'I do and I understand': The importance of reflective placements for the self-perceived work readiness of health sciences students

POPLHLTH 302: Health Service Placement is a community health placement program that forms the capstone course for the Bachelor in Health Sciences (BHSc) at the University of Auckland. It aims to enable Population Health students to develop through experience the competencies that they will need to be employed in a broad range of roles in the health sector, including health policy analysis, health management, health information and health promotion. It provides students with the opportunity to gain a critical understanding of an organisation through day-to-day engagement with the provision of health services, and thereby to transition from university to work and to develop life-long learning attitudes and skills. Eighty-three students enrolled in the course completed a questionnaire before and after their placement about their skills, confidence and readiness to participate in the health workforce, and their knowledge of it and the health needs of the NZ population. A mixed methods analysis of the data confirmed that students’ perceptions of their work-readiness improved over the course of the placement, in particular, where transferable skills such as confidence, time management, networking, the application of theory in practice, and team work were concerned

Knowledge Management in the Context of an Ageing Workforce: Organizational Memory and Mentoring

Organizational memory has significant potential for companies’ competitive advantage, with mentoring considered a particularly effective method of transferring this knowledge. Older workers are often considered ideal mentors because of their experience and alleged willingness to pass on their knowledge. There is an associated assumption that these workers anticipate and experience positive outcomes from mentoring others. This thesis tested if these assumptions hold up in 21st century workplaces - some discriminatory practices towards older workers and a career contract that no longer guarantees employment, may discourage knowledge sharing. An organizational memory scale was constructed to help test the assumptions and an exploratory factor analysis involving 143 employees from eight companies resulted in 21 items and five correlated factors including socio-political knowledge, job knowledge, external network, history, and industry knowledge. Two confirmatory factor analyses, the first involving 287 employees and the second 115 retirees, found support for five correlated first-order factors and a second order factor, organizational memory. In a third study involving 134 employees, support was found for a model of organizational memory and empowerment. Age was found to relate to organizational memory but this relationship was mediated by organizational tenure. In turn, organizational memory was found to relate to psychological empowerment and the frequency with which participants were requested to share knowledge at work. Organizational memory, empowerment and request to train and mentor others also positively related to organization-based self-esteem. In the fourth study, an organizational case study involving 78 employees, support was found for a model of organizational memory and the intention to mentor within the context of an aging workforce. Generativity and the expected cost of the time and effort involved in mentoring mediated the relationship between organizational memory (specifically, socio- political knowledge) and the intention to mentor. Furthermore those participants with high scores on both organizational memory and occupational self-efficacy anticipated more cost in time and effort, and indicated less intention to mentor, than those with high organizational memory but low occupational self-efficacy. These findings challenge the assumption that experienced workers are, as a matter of course, willing to mentor others. In a final study involving 96 retired individuals, there were no significant differences found between retirees with and those without experience as a mentor, in career satisfaction and unwelcome work ruminations. However notably, the study showed that participants did experience unwelcome work ruminations even (as in the case of some) well into retirement. The thesis concludes with a summary of findings as they relate to the assumptions under examination, an outline of the overall implications of the findings for future research and for organizational practice, and closing remarks about the overall research contribution of the thesis

The Concept of Leadership in the Health Care Sector

The health care sector is characterised by constant reforms aimed at the efficient delivery of safe, effective, and high-quality care. Effective leadership is required to lead and drive changes at all levels of the health system to actualise the goals of the ongoing reforms in health care organisations. Leadership in the health care sector is spread across management and clinical workforces, creating peculiar challenges. The chapter examines the concept of leadership in the health care sector within the context of the recent drive by health care organisations to identify essential competencies and training required by health management and leadership workforces for effective performance in roles. It concludes that further research is needed to build the evidence on the relationships between targeted training and professional development interventions, individual competence of leaders from health management and clinical backgrounds and organisational performance

Implications of New Zealand’s Primary Health Care Policies for Management and Leadership

Introduction: Reforms have been introduced since 2000 to make New Zealand’s health system primary care-led. A competent health management workforce is necessary to provide leadership for the goals of the reforms to be realised. Aim and objective : To review New Zealand’s key primary health care policies from 2000 to 2016 and consider their implications for management and leadership. Methods : A document analysis was undertaken using qualitative content analysis. Eligible documents were identified through the websites of relevant government and non-government agencies, World Health Organisation, and through Google Scholar. Findings :Two key policy trends relating to primary health care were identified. Firstly, a population health orientation to improve access to health care through community participation, and secondly, an integrated approach to promote collaboration within the health system, and between the health system and other sectors. The inferred management and leadership skillsets required to realise these policies included relationship management and collaboration, change management, and leadership. Conclusion: New Zealand’s primary health care sector underwent substantial reform between 2000 and 2016. Management and leadership capabilities need to be strengthened and developed for the benefits of the reforms to be realised

Outcomes and Impact of Training and Development in Health Management and Leadership in Relation to Competence in Role: A Mixed-Methods Systematic Review Protocol

Background: The need for competence training and development in health management and leadership workforces has been emphasised. However, evidence of the outcomes and impact of such training and development has not been systematically assessed. The aim of this review is to synthesise the available evidence of the outcomes and impact of training and development in relation to the competence of health management and leadership workforces. This is with a view to enhancing the development of evidence-informed programmes to improve competence. Methods and Analysis: A systematic review will be undertaken using a mixed-methods research synthesis to identify, assess and synthesise relevant empirical studies. We will search relevant electronic databases and other sources for eligible studies. The eligibility of studies for inclusion will be assessed independently by two review authors. Similarly, the methodological quality of the included studies will be assessed independently by two review authors using appropriate validated instruments. Data from qualitative studies will be synthesised using thematic analysis. For quantitative studies, appropriate effect size estimate will be calculated for each of the interventions. Where studies are sufficiently similar, their findings will be combined in meta-analyses or meta-syntheses. Findings from quantitative syntheses will be converted into textual descriptions (qualitative themes) using Bayesian method. Textual descriptions and results of the initial qualitative syntheses that are mutually compatible will be combined in mixed-methods syntheses. Discussion: The outcome of data collection and analysis will lead, first, to a descriptive account of training and development programmes used to improve the competence of health management and leadership workforces and the acceptability of such programmes to participants. Secondly, the outcomes and impact of such programmes in relation to participants’ competence as well as individual and organisational performance will be identified. If possible, the relationship between health contexts and the interventions required to improve management and leadership competence will be examined

Within-population genetic structure differs between two sympatric sister-species of ectomycorrhizal fungi, Rhizopogon vinicolor and R. vesiculosus

Using spatial autocorrelation analysis, we examined the within-population genetic structure of Rhizopogon vinicolor and R. vesiculosus, two hypogeous ectomycorrhizal (EM) species that are sympatric sister taxa known to differ in their clonal structure. We collected 121 sporocarps and 482 tuberculate EM of both species from a 20 ha forest stand dominated by Douglas-fir (Pseudotsuga menziesii). Field collections were identified to species with restriction fragment length polymorphism analysis of the nuclear ribosomal internal transcribed spacer. Five and six microsatellite markers were used to characterize the genetic diversity of EM and sporocarp samples from R. vesiculosus and R. vinicolor respectively. After correcting for genet structure, spatial autocorrelation analyses of the EM samples were used to test the null hypothesis that multilocus genotypes characterized from each species were randomly distributed within the study area. We detected positive and statistically significant fine-scale genetic structure up to 120 m within the R. vesiculosus sample. In contrast, no spatial genetic structure was evident for R. vinicolor, indicating that the genotypes characterized for this species were randomly distributed throughout the study area. Differences in statistical power or the nuclear count of basidiospores are unlikely agents of the genetic patterns observed. Our results suggest that differences in reproductive output or competitive ability may act individually or in combination to create clusters of similar genotypes for R. vesiculosus throughout the study area.This is the publisher’s final pdf. The published article is copyrighted by the Mycological Society of America and can be found at: http://www.msafungi.org/Keywords: genet, Rhizopogon, ectomycorrhizal, genetic structure, spatial autocorrelation, fung

What attributions do Australian high-performing general practices make for their success? Applying the clinical microsystems framework: a qualitative study

No commercial use is permitted unless otherwise expressly granted. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/Objectives To identify the success attributions of high-performing Australian general practices and the enablers and barriers they envisage for practices wishing to emulate them. Design Qualitative study using semi-structured interviews and content analysis of the data. Responses were recorded, transcribed verbatim and coded according to success characteristics of high-performing clinical microsystems. Setting Primary healthcare with the participating general practices representing all Australian states and territories, and representing metropolitan and rural locations. Participants Twenty-two general practices identified as high performing via a number of success criteria. The 52 participants were 19 general practitioners, 18 practice managers and 15 practice nurses. Results Participants most frequently attributed success to the interdependence of the team members, patient-focused care and leadership of the practice. They most often signalled practice leadership, team interdependence and staff focus as enablers that other organisations would need to emulate their success. They most frequently identified barriers that might be encountered in the form of potential deficits or limitations in practice leadership, staff focus and mesosystem support. Conclusions Practice leaders need to empower their teams to take action through providing inclusive leadership that facilitates team interdependence. Mesosystem support for quality improvement in general practice should focus on enabling this leadership and team building, thereby ensuring improvement efforts are converted into effective healthcare provision.The research reported in this article was funded by a grant from the Australian Government Department of Health

Exile Vol. XXXIX No. 1

Title Page by Ellen Gurley \u2793 i Epigraph by Ezra Poind ii Table of Contents iii-iv Remaining a Soldier by Kristin Kruse \u2793 1-2 Vietnam War Memorial by Brooke MacKaye 3 We both ride in back by Chris Macaluso \u2793 4 Artwork by Jamie Oliver \u2794 5 Liberal Dirge #1 by Charis Brummitt \u2796 6-7 Artwork (anonymous) 7 Two ex-lovers and a dirty glass door by Chris Macaluso \u2793 8 The Salt of the Air by Kristen Padden \u2793 9-12 Artwork (anonymous) 13 Artwork by Ellen Gurley \u2793 14 Sun-Child by Jen Rudgers \u2796 15 Crazy Horse by Kevin Nix \u2794 16 The Fall of the Western Field by Rich Croft \u2793 17 In the Closet by Beth Widmaier \u2795 18 Winter Strawberries by Katy Rudder \u2793 19 Still Life (anonymous) 19 For This and Much Beyond This Poem by Matt Wanat \u2795 20-21 Artwork by Peggy Ryan \u2793 22 The Cycle Repeats: Apathy by Ishak Kang \u2793 23 The Judge by Ellen Gurley \u2793 24 Pear Colored by Erin Dempsey \u2793 25-26 4-Square by Trey Dunham \u2794 27 Artwork by Jamie Oliver \u2794 28 Ink & Heroine by Rich Croft \u2793 29 Figments by Craig Bowers \u2793 30-31 Malfi Coast (anonymous) 31 Suzanne (anonymous) 32 Hey Stella by Carey Chistie \u2795 33 Turning Leaves by Erin Lott \u2796 34-35 Reclining Nude (anonymous) 35 Blazon by Matt Wanat \u2795 36-37 Artwork by Holly Aikens \u2793 38 Awake by A. Fair \u2796 39 Dell the Barber by Kevin Nix \u2795 40 Artwork by Holly Aikens \u2793 40 Tree House by Katy Rudder \u2793 41-46 Jailbait by Ellison J. Stind \u2795 47 Mother by Charis Brummitt \u2796 48-49 Artwork by Bess Hammer \u2795 49 Private Origami by Trey Dunham \u2794 50 Among the Tendrils of Sleep by J. Trevett Allen \u2795 51 Poet of the Unforgiven by Carey Christie \u2795 52 Stuntman Steve by Andrew Zobay \u2793 53 sculpture by Lily Streett \u2794 53 Wonderings of an Adopted Son by Andy Heckert \u2793 54-55 Artwork by Holly Aikens \u2793 55 Odd Binge by C. N. Polumbus \u2793 56-57 Artwork by Holly Aikens \u2793 57 Artwork by Peggy Ryan \u2793; untitled by Jennifer Wendell \u2794 (superimposed) 58 Shadows of Pearl by Travis Brady \u2793 59-60 October/Rt. 161 by Annette Gallagher 61 Artwork by Jamie Oliver \u2794 61 The Influx by Craig Bowers \u2793 62 Artwork by Michael Norpell \u2794 63 editorial board 64 Editorial decision is shared equally among the Editorial Board. -64 Cover: Jamie Oliver -64 NOTE: With the exeption of Malfi Coast , all artwork listed as anonymous in the published table of contents appears to be signed by Ellen Gurley. 37th Yea

Genetic fine mapping and genomic annotation defines causal mechanisms at type 2 diabetes susceptibility loci.

We performed fine mapping of 39 established type 2 diabetes (T2D) loci in 27,206 cases and 57,574 controls of European ancestry. We identified 49 distinct association signals at these loci, including five mapping in or near KCNQ1. 'Credible sets' of the variants most likely to drive each distinct signal mapped predominantly to noncoding sequence, implying that association with T2D is mediated through gene regulation. Credible set variants were enriched for overlap with FOXA2 chromatin immunoprecipitation binding sites in human islet and liver cells, including at MTNR1B, where fine mapping implicated rs10830963 as driving T2D association. We confirmed that the T2D risk allele for this SNP increases FOXA2-bound enhancer activity in islet- and liver-derived cells. We observed allele-specific differences in NEUROD1 binding in islet-derived cells, consistent with evidence that the T2D risk allele increases islet MTNR1B expression. Our study demonstrates how integration of genetic and genomic information can define molecular mechanisms through which variants underlying association signals exert their effects on disease

Knowledge Management in the Context of an Ageing Workforce: Organizational Memory and Mentoring

Organizational memory has significant potential for companies’ competitive advantage, with mentoring considered a particularly effective method of transferring this knowledge. Older workers are often considered ideal mentors because of their experience and alleged willingness to pass on their knowledge. There is an associated assumption that these workers anticipate and experience positive outcomes from mentoring others. This thesis tested if these assumptions hold up in 21st century workplaces - some discriminatory practices towards older workers and a career contract that no longer guarantees employment, may discourage knowledge sharing. An organizational memory scale was constructed to help test the assumptions and an exploratory factor analysis involving 143 employees from eight companies resulted in 21 items and five correlated factors including socio-political knowledge, job knowledge, external network, history, and industry knowledge. Two confirmatory factor analyses, the first involving 287 employees and the second 115 retirees, found support for five correlated first-order factors and a second order factor, organizational memory. In a third study involving 134 employees, support was found for a model of organizational memory and empowerment. Age was found to relate to organizational memory but this relationship was mediated by organizational tenure. In turn, organizational memory was found to relate to psychological empowerment and the frequency with which participants were requested to share knowledge at work. Organizational memory, empowerment and request to train and mentor others also positively related to organization-based self-esteem. In the fourth study, an organizational case study involving 78 employees, support was found for a model of organizational memory and the intention to mentor within the context of an aging workforce. Generativity and the expected cost of the time and effort involved in mentoring mediated the relationship between organizational memory (specifically, socio- political knowledge) and the intention to mentor. Furthermore those participants with high scores on both organizational memory and occupational self-efficacy anticipated more cost in time and effort, and indicated less intention to mentor, than those with high organizational memory but low occupational self-efficacy. These findings challenge the assumption that experienced workers are, as a matter of course, willing to mentor others. In a final study involving 96 retired individuals, there were no significant differences found between retirees with and those without experience as a mentor, in career satisfaction and unwelcome work ruminations. However notably, the study showed that participants did experience unwelcome work ruminations even (as in the case of some) well into retirement. The thesis concludes with a summary of findings as they relate to the assumptions under examination, an outline of the overall implications of the findings for future research and for organizational practice, and closing remarks about the overall research contribution of the thesis