Leadership development programme: a multi-method evaluation

This report investigates findings arising from a variety of forms of feedback provided by the first cohort of participants (2012-2013) in Cumbria Partnership Foundation Trust’s “Leadership Development” Programme (LDP). The report summarises both quantitative and qualitative feedback, and synthesises findings to provide a more three-dimensional overview of participant experience and systemic impact. Feedback reflects, throughout, the diversity of the participating cohort in terms of professional roles and levels of seniority

Learning Leaders: a multi-method evaluation, final report

This report investigates findings arising from a variety of forms of feedback on Cumbria Partnership Foundation Trust’s “Learning Leaders” Programme (henceforth LLP) running from 2012-2013

Mountains, cones and dilemmas of context: the case of "ordinary language" in philosophy and social scientific method

The order of influence from thesis to hypothesis, and from philosophy to the social sciences, has historically governed the way in which the abstraction and significance of language as an empirical object is determined. In this paper, an argument is made for the development of a more reflexive intellectual relationship between ordinary language philosophy (OLP) and the social sciences that it helped inspire. It is demonstrated that, and how, the social scientific traditions of ethnomethodology and conversation analysis press OLP to re-consider the variety of problematic abstractions it has previously made for the sake of philosophical clarity, thereby self-reinvigorating

The boy done good? Football’s clichés and the philosophy of language (games)

Football is often celebrated as a global language. No less global, though considerably less celebrated, is the plethora of football-specific clichés which make up the language of commentary, post-match interview and expert analysis. The persistence of clichés suggests they are an important element in understanding the world of football. However, cliché itself is a relatively unexplored philosophical phenomenon. In this presentation, findings are reported from some research for a forthcoming book chapter. We aim therein to challenge the philosophy of language to account for the meaning that football gives cliché, and, in turn, use this account to assess the difference between ‘good’ and ‘bad’ clichés in language of football. The problem is that, philosophically speaking, the notion of the ‘cliché’ seems to resist critical appraisal because of the number of different and opposing meanings that can be attributed to a clichéd statement: when it comes to definitions, cliché literally gives 110%. What, then, makes a cliché? More significantly, what differentiates ‘meaningful’ or ‘authoritative’ cliché from mere lazy or banal uses of language? As football is a game of two halves, we will explore two approaches within the philosophy of language for possible explanations, approaches that offer very different accounts of how such a use of cliché produces meaning; the approaches of Hans-Georg Gadamer and Ludwig Wittgenstein. Through a comparison of the effectiveness of these philosophies for assessing footballing cliché as meaningful, we explore (at the end of the day) what particular conditions enable cliché to be useful, and what conditions produce simply tiresome language

Silent about silence: the ethical importance of ‘non-talk’ in qualitative health research

One of the key tenets of ethically robust health research is the effective demonstration of what is said by participants, i.e. the preservation of a speaker’s original meaning, without misrepresentation or decontextualisation of verbal data to better fit a theoretical model or anticipated research outcome. This principle is grounded in long-standing philosophical traditions in both moral philosophy and the philosophy of research itself (see Alexandra & Miller 2009; Schwartz, Preece & Hendry 2002). While this, appropriately, directs health researchers to take great care in the ways they ‘tidy up’ these kinds of data during transcription and presentation for qualitative analyses, the same attention is rarely accorded to the matter of participant silence. As Harvey Sacks (1992) observes, pauses, non-answers and extended silences in any verbal interaction are central to the understanding of its practical, contextual sense. Not speaking when one is expected to, for example, or delaying an answer to a question it rather than providing it instantly, are not simply absences of activity but highly meaningful interpersonal events. To delete or overlook non-talk in qualitative data is therefore, potentially, an act of misrepresentation. Using evidence from an empirical study of the diagnosis of depression in primary care, this paper explores (a) some of the practical ways in which orthodox qualitative data presentation measures, even when reporting exactly what is said, can radically alter the sense of those data by failing to consistently highlight where non-talk is significant, and (b) the direct ethical implications thereof

Improving 3D ultrasound prostate localisation in radiotherapy through increased automation of interfraction matching.

Background and purpose Daily image guidance is standard care for prostate radiotherapy. Innovations which improve the accuracy and efficiency of ultrasound guidance are needed, particularly with respect to reducing interobserver variation. This study explores automation tools for this purpose, demonstrated on the Elekta Clarity Autoscan®. The study was conducted as part of the Clarity-Pro trial (NCT02388308). Materials and methods Ultrasound scan volumes were collected from 32 patients. Prostate matches were performed using two proposed workflows and the results compared with Clarity's proprietary software. Gold standard matches derived from manually localised landmarks provided a reference. The two workflows incorporated a custom 3D image registration algorithm, which was benchmarked against a third-party application (Elastix). Results Significant reductions in match errors were reported from both workflows compared to standard protocol. Median (IQR) absolute errors in the left-right, anteroposterior and craniocaudal axes were lowest for the Manually Initiated workflow: 0.7(1.0) mm, 0.7(0.9) mm, 0.6(0.9) mm compared to 1.0(1.7) mm, 0.9(1.4) mm, 0.9(1.2) mm for Clarity. Median interobserver variation was ≪0.01 mm in all axes for both workflows compared to 2.2 mm, 1.7 mm, 1.5 mm for Clarity in left-right, anteroposterior and craniocaudal axes. Mean matching times was also reduced to 43 s from 152 s for Clarity. Inexperienced users of the proposed workflows attained better match precision than experienced users on Clarity. Conclusion Automated image registration with effective input and verification steps should increase the efficacy of interfraction ultrasound guidance compared to the current commercially available tools

The Sorghum bicolor reference genome: improved assembly, gene annotations, a transcriptome atlas, and signatures of genome organization.

Sorghum bicolor is a drought tolerant C4 grass used for the production of grain, forage, sugar, and lignocellulosic biomass and a genetic model for C4 grasses due to its relatively small genome (approximately 800 Mbp), diploid genetics, diverse germplasm, and colinearity with other C4 grass genomes. In this study, deep sequencing, genetic linkage analysis, and transcriptome data were used to produce and annotate a high-quality reference genome sequence. Reference genome sequence order was improved, 29.6 Mbp of additional sequence was incorporated, the number of genes annotated increased 24% to 34 211, average gene length and N50 increased, and error frequency was reduced 10-fold to 1 per 100 kbp. Subtelomeric repeats with characteristics of Tandem Repeats in Miniature (TRIM) elements were identified at the termini of most chromosomes. Nucleosome occupancy predictions identified nucleosomes positioned immediately downstream of transcription start sites and at different densities across chromosomes. Alignment of more than 50 resequenced genomes from diverse sorghum genotypes to the reference genome identified approximately 7.4 M single nucleotide polymorphisms (SNPs) and 1.9 M indels. Large-scale variant features in euchromatin were identified with periodicities of approximately 25 kbp. A transcriptome atlas of gene expression was constructed from 47 RNA-seq profiles of growing and developed tissues of the major plant organs (roots, leaves, stems, panicles, and seed) collected during the juvenile, vegetative and reproductive phases. Analysis of the transcriptome data indicated that tissue type and protein kinase expression had large influences on transcriptional profile clustering. The updated assembly, annotation, and transcriptome data represent a resource for C4 grass research and crop improvement

Invasive Haemophilus influenzae Infections after 3 Decades of Hib Protein Conjugate Vaccine Use.

Haemophilus influenzae serotype b (Hib) was previously the most common cause of bacterial meningitis and an important etiologic agent of pneumonia in children aged <5 years. Its major virulence factor is the polyribosyl ribitol phosphate (PRP) polysaccharide capsule. In the 1980s, PRP-protein conjugate Hib vaccines were developed and are now included in almost all national immunization programs, achieving a sustained decline in invasive Hib infections. However, invasive Hib disease has not yet been eliminated in countries with low vaccine coverage, and sporadic outbreaks of Hib infection still occur occasionally in countries with high vaccine coverage. Over the past 2 decades, other capsulated serotypes have been recognized increasingly as causing invasive infections. H. influenzae serotype a (Hia) is now a major cause of invasive infection in Indigenous communities of North America, prompting a possible requirement for an Hia conjugate vaccine. H. influenzae serotypes e and f are now more common than serotype b in Europe. Significant year-to-year increases in nontypeable H. influenzae invasive infections have occurred in many regions of the world. Invasive H. influenzae infections are now seen predominantly in patients at the extremes of life and those with underlying comorbidities. This review provides a comprehensive and critical overview of the current global epidemiology of invasive H. influenzae infections in different geographic regions of the world. It discusses those now at risk of invasive Hib disease, describes the emergence of other severe invasive H. influenzae infections, and emphasizes the importance of long-term, comprehensive, clinical and microbiologic surveillance to monitor a vaccine's impact