detailed descriptions in the form of condensed narratives of each student's preferences concerning supervision. Furthermore, a cross-sectional analysis was conducted, in order to determine what typically characterized this sample. As expected, we both found major individual differences, but also similarities within and across the sample that confirm previous findings in the literature. With respect to the latter, our findings are very close to those in the existing literature in the field. The beginning therapists prefer supervision in which advice and clear and specific instructions are given on how to do the job, where theoretical considerations are included, and the supervisor supports, affirms and structures the sessions. However, of particular interest are the major individual differences that emerged. These are conspicuous in the presented narratives of each student therapist. Thus, to some therapists, seemingly frustrating supervisory experiences turned out to be very helpful. Role modelling and the parallel process also were found to be of importance for learning. A practical implication of these differences is that supervisors should not merely follow the general directions given in the literature for supervising beginning

In this article the author argues that research interviewing can be a form of research practice in which the subjects of study can object to the researcher's questions and the interview's theme. Researchers performing qualitative interviews should pay particular attention to situations where interviewees object to what we think, say, and write about them. The author draws on empirical examples where the objections and hesitations voiced by the interviewees toward the interviewer's questions became part of reconsidering the initial theoretical concepts guiding the research process. She argues that the interviewer should not provoke such situations but, rather, be sensitive enough to remain open to the possibility that the interviewee might feel a need to object to or refuse the researcher's interpretations. When this happens, it can allow for a fruitful exploration of the theme of conversation and the researcher's agenda.