(Re)creating a healthy self in and through disability sport:autoethnographic chaos and quest stories from a sportswoman with cerebral palsy

Those with physical disabilities are at increased risk of poor physical, mental and social health. Despite widely reported physiological and psychosocial benefits of sport for disabled people’s health and wellbeing, participation remains low and is in decline. Subsequently, we answer calls for greater focus on individuals’ voices to understand the complexities of disabled people’s participation in sport. Through a narrative autoethnographic approach we critically show and examine the lived experiences of a young female sportswoman with a disability (Gemma), as she reflects on the role of sport in, through and beyond her childhood. Framed within Arthur Frank’s narratives of injury and illness, we highlight the sport-based posthumanist narrative(s) that enabled Gemma’s (re)construction of a healthy self. Ultimately, we offer narrative inquiry, including autoethnographic methods, as a framework for understanding the lived experiences of children and young people with physical disabilities and practical recommendations for expanding narrative resources

Book Review: A New History of Management

A New History of Management (ANHM) sets a renewed and higher standard for teaching the history of our field. It confronts commonly accepted textbook representations of the history of management with novel interpretations of ‘classical texts’, supported by new historical case materials, which together challenge many conventional narratives about management that would typically be taught in business schools. In the authors’ words, “without critical questioning, the little that we remember of our past becomes inevitable, both as the truth about our past and for our future horizons too” (p. 320). The authors of ANHM expect that readers who understand the socio-political contexts which led to the development of each of the ‘classics’, will be convinced to abandon the idea that management theory emerged solely as a response to, and in the quest for, efficiency.Output Type: Book Revie

Unseen and unheard? Women managers and organizational learning

This paper aims to use (in)visibility as a lens to understand the lived experience of six women managers in the headquarters of a large multinational organization in the UK to identify how “gender” is expressed in the context of organizational learning. Design/methodology/approach: The researchers take a phenomenological approach via qualitative data collection with a purposeful sample – the six female managers in a group of 24. Data were collected through quarterly semi-structured interviews over 12 months with the themes – knowledge, interaction and gender. Findings: Organizations seek to build advantage to gain and retain competitive leadership. Their resilience in a changing task environment depends on their ability to recognize, gain and use knowledge likely to deliver these capabilities. Here, gender was a barrier to effective organizational learning with women’s knowledge and experience often unseen and unheard. Research limitations/implications: This is a piece of research limited to exploration of gender as other, but ethnicity, age, social class, disability and sexual preference, alone or in combination, may be equally subject to invisibility in knowledge terms; further research would be needed to test this however. Practical implications: Practical applications relate to the need for organizations to examine and address their operations for exclusion based on perceived “otherness”. Gendered organizations cause problems for their female members, but they also exclude the experience and knowledge of key individuals as seen here, where gender impacted on effective knowledge sharing and cocreation of knowledge. Social implications: The study offers further evidence of gendered organizations and their impacts on organizational effectiveness, but it also offers insights into the continues social acceptance of a masculinized normative model for socio-economic practice. Originality/value: This exploration of gender and organizational learning offers new insights to help explain the way in which organizational learning occurs – or fails to occur – with visibility/invisibility of one group shaped by gendered attitudes and processes. It shows that organizational learning is not gender neutral (as it appears in mainstream organizational learning research) and calls for researchers to include this as a factor in future research

Talent management in English universities during the coronavirus pandemic

This article reports a longitudinal study exploring talent management, through narratives provided by a group of managers of doctoral programmes in eight UK universities during the 2020 coronavirus outbreak. These managers were also academics, researchers and doctoral supervisors and their perspectives were gathered before and during “lockdown,” and then into the subsequent confused period of semi-lockdown / second lockdown, as cases of Coronavirus increased again in late 2020. Changing socio-economic circumstances, together with the added pressures of family responsibilities, impacted on participants' perceptions of changing roles and relationships during the pandemic. Over 12 months, six semi-structured online interviews (each lasting between 50 and 120 minutes) were conducted, using available platforms, with intervening emails. The narratives showed both formal and informal “talent management methods” and emphasized the need to use both to attract and retain international students

Validity and Reliability of a Smartphone App for Gait and Balance Assessment

Advances in technology provide an opportunity to enhance the accuracy of gait and balance assessment, improving the diagnosis and rehabilitation processes for people with acute or chronic health conditions. This study investigated the validity and reliability of a smartphone-based application to measure postural stability and spatiotemporal aspects of gait during four static balance and two gait tasks. Thirty healthy participants (aged 20–69 years) performed the following tasks: (1) standing on a firm surface with eyes opened, (2) standing on a firm surface with eyes closed, (3) standing on a compliant surface with eyes open, (4) standing on a compliant surface with eyes closed, (5) walking in a straight line, and (6) walking in a straight line while turning their head from side to side. During these tasks, the app quantified the participants’ postural stability and spatiotemporal gait parameters. The concurrent validity of the smartphone app with respect to a 3D motion capture system was evaluated using partial Pearson’s correlations (r(p)) and limits of the agreement (LoA%). The within-session test–retest reliability over three repeated measures was assessed with the intraclass correlation coefficient (ICC) and the standard error of measurement (SEM). One-way repeated measures analyses of variance (ANOVAs) were used to evaluate responsiveness to differences across tasks and repetitions. Periodicity index, step length, step time, and walking speed during the gait tasks and postural stability outcomes during the static tasks showed moderate-to-excellent validity (0.55 ≤ r(p) ≤ 0.98; 3% ≤ LoA% ≤ 12%) and reliability scores (0.52 ≤ ICC ≤ 0.92; 1% ≤ SEM% ≤ 6%) when the repetition effect was removed. Conversely, step variability and asymmetry parameters during both gait tasks generally showed poor validity and reliability except step length asymmetry, which showed moderate reliability (0.53 ≤ ICC ≤ 0.62) in both tasks when the repetition effect was removed. Postural stability and spatiotemporal gait parameters were found responsive (p < 0.05) to differences across tasks and test repetitions. Along with sound clinical judgement, the app can potentially be used in clinical practice to detect gait and balance impairments and track the effectiveness of rehabilitation programs. Further evaluation and refinement of the app in people with significant gait and balance deficits is needed

HNF4A and GATA6 loss reveals therapeutically actionable subtypes in pancreatic cancer

Pancreatic ductal adenocarcinoma (PDAC) can be divided into transcriptomic subtypes with two broad lineages referred to as classical (pancreatic) and squamous. We find that these two subtypes are driven by distinct metabolic phenotypes. Loss of genes that drive endodermal lineage specification, HNF4A and GATA6, switch metabolic profiles from classical (pancreatic) to predominantly squamous, with glycogen synthase kinase 3 beta (GSK3β) a key regulator of glycolysis. Pharmacological inhibition of GSK3β results in selective sensitivity in the squamous subtype; however, a subset of these squamous patient-derived cell lines (PDCLs) acquires rapid drug tolerance. Using chromatin accessibility maps, we demonstrate that the squamous subtype can be further classified using chromatin accessibility to predict responsiveness and tolerance to GSK3β inhibitors. Our findings demonstrate that distinct patterns of chromatin accessibility can be used to identify patient subgroups that are indistinguishable by gene expression profiles, highlighting the utility of chromatin-based biomarkers for patient selection in the treatment of PDAC

COSMOS-UK user guide: users’ guide to sites, instruments and available data (version 2.10)

The COSMOS-UK User Guide is a comprehensive guide to the data collected by COSMOS-UK, including the near-real time soil moisture data derived from counts of netrons derived from cosmic rays. The User Guide contains: i) information about the sites, their locations and other meta data. ii) Details of the instruments deployed at each site. iii) Background information about the cosmic ray neutron counter which is used to derive soil moisture within a 12 hectare footprint. iv) Descriptions of data and information products that are available from COSMOS-UK

BHPR research: qualitative1. Complex reasoning determines patients' perception of outcome following foot surgery in rheumatoid arhtritis

Background: Foot surgery is common in patients with RA but research into surgical outcomes is limited and conceptually flawed as current outcome measures lack face validity: to date no one has asked patients what is important to them. This study aimed to determine which factors are important to patients when evaluating the success of foot surgery in RA Methods: Semi structured interviews of RA patients who had undergone foot surgery were conducted and transcribed verbatim. Thematic analysis of interviews was conducted to explore issues that were important to patients. Results: 11 RA patients (9 ♂, mean age 59, dis dur = 22yrs, mean of 3 yrs post op) with mixed experiences of foot surgery were interviewed. Patients interpreted outcome in respect to a multitude of factors, frequently positive change in one aspect contrasted with negative opinions about another. Overall, four major themes emerged. Function: Functional ability & participation in valued activities were very important to patients. Walking ability was a key concern but patients interpreted levels of activity in light of other aspects of their disease, reflecting on change in functional ability more than overall level. Positive feelings of improved mobility were often moderated by negative self perception ("I mean, I still walk like a waddling duck”). Appearance: Appearance was important to almost all patients but perhaps the most complex theme of all. Physical appearance, foot shape, and footwear were closely interlinked, yet patients saw these as distinct separate concepts. Patients need to legitimize these feelings was clear and they frequently entered into a defensive repertoire ("it's not cosmetic surgery; it's something that's more important than that, you know?”). Clinician opinion: Surgeons' post operative evaluation of the procedure was very influential. The impact of this appraisal continued to affect patients' lasting impression irrespective of how the outcome compared to their initial goals ("when he'd done it ... he said that hasn't worked as good as he'd wanted to ... but the pain has gone”). Pain: Whilst pain was important to almost all patients, it appeared to be less important than the other themes. Pain was predominately raised when it influenced other themes, such as function; many still felt the need to legitimize their foot pain in order for health professionals to take it seriously ("in the end I went to my GP because it had happened a few times and I went to an orthopaedic surgeon who was quite dismissive of it, it was like what are you complaining about”). Conclusions: Patients interpret the outcome of foot surgery using a multitude of interrelated factors, particularly functional ability, appearance and surgeons' appraisal of the procedure. While pain was often noted, this appeared less important than other factors in the overall outcome of the surgery. Future research into foot surgery should incorporate the complexity of how patients determine their outcome Disclosure statement: All authors have declared no conflicts of interes

Adjunctive rifampicin for Staphylococcus aureus bacteraemia (ARREST): a multicentre, randomised, double-blind, placebo-controlled trial.

BACKGROUND: Staphylococcus aureus bacteraemia is a common cause of severe community-acquired and hospital-acquired infection worldwide. We tested the hypothesis that adjunctive rifampicin would reduce bacteriologically confirmed treatment failure or disease recurrence, or death, by enhancing early S aureus killing, sterilising infected foci and blood faster, and reducing risks of dissemination and metastatic infection. METHODS: In this multicentre, randomised, double-blind, placebo-controlled trial, adults (≥18 years) with S aureus bacteraemia who had received ≤96 h of active antibiotic therapy were recruited from 29 UK hospitals. Patients were randomly assigned (1:1) via a computer-generated sequential randomisation list to receive 2 weeks of adjunctive rifampicin (600 mg or 900 mg per day according to weight, oral or intravenous) versus identical placebo, together with standard antibiotic therapy. Randomisation was stratified by centre. Patients, investigators, and those caring for the patients were masked to group allocation. The primary outcome was time to bacteriologically confirmed treatment failure or disease recurrence, or death (all-cause), from randomisation to 12 weeks, adjudicated by an independent review committee masked to the treatment. Analysis was intention to treat. This trial was registered, number ISRCTN37666216, and is closed to new participants. FINDINGS: Between Dec 10, 2012, and Oct 25, 2016, 758 eligible participants were randomly assigned: 370 to rifampicin and 388 to placebo. 485 (64%) participants had community-acquired S aureus infections, and 132 (17%) had nosocomial S aureus infections. 47 (6%) had meticillin-resistant infections. 301 (40%) participants had an initial deep infection focus. Standard antibiotics were given for 29 (IQR 18-45) days; 619 (82%) participants received flucloxacillin. By week 12, 62 (17%) of participants who received rifampicin versus 71 (18%) who received placebo experienced treatment failure or disease recurrence, or died (absolute risk difference -1·4%, 95% CI -7·0 to 4·3; hazard ratio 0·96, 0·68-1·35, p=0·81). From randomisation to 12 weeks, no evidence of differences in serious (p=0·17) or grade 3-4 (p=0·36) adverse events were observed; however, 63 (17%) participants in the rifampicin group versus 39 (10%) in the placebo group had antibiotic or trial drug-modifying adverse events (p=0·004), and 24 (6%) versus six (2%) had drug interactions (p=0·0005). INTERPRETATION: Adjunctive rifampicin provided no overall benefit over standard antibiotic therapy in adults with S aureus bacteraemia. FUNDING: UK National Institute for Health Research Health Technology Assessment