‘Multi-directional management’: Exploring the challenges of performance in the World Class Programme environment

Driven by the ever-increasing intensity of Olympic competition and the ‘no compromise – no stone unturned’ requirements frequently addressed by HM Government and its main agency, UK Sport, a change in culture across Olympic team landscapes is a common occurrence. With a focus on process, this paper presents reflections from eight current or recently serving UK Olympic sport Performance Directors on their experiences of creating and disseminating their vision for their sport, a vital initial activity of the change initiative. To facilitate a broad overview of this construct, reflections are structured around the vision’s characteristics and foundations, how it is delivered to key stakeholder groups, how it is influenced by these groups, the qualities required to ensure its longevity and its limitations. Emerging from these perceptions, the creation and maintenance of a shared team vision was portrayed as a highly dynamic task requiring the active management of a number of key internal and external stakeholders. Furthermore, the application of ‘dark’ traits and context-specific expertise were considered critical attributes for the activity’s success. Finally, recent calls for research to elucidate the wider culture optimisation process are reinforced

Reflective Journaling: A Theoretical Model and Digital Prototype for Developing Resilience and Creativity

Reflection is commonly discussed as a tool for personal and professional development that is becoming increasingly important in today’s global and digital world. In this paper, we propose a model that suggests ways in which reflection, in the form of Reflective Journaling, can support the development of creativity and resilience, which are needed to enable individuals to function effectively in a fast-changing environment. In addition, the model proposes ways in which external support and progress monitoring can be used in conjunction with skills in adaptive resilience and structured creativity, to support the maintenance of reflective journaling as a habit, in the longer term, thus creating virtuous cycles of skills and behaviours that can reinforce each other. Based on our model, and additional user research, we describe the design of a first digital prototype that aims to support the use of Reflective Journaling and to develop creativity and resilience through suggested mechanisms. Initial evaluations of our prototype are positive. It has been well-received by early test users, and has the potential to address all the connections defined. We therefore suggest that the theoretical model can be used to develop digital tools, such as the one included, to help those who wish to develop the habit of reflective journaling, and through that a range of other skills associated with resilience and creative thinking. We see this as a starting point for investigating this potential in more depth

Framework, principles and recommendations for utilising participatory methodologies in the co-creation and evaluation of public health interventions

Background: Due to the chronic disease burden on society, there is a need for preventive public health interventions to stimulate society towards a healthier lifestyle. To deal with the complex variability between individual lifestyles and settings, collaborating with end-users to develop interventions tailored to their unique circumstances has been suggested as a potential way to improve effectiveness and adherence. Co-creation of public health interventions using participatory methodologies has shown promise but lacks a framework to make this process systematic. The aim of this paper was to identify and set key principles and recommendations for systematically applying participatory methodologies to co-create and evaluate public health interventions. Methods: These principles and recommendations were derived using an iterative reflection process, combining key learning from published literature in addition to critical reflection on three case studies conducted by research groups in three European institutions, all of whom have expertise in co-creating public health interventions using different participatory methodologies. Results: Key principles and recommendations for using participatory methodologies in public health intervention co-creation are presented for the stages of: Planning (framing the aim of the study and identifying the appropriate sampling strategy); Conducting (defining the procedure, in addition to manifesting ownership); Evaluating (the process and the effectiveness) and Reporting (providing guidelines to report the findings). Three scaling models are proposed to demonstrate how to scale locally developed interventions to a population level. Conclusions: These recommendations aim to facilitate public health intervention co-creation and evaluation utilising participatory methodologies by ensuring the process is systematic and reproducible

Computer-assisted detection of pulmonary embolism: evaluation of pulmonary CT angiograms performed in an on-call setting

Item does not contain fulltextPURPOSE: The purpose of the study was to assess the stand-alone performance of computer-assisted detection (CAD) for evaluation of pulmonary CT angiograms (CTPA) performed in an on-call setting. METHODS: In this institutional review board-approved study, we retrospectively included 292 consecutive CTPA performed during night shifts and weekends over a period of 16 months. Original reports were compared with a dedicated CAD system for pulmonary emboli (PE). A reference standard for the presence of PE was established using independent evaluation by two readers and consultation of a third experienced radiologist in discordant cases. RESULTS: Original reports had described 225 negative studies and 67 positive studies for PE. CAD found PE in seven patients originally reported as negative but identified by independent evaluation: emboli were located in segmental (n = 2) and subsegmental arteries (n = 5). The negative predictive value (NPV) of the CAD algorithm was 92% (44/48). On average there were 4.7 false positives (FP) per examination (median 2, range 0-42). In 72% of studies or=10 FP. CONCLUSION: CAD identified small emboli originally missed under clinical conditions and found 93% of the isolated subsegmental emboli. On average there were 4.7 FP per examination.1 april 201

‘It’s quite weird to write … you feel like a nut job’: the practical and emotional consequences of writing personal reflections for assessment in psychology

Setting the tone for reflective writing – should the first person, populated approach that currently dominates be ethically questioned? An active voice is recommended to enhance ‘power’ and emotional investment in reflection, but often presents practical difficulties for students conditioned in ‘scientific’ depopulated ways. Beyond the practical, being instructed to employ a personal tone could exacerbate the emotional risks involved for vulnerable students. Ethical questioning is an area of reflection and teaching that has been largely neglected. The current paper responds to this gap, discursively considering the impact of requiring students to reflect using the first person and how this could intersect with emotionality components, located within the experiences of MSc Forensic Psychology students. Six students that had recently undertaken a reflective practice assignment volunteered to take part in a semi-structured interview about their experiences. For some students the themes of personal pronoun use and emotionality intersected, whereby at deeper levels of analysis the emotional impact was compounded by first person usage. Assessing the risk of enhanced vulnerability to psychological discomfort, implementing practical strategies to mediate this and the support procedures followed when requiring students to reflect are reviewed

Cardiothoracic CT: one-stop-shop procedure? Impact on the management of acute pulmonary embolism

In the treatment of pulmonary embolism (PE) two groups of patients are traditionally identified, namely the hemodynamically stable and instable groups. However, in the large group of normotensive patients with PE, there seems to be a subgroup of patients with an increased risk of an adverse outcome, which might benefit from more aggressive therapy than the current standard therapy with anticoagulants. Risk stratification is a commonly used method to define subgroups of patients with either a high or low risk of an adverse outcome. In this review the clinical parameters and biomarkers of myocardial injury and right ventricular dysfunction (RVD) that have been suggested to play an important role in the risk stratification of PE are described first. Secondly, the use of more direct imaging techniques like echocardiography and CT in the assessment of RVD are discussed, followed by a brief outline of new imaging techniques. Finally, two risk stratification models are proposed, combining the markers of RVD with cardiac biomarkers of ischemia to define whether patients should be admitted to the intensive care unit (ICU) and/or be given thrombolysis, admitted to the medical ward, or be safely treated at home with anticoagulant therapy

Reflective teaching, inclusive teaching and the teacher's tasks in the inclusive classroom:a literary investigation

This article has three aims: to continue the process of giving credence to reflective teaching, which is integral to effective teaching and learning; to make explicit the connections between reflective teaching and inclusive teaching; and to identify key tasks for teachers in the inclusive classroom. Relevant articles were selected for inclusion in this review by searching online databases for key words and phrases. Findings reveal that the following features of reflective teaching connect with and are fundamental to inclusive teaching: giving careful consideration or thought; questioning personal assumptions, values, and beliefs; taking initiatives; using intuition; taking part in development and change; and the use of journalling. Teachers' tasks in the inclusive classroom include giving careful consideration to what is to be taught and how it is to be taught (rather than who is to learn); considering the learning needs of all students (not just those with additional needs); questioning beliefs and rejecting deterministic and associated ideas; reflecting on the classroom situation; constantly seeking out and trying new things to support all learners; discussing new initiatives with colleagues in order to receive feedback; examining, framing and attempting to solve dilemmas of the classroom; using journals to track students' learning; and taking responsibility for their own professional growth and understanding

An Alternate Method of Classifying Allergic Bronchopulmonary Aspergillosis Based on High-Attenuation Mucus

Allergic bronchopulmonary aspergillosis (ABPA) is classified radiologically based on the findings of central bronchiectasis (CB) and other radiologic features (ORF). However, the long-term clinical significance of these classifications remains unknown. We hypothesized that the immunological activity and outcomes of ABPA could be predicted on HRCT chest finding of high-attenuation mucus (HAM), a marker of inflammatory activity. In this study, we evaluate the severity and clinical outcomes of ABPA with different radiological classifications. specific IgE levels, eosinophil count) severity of the disease and clinical outcomes in various classifications were analyzed.Of the 234 (123 males, 111 females; mean age, 34.1 years) patients, 55 (23.5%) had normal HRCT, 179 (76.5%) had CB, 49 (20.9%) had HAM, and 27 (11.5%) had ORF. All immunological markers were consistently higher in the HAM classification, while in other classifications these findings were inconsistent. On multivariate analysis, the factors predicting frequent relapses were presence of HAM (OR 7.38; 95% CI, 3.21–17.0) and CB (OR 3.93; 95% CI, 1.63–9.48) after adjusting for ORF.The classification scheme based on HAM most consistently predicts immunological severity in ABPA. Central bronchiectasis and HAM are independent predictors of recurrent relapses in ABPA. Hence, HAM should be employed in the radiological classification of ABPA