Experiences of a Clinical Leadership Programme and its subsequent impact: A Constructivist Inquiry

Using a Constructivist methodology, combining elements of Fourth Generation Evaluation and Grounded Theory (Guba and Lincoln, 1989; Charmaz, 2014), this study explored the impact over time of the Delivering Better Care Leadership Programme, to better understand the factors that enabled or hindered subsequent changes. The study involved three Phases and data were collected longitudinally, primarily using interviews with a range of stakeholders. The study was underpinned by the ‘Senses Framework’ and ‘enriched environments’ (Nolan et al., 2006; Brown, 2005), and resulted in the development of the Five Cs’ substantive theory comprising: Context, Catalyst, Chronology, Conditions and Consequences. This theory, when used in conjunction with the Senses Framework, illuminates experiences and subsequent Consequences of participants, their teams and the wider organisation over time, and highlights the Conditions needed to create and sustain positive Consequences for participants and the wider Context. The importance of relationships emerged as being paramount. In order to create the Conditions, necessary for enriched environments, a number of enabling factors were identified, including support from colleagues, the promotion of autonomy, intrinsic motivation and drive, and opportunities for continual learning and development. On the basis of this study, the promotion of ‘relationship-centred leadership’ is suggested as a way forward for future initiatives. Implications for on-going leadership development programmes are considered, particularly in the challenging and complex landscape of the National Health Service (NHS), as are the contribution that the study makes to advancing knowledge. Methodologically, the study also argues for an expansion of the EA Matrix via the addition of two further dimensions: Evaluate and Embed Action. The study concludes that the Five C’s theory, allied with Senses Framework, provides a facilitation mechanism to foster relationship-centred leadership, which has the potential to further promote a compassionate, collective leadership culture, so vital for the NHS at this time

Flipping Argument

This project utilizes the concept of “flipping the classroom” pioneered by the Kahn Academy to help students understand Aristotelian elements of argument (ethos, pathos, and logos). The four lesson plans require students to preview existing internet resources depicting practical applications of rhetorical concepts, and then invites them to utilize these concepts in the classroom. Students learn to recognize logical fallacies and types of argumentative appeals as they are used (and misused) in popular culture and in literature. The project as a whole has the additional benefit of encouraging students to identify and critically evaluate explicit and implicit arguments in a range of media, from blogs, to YouTube videos, to television drama, to advertising. Students will gain a sense of what makes an effective argument, and how argument is deployed in daily life, popular culture and literature

Acupuncturists as Entrepreneurs: Experiences of New Professionals Founding Private Practices

The entrepreneurship aspects of private professional practice has been largely overlooked in both the literature and most graduate school professional programs, including acupuncture and oriental medicine (AOM). Because selfemployment in a private practice is the path for the majority of acupuncturists at the present time, they must exhibit entrepreneurial behaviors, and they receive little support from the profession. This research explored 12 new professionals’ experiences founding their private practices in depth using narrative methodology in order to gain insights to guide future research and interventions. Analysis focused on cognition/perception (C), social capital (S) and entrepreneurial learning (L) process aspects in the experiences of these professionals at the individual, community/profession, and larger society levels using Salzer’s (1998) and Rappaport’s (1994) conception of socializing influences as lenses. All three factors appear to be important to entrepreneurship in a professional context, and they interact with each other on multiple levels. As to Cognition/Perception (C), the study found that those embracing entrepreneurship aspects of practice had enhanced success, while those resisting it experienced difficulty until their perceptions changed. Thus, findings supported Hofer and Sandberg’s (1987) contention that entrepreneurship can be learned. As to Social Capital (S), those whose focus is inward and engagement is primarily within the profession experienced isolation and difficulty to a greater degree, while those who engaged the larger society and built cross-profession networks found their connections more satisfying and helpful. Those who adopted an outward-looking, society-focused, transformational vision for their practice seemed to enjoy the most business success, professional development and satisfaction. As to Entrepreneurial learning (L), Daley’s (1999) novice-toexpert professional development model was adapted to describe mutuallyreinforcing, interactive professional and business learning trajectories. Those engaging in experiential learning and reflective behaviors reported increased levels of both business and professional development. Participants provided a rich trove of insights based upon their experiences that may be helpful to new professionals starting private practices, including seeking a business mentor rather than one from the profession at first, engaging the larger society with a transformational healthcare vision, locating in an underserved area and removing cultural barriers as important practices. Recommendations for future research and suggested interventions for improving experience and outcomes for new professionals are offered

Validation of The Physical Activity Interview With Third and Fifth Grade Children

This study investigated the validity of the Physical Activity Interview (PAI) for assessing children's self-reported physical activity. Third and fifth graders wore an accelerometer and were interviewed using the PAI to determine 12-hour recall accuracy for activity expressed as energy expenditure (EE). Caltrac estimates of EE for the 12-hour day (12-HEE) and activity EE were the validation criteria. 12-HEE correlations were significant (p<.001) between Caltrac and PAI for third (r=.79) and fifth grade (r=.80). Caltrac and PAI Total Activity were significant for fifth grade (r=.82, p<.001) but not for third grade (r=.36, p<.021). Analysis of tertiles based on the Caltrac demonstrated that the PAI significantly (p<.002) discriminated between activity levels for fifth graders but not for third. The use of PAI may be age-dependent

Predoctoral Interns\u27 Nondisclosure in Supervision

In interviews with 14 counseling center predoctoral interns regarding a significant nondisclosure in supervision, eight interns reported good supervisory relationships and six indicated that they experienced problematic supervisory relationships. Nondisclosures for the interns in good supervisory relationships related to personal reactions to clients, whereas nondisclosures for interns in problematic supervisory relationships related to global dissatisfaction with the supervisory relationship. In both groups, interns mentioned concerns about evaluation and negative feelings as typical reasons for nondisclosure. Additional reasons for nondisclosure for interns in problematic supervision were power dynamics, inhibiting demographic or cultural variables, and the supervisor\u27s theoretical orientation. Both groups described negative effects of nondisclosure on themselves and their relationships with clients. Interns in problematic supervision also reported that nondisclosures had negative effects on the supervisory relationship

APOE and FABP2 Polymorphisms and History of Myocardial Infarction, Stroke, Diabetes, and Gallbladder Disease

Dysfunctional lipid metabolism plays a central role in pathogenesis of major chronic diseases, and genetic factors are important determinants of individual lipid profiles. We analyzed the associations of two well-established functional polymorphisms (FABP2 A54T and APOE isoforms) with past and family histories of 1492 population samples. FABP2-T54 allele was associated with an increased risk of past history of myocardial infarction (odds ratio (OR) = 1.51). Likewise, the subjects with APOE4, compared with E2 and E3, had a significantly increased risk of past history myocardial infarction (OR = 1.89). The OR associated with APOE4 was specifically increased in women for past history of myocardial infarction but decreased for gallstone disease. Interactions between gender and APOE isoforms were also significant or marginally significant for these two conditions. FABP2-T54 allele may be a potential genetic marker for myocardial infarction, and APOE4 may exert sex-dependent effects on myocardial infarction and gallbladder disease

Psychometric evaluation of the ostomy complication severity index

PURPOSE: The purpose of this study was to evaluate the psychometric properties of a new instrument to measure incidence and severity of ostomy complications early in the postoperative period. SUBJECTS AND SETTINGS: 71 participants were enrolled, most were men (52%), white (96%), and married or partnered (55%). The mean age of participants was 57 ± 15.09 years (mean ± SD). Fifty-two participants (84%) experienced at least 1 ostomy complication in the 60-day postoperative period. The research setting was 3 acute care settings within a large healthcare system in the Midwestern United States. INSTRUMENT: We developed an evidence-based conceptual model to guide development and evaluation of a new instrument, the Pittman Ostomy Complication Severity Index (OCSI). The OCSI format includes Likert-like scale with 9 individual items scored 0 to 3 and a total score computed by summing the individual items. Higher scores indicate more severe ostomy complications. METHOD: This study consisted of 2 phases: (1) an expert review, conducted to establish content validity; and (2) a prospective, longitudinal study design, to examine psychometric properties of the instrument. A convenience sample of 71 adult patients who underwent surgery to create a new fecal ostomy was recruited from 3 hospitals. Descriptive analyses, content validity indices, interrater reliability testing, and construct validity testing were employed. RESULTS: Common complications included leakage (60%), peristomal moisture-associated dermatitis (50%), stomal pain (42%), retraction (39%), and bleeding (32%). The OCSI demonstrated acceptable evidence of content validity index (CVI = 0.9) and interrater reliability for individual items (k = 0.71-1.0), as well as almost perfect agreement for total scores among raters (ICC = 0.991, P = .001). Construct validity of the OCSI was supported by significant correlations among variables in the conceptual model (complications, risk factors, stoma care self-efficacy, and ostomy adjustment). CONCLUSION: OCSI demonstrated acceptable validity and reliability and can be used to assess incidence and severity of ostomy complications in the early postoperative period. We found the OCSI to be brief, easy-to-use, and clinically practical. It can be used to (a) identify priority areas for nursing intervention related to the ostomy, (b) determine appropriate interventions to prevent or treat complications, and (c) evaluate the effects of nursing interventions designed to improve outcomes for patients with ostomies

The permeation of dynorphin A 1–6 across the blood brain barrier and its effect on bovine brain microvessel endothelial cell monolayer permeability

Dynorphin A 1–17 (Dyn A 1–17) is an endogenous neuropeptide known to act at the kappa opioid receptor; it has been implicated in a number of neurological disorders, including neuropathic pain, stress, depression, and Alzheimer’s and Parkinson’s diseases. The investigation of Dyn A 1–17 metabolism at the blood-brain barrier (BBB) is important since the metabolites exhibit unique biological functions compared to the parent compound. In this work, Dyn A 1–6 is identified as a metabolite of Dyn A 1–17 in the presence of bovine brain microvessel endhothelial cells (BBMECs), using LC-MS/MS. The transport of Dyn A 1–6 at the BBB was examined using this in vitro cell culture model of the BBB. Furthermore, the permeation of the BBB by the low molecular weight, permeability marker fluorescein was characterized in the presence and absences of Dyn A 1–6

Learning in a pandemic : primary school children’s emotional engagement with remote schooling during the Spring 2020 Covid-19 lockdown in Ireland

Open Access funding provided by the IReL Consortium. This study was funded by UK Research and Innovation-Economic and Social Research Council and the Irish Research Council under the ‘ESRC-IRC UK/Ireland Networking Grants’. The Children’s School Lives study, on which this analysis is based, is conducted by University College Dublin and funded by the National Council for Curriculum and Assessment through a grant awarded to Dympna Devine, Jennifer Symonds, Senaeen Sloan, and Gabriela Martinez Sainz.The COVID-19 pandemic resulted in the greatest disruption to children’s schooling in generations. This study analyses primary school children’s emotional engagement with remote schooling during the Spring 2020 lockdown in the Republic of Ireland, which involved one of the longest school closures among rich countries at the time. It investigates whether children’s engagement with their remote schooling varied by personal and family characteristics, using data from the Children’s School Lives (CSL) surveys. CSL is a nationally representative study of primary schools in Ireland, which collected information from children aged 8–9 years in May – August 2019 and in May – July 2020. Linear regression estimates with school fixed effects are based on the analytic sample of nearly 400 children (from across 71 schools) who took part in both waves and have complete data on all the key variables. Emotional engagement with schooling is measured using child-reported items on satisfaction with schooling. Everything else being equal, children who reported higher engagement with schooling before the pandemic were more engaged with remote schooling during the lockdown. Although there were no significant differences by family affluence, children with greater resources for home schooling reported higher levels of engagement. This includes having a computer or a laptop for schoolwork, having someone to help with schoolwork if the child is worried about falling behind, and having schoolwork checked by a teacher. This points to the paramount importance of adequate digital technologies in the home as well as the availability of help during periods of remote schooling.Publisher PDFPeer reviewe

Making Summer Count: How Summer Programs Can Boost Children's Learning

Examines evidence that summer programs can help counter the "summer slide" that disproportionately affects low-income students and contributes to the achievement gap; identifies obstacles to program provision; analyzes costs; and offers recommendations