A leader developing leadership: a case study

This study examines the development of leadership. The aim is to investigate the concept of a leader (the headteacher) developing leadership in a new and developing school. The study explores the notion of a vision for leadership, the structures which are evident each year and the development of leaders and leadership within the school. This case study research was undertaken in a single school at the end of its first seven years at the point when the first cohort of students went to university and the school converted to a new academy. The presence of two consecutive Ofsted judgements of outstanding leadership suggested leadership had developed well making this an appropriate environment in which to investigate leadership development. This post facto study adopts a qualitative approach gathering data from three sources: an extended series of interviews with the headteacher; semi-structured interviews with a sample of middle leaders who had had different experiences within the school and documentary evidence in the form of staffing structures from each of the previous school years. These three sources provided a means for the triangulation of evidence. A number of points emerge from the study: the variance in perspectives of the headteacher and middle leaders; the changes in structure and the growth of a hierarchy; the development of leadership factors such as communication and external pressures which impact on this. The research identifies a number of key elements: the concept of leadership which appears organic and changing and where different leadership experiences can coexist within a planned leadership model; the relationship between leadership vision, leadership structure and leadership development and the changes to the relationship over time; communicating theleadership vision through change from opening to establishment. The research challenges the belief that leadership is an entity or concept defined by a fixed set of skills and features. The research moves forward from models of distributed and hybrid leadership to demonstrate the complexity, fluidity and flexibility of leadership development. The process of and deployment of leadership affects and is affected by the context and must be able to respond to all contingencies. The quality of information is essential in making decisions regarding leadership. The qualilty of communication of that information enhances knowledge across the organisation and secures commitment and engagement of all middle leaders

Racial gaps in child health insurance coverage in four south American countries: The role of wealth, human capital, and other household characteristics

Objective. To evaluate the extent of racial gaps in child health insurance coverage in South America and study the contribution of wealth, human capital, and other household characteristics to accounting for racial disparities in insurance coverage. Data Sources/Study Setting. Primary data collected between 2005 and 2006 in 30 pediatric practices in Argentina, Brazil, Ecuador, and Chile. Design. Country-specific regression models are used to assess differences in insurance coverage by race. A decomposition model is used to quantify the extent to which wealth, human capital, and other household characteristics account for racial disparities in insurance coverage. Data Collection/Extraction Methods. In-person interviews were conducted with the mothers of 2,365 children. Principal Findings. The majority of children have no insurance coverage except in Chile. Large racial disparities in insurance coverage are observed. Household wealth is the single most important household-level factor accounting for racial disparities in coverage and is significantly and positively associated with coverage, followed by maternal education and employment/occupational status. Geographic differences account for the largest part of racial disparities in insurance coverage in Argentina and Ecuador. Conclusions. Increasing the coverage of children in less affluent families is important for reducing racial gaps in health insurance coverage in the study countries.Fil: Wehby, George. University of Iowa; Estados UnidosFil: Murray, Jeffrey C.. University of Iowa; Estados UnidosFil: McCarthy, Ann Marie. University of Iowa; Estados UnidosFil: Castilla, Eduardo Enrique. Centro de Educación Medica E Invest.clinicas; Argentina. Fundación Oswaldo Cruz; Brasil. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentin

Integrating Emerging Areas of Nursing Science into PhD Programs

The Council for the Advancement of Nursing Science aims to “facilitate and recognize life-long nursing science career development” as an important part of its mission. In light of fast-paced advances in science and technology that are inspiring new questions and methods of investigation in the health sciences, the Council for the Advancement of Nursing Science convened the Idea Festival for Nursing Science Education and appointed the Idea Festival Advisory Committee to stimulate dialogue about linking PhD education with a renewed vision for preparation of the next generation of nursing scientists. Building on the 2010 American Association of Colleges of Nursing Position Statement “The Research-Focused Doctoral Program in Nursing: Pathways to Excellence,” Idea Festival Advisory Committee members focused on emerging areas of science and technology that impact the ability of research-focused doctoral programs to prepare graduates for competitive and sustained programs of nursing research using scientific advances in emerging areas of science and technology. The purpose of this article is to describe the educational and scientific contexts for the Idea Festival, which will serve as the foundation for recommendations for incorporating emerging areas of science and technology into research-focused doctoral programs in nursing

Emerging Areas of Science: Recommendations for Nursing Science Education from the Council for the Advancement of Nursing Science Idea Festival

The Council for the Advancement of Nursing Science aims to “facilitate and recognize life-long nursing science career development” as an important part of its mission. In light of fast-paced advances in science and technology that are inspiring new questions and methods of investigation in the health sciences, the Council for the Advancement of Nursing Science convened the Idea Festival for Nursing Science Education and appointed the Idea Festival Advisory Committee (IFAC) to stimulate dialogue about linking PhD education with a renewed vision for preparation of the next generation of nursing scientists. Building on the 2005 National Research Council report Advancing The Nation\u27s Health Needs and the 2010 American Association of Colleges of Nursing Position Statement on the Research-Focused Doctorate Pathways to Excellence, the IFAC specifically addressed the capacity of PhD programs to prepare nursing scientists to conduct cutting-edge research in the following key emerging and priority areas of health sciences research: omics and the microbiome; health behavior, behavior change, and biobehavioral science; patient-reported outcomes; big data, e-science, and informatics; quantitative sciences; translation science; and health economics. The purpose of this article is to (a) describe IFAC activities, (b) summarize 2014 discussions hosted as part of the Idea Festival, and (c) present IFAC recommendations for incorporating these emerging areas of science and technology into research-focused doctoral programs committed to preparing graduates for lifelong, competitive careers in nursing science. The recommendations address clearer articulation of program focus areas; inclusion of foundational knowledge in emerging areas of science in core courses on nursing science and research methods; faculty composition; prerequisite student knowledge and skills; and in-depth, interdisciplinary training in supporting area of science content and methods

Emerging Areas of Nursing Science and PhD Education for The 21\u3csup\u3est\u3c/sup\u3e Century: Response to Commentaries

We respond to commentaries from the American Academy of Nursing, the American Association of Colleges of Nursing, and the National Institute of Nursing Research on our thoughts about integrating emerging areas of science into nursing PhD programs. We identify areas of agreement and focus our response on cross-cutting issues arising from cautions about the unique focus of nursing science and how best to proceed with incorporation of emerging areas of science into nursing PhD programs

Description of the methodology used in an ongoing pediatric care interventional study of children born with cleft lip and palate in South America [NCT00097149]

Background: The contribution of birth defects, including cleft lip and palate, to neonatal and infant mortality and morbidity is substantial. As other mortality and morbidity causes including infections, hygiene, prematurity, and nutrition are eradicated in less developed countries, the burden of birth defects will increase proportionally. Methods/Design: We are using cleft lip and palate as a sentinel birth defect to evaluate its burden on neonatal and infant health and to assess the effectiveness of systematic pediatric care during the first month and first two years of life in decreasing this burden. The neonatal intervention, consisting of weekly pediatric evaluation and referral to appropriate care, is delivered to about 696 infants born with cleft lip and/or palate in 47 hospitals in South America. Neonatal mortality in this group will be compared to that in a retrospective control group of about 464 infants born with cleft lip and/or palate in the same hospitals. The subgroup of infants with isolated clefts of both the lip and palate (about 264) is also randomized into two groups, intervened and non-intervened, and further followed up over 2 years. Intervened cases are evaluated by pediatricians every three months and referred for appropriate care. The intervened and non-intervened cases will be compared over study outcomes to evaluate the intervention effectiveness. Non-intervened cases are matched and compared to healthy controls to assess the burden of cleft lip and palate. Outcomes include child's neurological and physical development and family social and economic conditions. Discussion: Large-scale clinical trials to improve infant health in developing countries are commonly suggested, making it important to share the methods used in ongoing studies with other investigators implementing similar research. We describe here the content of our ongoing pediatric care study in South America. We hope that this may help researchers targeting this area to plan their studies more effectively and encourage the development of similar research efforts to target other birth defects or infant outcomes such as prematurity and low birth weight.Instituto Multidisciplinario de Biología Celula

Comparative diet-gut microbiome analysis in Crohn’s disease and Hidradenitis suppurativa

IntroductionThe chronic inflammatory skin disease Hidradenitis suppurativa (HS) is strongly associated with Crohn’s Disease (CD). HS and CD share clinical similarities and similar inflammatory pathways are upregulated in both conditions. Increased prevalence of inflammatory disease in industrialised nations has been linked to the Western diet. However, gut microbiota composition and diet interaction have not been compared in HS and CD.MethodsHere we compared the fecal microbiota (16S rRNA gene amplicon sequencing) and habitual diet of previously reported subjects with HS (n = 55), patients with CD (n = 102) and controls (n = 95).Results and discussionPatients with HS consumed a Western diet similar to patients with CD. Meanwhile, habitual diet in HS and CD was significantly different to controls. Previously, we detected differences in microbiota composition among patients with HS from that of controls. We now show that 40% of patients with HS had a microbiota configuration similar to that of CD, characterised by the enrichment of pathogenic genera (Enterococcus, Veillonella and Escherichia_Shigella) and the depletion of putatively beneficial genera (Faecalibacterium). The remaining 60% of patients with HS harboured a normal microbiota similar to that of controls. Antibiotics, which are commonly used to treat HS, were identified as a co-varying with differences in microbiota composition. We examined the levels of several inflammatory markers highlighting that growth-arrest specific 6 (Gas6), which has anti-inflammatory potential, were significantly lower in the 40% of patients with HS who had a CD microbiota configuration. Levels of the pro-inflammatory cytokine IL-12, which is a modulator of intestinal inflammation in CD, were negatively correlated with the abundance of health-associated genera in patients with HS. In conclusion, the fecal microbiota may help identify patients with HS who are at greater risk for development of CD

High frequency DC-DC converter with co-packaged planar inductor and power IC

The paper introduces the trend of integration and miniaturization of power converters with potential for enhanced efficiency, form factor reduction and cost reduction. To demonstrate the concept of highly integrated switched mode power supply with integrated magnetic, a system-in-package DC-DC converter using a stacked co-packaging approach is developed. A system approach was taken to the design, and functional integration, using 3-D packaging for realizing a power supply in package solution (PwrSiP). The target integrated converter is capable of handling an input voltage of 5V and frequencies up to 40MHz. A DC-DC converter IC on a 0.35μm CMOS process was designed to meet this goal. In parallel with the IC design, technology development for on-silicon integrated micro-inductors was completed to achieve small-form factor and extremely low profile. A maximum measured efficiency of 83% and 78% was achieved on the stacked converter operating at 20MHz and 40MHz, respectively. The stacked approach showed a 30% area reduction compared to side-by-side implementation with external discrete inductor