‘The costumes don’t do it for me’: Obstacles to the translation of ‘new’ management ideas

It has been argued that management support is important to successfully translate new management ideas into practice. Through focusing on the obstacles to the translation of a management guru text in a manufacturing organisation, we point towards a far more uncertain situation. First, we explore the paradoxical situation of engaged managers undermining the implementation of new ideas. Second, we consider how attempts to use humour to aid translation may generate a variety of unintended employee translations. Third, we examine how the objects that management enlist to support translation can thwart change. It has been argued that ‘technological’ and ‘textual’ objects exercise agency through making humans act in intended ways. Into this mix, we add ‘cultural’ objects (in our case costumes) and argue that while they exercise agency, the outcomes they produce may hinder managerial designs

Correspondence between electronic structure calculations and simulations: nonadiabatic dynamics in CS2

The choice of ab initio electronic structure method is an important factor in determining the fidelity of nonadiabatic dynamics simulations. We present an in-depth comparison of two simulations of photodissociation in the CS2 molecule following excitation to the 1 1^B_2 state. The simulations account for nonadiabatic and spin-orbit coupling, and are performed using the SHARC surface-hopping approach combined with state-averaged SA8-CASSCF(8,6)/SVP and SA8-CASSCF(10,8)/SVP {\it{ab initio}} calculations, with additional reference calculations at the MRCI(14,10)/aug-cc-pvTZ level. The relative performance and veracity of the simulations can be assessed by inspection of the potential energy curves along specific coordinates. The simulations demonstrate direct competition between internal conversion and intersystem crossing, with strong correlation between molecular geometry, electronic state density, and dynamics

Valorising Nutrient-Rich Digestate as a Waste-Based Media for Microalgal Cultivation: Bench-Scale Filtration Characterisation and Scale-Up for a Commercial Recovery Process

Cultivating microalgae requires a nitrogen and phosphorous feed source. Anaerobic digestion waste (digestate) provides a cheap sustainable feedstock for these materials. Previous studies have successfully demonstrated the feasibility of nutrient recovery and subsequent algae growth. There is now a need to fully characterise digestate filtration to improve our understanding of this process prior to its commercialisation. In this work, digestate filtration is characterised at bench scale using frontal (dead-end) filtration and a 100 kDa MWCO ultrafiltration membrane. Our experiments demonstrated rapid cake formation causing significant flux decline. The steady-state permeate flux for digestate was 2.4 to 4.8 L m−2 h−1, a reduction of ~90% compared to clean water flux. The specific cake resistance was ~1015 m kg−1 and the compressibility index 1.07. A series of four filtration and cleaning cycles showed 90% flux recovery following a clean water wash. Digestate filtration was then evaluated at a commercial scale using crossflow and the KOCH ABCOR® tubular membrane (100 kDa MWCO). The results were similar to those at the bench scale, i.e., rapid initial fouling leading to a period of steady-state flux (approximately 7 L m−2 h−1). The commercial membrane was flushed with water and diluted bleach after each use, and a digestate permeate flux decline of only 4.8% over a 12-month active use period was observed. The present research provides bench scale characterisation and demonstrates the commercial scale operation of anaerobic digestate filtration using ultrafiltration. The overall filtration performance was excellent, and the process can now be scaled to any operational capacity

Caring for transgender people: looking beyond the hype.

This special issue of Sexual Health presents a collection of articles that addresses issues facing transgender individuals that are particularly challenging. Issues covered range from sexual health education in schools, the need for accurate epidemiological measurements, the perils of inaccurate diagnostic labels of transgender children, legal issues, the disproportionately high prevalence of HIV and sexually transmissible infections (STIs), and the role of primary care. We need to think critically, constructively and compassionately about transgender people. Particularly, we must look beyond the hype and objectively consider the evidence, without forgetting the people who are trying to cope with feelings that may be causing them great distress

"I just want to feel safe going to a doctor": Experiences of female patients with chronic conditions in Australia

Background: The androcentric history of medicine and medical research has led to an ongoing sex and gender gap in health research and education. Sex and gender gaps in research and education may translate into real-life health inequities for women. This study aimed to explore the experiences of female patients with chronic health conditions in the Australian health system, considering existing sex and gender gaps in medicine. Methods: This qualitative study used semistructured in-depth interviews with a sample of adult women with chronic conditions in Australia. Thematic analysis was undertaken, guided by Braun and Clarke. Software NVivoX64 assisted in the management of the data. Coding was performed before grouping into subthemes and central themes. To allow for potential researcher biases, the principal researcher engaged in the practice of reflexivity, including the writing of detailed notes during analysis. Results: Twenty adult Australian women with chronic conditions were interviewed. Diagnoses were varied and included Ehlers–Danlos syndrome, chronic fatigue syndrome, functional neurological disorder, and inflammatory bowel disease. Four central themes emerged: diagnostic difficulties; spectrum of health care experiences; understanding medical complexity; and coping with symptoms. Conclusions: Women with chronic conditions in Australia report pain, fatigue, and suffering that significantly impacts upon their daily lives. There was a shared experience of feeling that the pain and suffering of women was dismissed or not taken seriously. Many women expressed trauma because of their experiences in health care and often this led to a fear of accessing health services. The participants highlighted a need for more knowledge, understanding, and empathy from health care practitioners

Mind the gap: reporting and analysis of sex and gender in clinical trials in Australia, a cross-sectional study

Introduction: Historically, medical studies have underrepresented female participants and most research data have been collected from males and generalized to other genders. This article aims to determine if there is a sex and/or gender gap in recent Australian health research. Methods: This descriptive cross-sectional study of the published literature examines recent Australian-based clinical trials for inclusion of sex and gender. Medians and interquartile ranges (IQRs) were calculated for study sample sizes and female:male representation. Proportion of sex and/or gender was analyzed by the clinical specialty of the trials. t-Tests were used to ascertain significance of any difference in recruitment of female and males. Results: A total of 88 articles were included in the analysis. Most studies (n = 63) were randomized clinical controlled trials. Overall women constituted 55% (IQR 30% of all participants). Of the 71 mixed-sex studies, only 8.9% (n = 7) analyzed the data by sex. Women were significantly underrepresented in cardiology and nephrology studies and overrepresented in psychiatry, care of the elderly, and orthopedic studies. Conclusions: When analyzed by specialty, women are overrepresented in specialties considered to be female patient dominated, such as psychiatry and care of the elderly, and underrepresented in specialties such as cardiology and nephrology. The overrepresentation of women in some specialties can reinforce gender stereotypes, potentially harming women. In addition, exclusion of males from these areas of research may be of disservice to men’s health

Sex inequalities in medical research: a systematic scoping review of the literature

Background: Historically, medical studies have excluded female participants and research data have been collected from males and generalized to females. The gender gap in medical research, alongside overarching misogyny, results in real-life disadvantages for female patients. This systematic scoping review of the literature aims to determine the extent of research into the medical research sex and gender gap and to assess the extent of misogyny, if any, in modern medical research. Methods: Initial literature searches were conducted using PubMed, Science Direct, PsychINFO and Google Scholar. Articles published between January 01, 2009, and December 31, 2019, were included. An article was deemed to display misogyny if it discussed the female aesthetic in terms of health, but did not measure health or could not be utilized to improve clinical practice. Results: Of the 17 included articles, 12 examined the gender gap in medical research and 5 demonstrated misogyny, assessing female attractiveness for alleged medical reasons. Females remain broadly under-represented in the medical literature, sex and gender are poorly reported and inadequately analyzed in research, and misogynistic perceptions continue to permeate the narrative. Conclusion: The gender gap and misogynistic studies remain present in the contemporary medical literature. Reasons and implications for practice are discussed

An Unusual ED Case: Aortic Aneurysm Presenting as CHF Exacerbation

There has been a significant increase in the incidence of thoracic aortic aneurysms, currently making aneurysmal disease the 18th most common cause of death within the United States. This disease is typically an insidious one, with the aorta growing an average of only 0.1 cm per year. Consequently, most patients remain asymptomatic until late stages of the disease when dissection or worse, rupture has occurred. Under extremely rare circumstances, thoracic aortic aneurysms can present clinically due to mass effect. Airway, esophageal and vascular compression, secondary to aortic arch dilation has been previously documented. The condition can be acquired or congenital, and can also manifest as double aortic arch, aberrant subclavian artery, and pulmonary artery sling. Additionally, Kommerell’s diverticulum, a bulbous configuration at the proximal descending aorta of left or right arch configuration, is a rare cause of tracheobronchial compression. Regardless of its form, mass effect due to thoracic vascular abnormality such as aneurysm can lead to tracheomalacia, and ultimately airway collapse, under chronic conditions. Clinical presentation can vary from cough, to hoarseness of voice, chest pain, and in the case of our patient, progressive dyspnea which was initially mistaken for acute exacerbation of chronic heart failure

Evidence-Based Medicine: Feminist Criticisms and Implications for Women's Health

Evidence-based medicine (EBM) dates back to 19th-century Paris and started out as a new paradigm for practicing medicine, with the aim of replacing anecdote with high-quality evidence from positivist-style research. Despite the clear logic underpinning EBM, there have been numerous criticisms, including maintenance of an archaic view of evidence as "facts," failure to acknowledge that all research is underpinned by the beliefs of the researcher, and the simple fact that medical research has historically been androcentric and results generalized to female patients. In this essay, we discuss the criticisms of EBM, with a focus on feminist critiques based on three central feminist epistemologies: feminist empiricism, standpoint theory, and social constructivism. We argue that EBM potentially perpetuates gaps in women's health and advocate for incorporating feminist epistemologies into future medical research to garner further understanding of social influences on women's health. In addition, we argue that EBM may degrade the clinical acumen and that critical thinking should become a key component of medical school curricula. "To question the foundations of a discipline or practice is not necessarily to deny its value, but rather to stimulate a judicious and balanced appraisal of its merits."1 Evidence-based medicine (EBM) started out as a new paradigm for practicing medicine, replacing theoretical reasoning and anecdote with evidence from high-quality studies.2 From the outset, critics have expressed concerns that methods for gathering evidence are flawed and questioned the external validity of studies gathering information from groups of people and applying them to the individual.3 In this study, we will review the conceptual background of EBM, discuss some of the general criticisms of EBM, and finally critique EBM from a feminist perspective