Standardised practices in the networked management of congenital hyperinsulinism: a UK national collaborative consensus

Congenital hyperinsulinism (CHI) is a condition characterised by severe and recurrent hypoglycaemia in infants and young children caused by inappropriate insulin over-secretion. CHI is of heterogeneous aetiology with a significant genetic component and is often unresponsive to standard medical therapy options. The treatment of CHI can be multifaceted and complex, requiring multidisciplinary input. It is important to manage hypoglycaemia in CHI promptly as the risk of long-term neurodisability arising from neuroglycopaenia is high. The UK CHI consensus on the practice and management of CHI was developed to optimise and harmonise clinical management of patients in centres specialising in CHI as well as in non-specialist centres engaged in collaborative, networked models of care. Using current best practice and a consensus approach, it provides guidance and practical advice in the domains of diagnosis, clinical assessment and treatment to mitigate hypoglycaemia risk and improve long term outcomes for health and well-being

A novel strategy for the isolation and identification of environmental Burkholderia cepacia complex bacteria.

The purpose of this study was to develop a novel strategy for the isolation and identification of Burkholderia cepacia complex bacteria from the home environment of cystic fibrosis (CF) patients. Water and soil samples were enriched in a broth containing 0.1% l-arabinose, 0.1% l-threonine, and a mixture of selective agents including 1 microgml(-1) C-390, 600U ml(-1) polymyxin B sulfate, 10 microgml(-1) gentamycin, 2 microgml(-1) vancomycin and 10 microgml(-1) cycloheximide. On selective media (consisting of the same components as above plus 1.8% agar), several dilutions of the enrichment broth were inoculated and incubated for 5 days at 28 degrees C. Isolates with different randomly amplified polymorphic DNA patterns were inoculated in Stewart's medium. Putative B. cepacia complex bacteria were confirmed by means of recA PCR and further identified by HaeIII-recA restriction fragment length polymorphism analysis. Our results suggest that these organisms may be more widespread in the home environment than previously assumed and that plant associated soil and pond water may be reservoirs of B. cepacia complex infection in CF patients.Journal ArticleResearch Support, Non-U.S. Gov'tSCOPUS: ar.jinfo:eu-repo/semantics/publishe

Using the theory of social representations to explore difference in the research relationship

This article explores how the question of difference can be addressed within the research relationship. The first part of the article analyses the consequences of difference in one particularly compelling research encounter where accusations of racism damaged the research relationship. The author argues that we need to examine the researcher-researched relationship in detail and investigate the recognition of difference that structures this relationship in order to analyse material drawn from research. The second part of the article shows how this may be done within a particular social psychological perspective - that of the theory of social representations. This enables an exploration into the relationship between what is said, who said it and to whom, or, in other words, an analysis of the relationship between representations emerging and identities being played out in the research context. The value of this approach is illustrated by studying an example from the author's own research. The final part of the article demonstrates that difference in the researcher-researched relationship is not simply a problem of methodology but needs to be analysed as a feature of human relations. The article argues that an understanding of the relationship between social representations and identities illuminates the question of difference in qualitative research and demonstrates the value of difference

Transformational leadership and moral reasoning.

Terms such as moral and ethical leadership are used widely in theory, yet little systematic research has related a sociomoral dimension to leadership in organizations. This study investigated whether managers’ moral reasoning (n 132) was associated with the transformational and transactional leadership behaviors they exhibited as perceived by their subordinates (n 407). Managers completed the Defining Issues Test (J. R. Rest, 1990), whereas their subordinates completed the Multifactor Leadership Ques-tionnaire (B. M. Bass & B. J. Avolio, 1995). Analysis of covariance indicated that managers scoring in the highest group of the moral-reasoning distribution exhibited more transformational leadership behav-iors than leaders scoring in the lowest group. As expected, there was no relationship between moral-reasoning group and transactional leadership behaviors. Implications for leadership development are discussed. There has been growing interest in the development and pro-motion of moral or ethical leadership in organizations. Recent attention to this somewhat ethereal notion has created inspiring profiles (e.g., Coles, 2000; H. E. Gardner, 1996; J. W. Gardner, 1990) of leaders celebrated for their actions in commerce and history; however, few systematic attempts have been made to operationalize this dimension in relation to everyday leadership in organizations. To date, organizational researchers interested in the moral potential of leadership (e.g., Bass & Steidlmeier, 1999