Anterior pituitary gland dysfunction following mild traumatic brain injury

Traumatic brain injury (TBI) is a major cause of morbidity and mortality worldwide. Many sufferers never return to their pre-injury level of function and have life-long health and socioeconomic problems that limit their daily activities. In the last two decades there has been renewed interest in whether post-TBI anterior pituitary dysfunction (PTPD) contributes to morbidity. The PhD focuses on patients with mild TBI (mTBI). My aims are to explore the scientific evidence for PTPD including its prevalence in the TBI population and how it is currently managed by Neurosurgeons in Great Britain and Ireland. I also performed a prospective, feasibility study to determine if a larger study of the acute and long-term effects of isolated mTBI on anterior pituitary function was deliverable. Pilot data are presented in this thesis. Our systematic review demonstrated that PTPD occurs in one-third of patients 12 months after TBI and we found disparities in surveillance practices across the UK and Ireland. We demonstrated in our feasibility study that 44% of patients have abnormal anterior pituitary hormone activity in the first 7 days following mTBI and 20% of patients who were followed up at 6 months had evidence of PTPD. We found no evidence that PTPD occurs as a result of structural damage to the anterior pituitary gland, suggesting other, yet to be determined factors play a role. A large, prospective, multi-centre study is needed to better understand the pathophysiology and incidence of PTPD

Promoting padawans: a survey examining the state of mentorship in neurosurgical training in the United Kingdom

Mentorship has long since been acknowledged as an integral part of Neurosurgical training. The authors sought to evaluate the state of mentorship in Neurosurgical training in the United Kingdom (UK). A 28-point questionnaire was sent to all neurosurgical trainees in the UK and Ireland via the British Neurosurgical Trainee’s Association (BNTA), comprising 180 trainees. There were 75 responses (180 trainees on the mailing list, 42% response rate). Despite all respondents reporting it to be at least somewhat important to have a mentor, 16% felt they had no mentors. The mean number of mentors was 2.91 with 72% of respondents having more than 1 mentor. In terms of the content of mentorship relationships, 63% were comfortable discussing career related topics with their mentor to a high or very high degree but only 29% felt comfortable discussing their general wellbeing. With regards to allocated educational supervisors, 43% thought this person to be a ‘low’ or ‘very low’ source of mentorship. The three most important traits of the ideal mentor as reported by respondents were: someone chosen by them (48%), working in the same hospital (44%) and having received formal mentorship training (36%). The current perception of mentorship in Neurosurgery from the surveyed trainees is mixed. A healthy majority of trainees benefit from mentorship of some kind, whilst a significant minority feel underserved. The surveyed trainees feel mentorship is slanted more towards clinical and professional aspects of development than it is towards personal ones. Suggestions for future insight would be an evaluation of senior registrar and consultant sentiments towards mentorship, whilst exploration into more flexible models for establishing mentoring relationships may help to address the heavy importance of trainee choice which is voiced by this survey’s results.</p

Responsible innovation in organisations:unpacking the effects of leader trustworthiness and organizational culture on employee creativity

Abstract Ongoing changes in competitiveness and advancements in technology are challenging the ability of manufacturing firms to bring about responsible innovation in emerging economies. A crucial response to this situation involves supporting employee creativity as a strategy suited to foster responsible innovation. Prior research has established a positive correlation between employee creativity and responsible innovation. However, when attempting to promote employee creativity, firms are often faced with challenges to their organizational culture (OC), especially in the presence of limited employee trust in their leaders. Although, extant research has suggested a positive correlation between leader trustworthiness and employee creativity, little is known of the stability of such relationship under diverse OCs. Also, previous research on the correlation between OC and employee creativity has yielded conflicting findings, thus failing to contribute to the knowledge of how organisations may further engage in responsible innovation. Consequently, we investigated the influence of diverse OCs on employee creativity, and how leader trustworthiness affects the relationship between them. To do so, we undertook a quantitative analysis of a coded cross-sectional survey involving 222 participants from 54 manufacturing organizations in Malaysia. The survey data were evaluated through partial least squares structural equation modelling (PLS-SEM). An importance-performance map analysis shows that clan OC has the strongest positive correlation with employee creativity and exerts the highest level of importance to it. Surprisingly, leader trustworthiness was found to decrease employee creativity and to strengthen the positive relationships of market and hierarchical OC with employee creativity. Our study offers novel insights into how diverse OCs and leader trustworthiness impact employee creativity in an emerging economy context