Systems leadership in the early years

This paper describes a new leadership coaching model that was delivered as part of Manchester city region's delivery of the Department for Education's Early Outcomes Fund. The coaching model explicitly paralleled the relational practices that are increasingly shaping early intervention policy and practice. Goodwin's theory of professional vision ( 1994 ) and Shotter's theorisation of with-ness ( 2011 ) provided the conceptual lens for this paper. The coaching facilitation aimed to afford the emergence of a new way of seeing leadership by scrutinising events of relational practice between participants in the coaching sessions (using video recording and review) and creating discursive practices using strengths-based analysis. We exemplify the coaching model using notes from a collaborative ethnographic evaluation of the six half-day group coaching sessions, surfacing how a new way of seeing silence may have seeded a new ‘object of knowledge’ in the group's emerging professional vision of leadership in the early years

Screening archaeological bone for palaeogenetic and palaeoproteomic studies.

The recovery and analysis of ancient DNA and protein from archaeological bone is time-consuming and expensive to carry out, while it involves the partial or complete destruction of valuable or rare specimens. The fields of palaeogenetic and palaeoproteomic research would benefit greatly from techniques that can assess the molecular quality prior to sampling. To be relevant, such screening methods should be effective, minimally-destructive, and rapid. This study reports results based on spectroscopic (Fourier-transform infrared spectroscopy in attenuated total reflectance [FTIR-ATR]; n = 266), palaeoproteomic (collagen content; n = 226), and palaeogenetic (endogenous DNA content; n = 88) techniques. We establish thresholds for three different FTIR indices, a) the infrared splitting factor [IRSF] that assesses relative changes in bioapatite crystals' size and homogeneity; b) the carbonate-to-phosphate [C/P] ratio as a relative measure of carbonate content in bioapatite crystals; and c) the amide-to-phosphate ratio [Am/P] for assessing the relative organic content preserved in bone. These thresholds are both extremely reliable and easy to apply for the successful and rapid distinction between well- and poorly-preserved specimens. This is a milestone for choosing appropriate samples prior to genomic and collagen analyses, with important implications for biomolecular archaeology and palaeontology

Progression of atypical parkinsonian syndromes: PROSPECT-M-UK study implications for clinical trials

The advent of clinical trials of disease-modifying agents for neurodegenerative disease highlights the need for evidence-based endpoint selection. Here we report the longitudinal PROSPECT-M-UK study of progressive supranuclear palsy, corticobasal syndrome, multiple system atrophy and related disorders, to compare candidate clinical trial endpoints. In this multicentre United Kingdom study, participants were assessed with serial questionnaires, motor examination, neuropsychiatric and magnetic resonance imaging assessments at baseline, six and twelve-months. Participants were classified by diagnosis at baseline and study end, into Richardson syndrome, progressive supranuclear palsy-subcortical (progressive supranuclear palsy-parkinsonism and progressive gait freezing subtypes), progressive supranuclear palsy-cortical (progressive supranuclear palsy-frontal, progressive supranuclear palsy-speech-and-language, and progressive supranuclear palsy-corticobasal syndrome subtypes), multiple system atrophy-parkinsonism, multiple system atrophy-cerebellar, corticobasal syndrome with and without evidence of Alzheimer’s disease pathology and indeterminate syndromes. We calculated annual rate of change, with linear mixed modelling, and sample sizes for clinical trials of disease modifying agents, according to group and assessment type. Two hundred forty-three people were recruited (117 progressive supranuclear palsy, 68 corticobasal syndrome, 42 multiple system atrophy and 16 indeterminate; 138 [56.8%] male; age at recruitment 68.7 ± 8.61 years). One hundred fifty-nine completed six-month assessment (82 progressive supranuclear palsy, 27 corticobasal syndrome, 40 multiple system atrophy and 10 indeterminate) and 153 completed twelve-month assessment (80 progressive supranuclear palsy, 29 corticobasal syndrome, 35 multiple system atrophy and 9 indeterminate). Questionnaire, motor examination, neuropsychiatric and neuroimaging measures declined in all groups, with differences in longitudinal change between groups. Neuroimaging metrics would enable lower sample sizes to achieve equivalent power for clinical trials than cognitive and functional measures, often achieving N < 100 required for one-year two-arm trials (with 80% power to detect 50% slowing). However, optimal outcome measures were disease specific. In conclusion, phenotypic variance within progressive supranuclear palsy, corticobasal syndrome and multiple system atrophy is a major challenge to clinical trial design. Our findings provide an evidence base for selection of clinical trial endpoints, from potential functional, cognitive, clinical or neuroimaging measures of disease progression

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Commentary on Chapters 8 and 9

Chapters 8 and 9 address young children’s early language learning from a rights perspective, as articulated through the United Nations Convention on the Rights of the Child (UNCRC). In Chap. 8, Andrea Tures argues for a cultural-historical approach to enhance young children’s individual voices in the learning process. In Chap. 9, Sheila Degotardi and Feifei Han consider how dialogical approaches to language development may actively involve infants and young children in language learning with their educators. The originality of the two chapters stems from their challenge to the dominance of monologist approaches to young children’s language learning still prevalent in early childhood education and care (ECEC) policy contexts in many parts of the world. The authors argue that these prevailing approaches militate against young children’s rights, as children are active knowing agents navigating their everyday lives within the structures and institutions they inhabit. The discussions, arguments and approaches the authors provide could be of interest to the wider global education community

L'occupation du bassin de Neuwied (Rhénanie centrale, Allemagne) par les Magdaléniens et les groupes à Federmesser (aziliens)

Schaaffhausen’s initial excavation, two large Magdalenian sites •Andernach and Gönnersdorf •as well as six Federmesser sites are known from the Central Rhineland. The latter are Andernach (upper find horizon), Boppard, Niederbieber (the most extensive of these sites), Kettig and Urbar, all of which pre-date the Laacher See eruption, and Bad Breisig, post-dating this event. Furthermore, repeated discoveries of isolated hearths show human activities in the Allerød landscape away from the larger encampments. The archaeological record provides detailed insight into both the environment and life of the Central Rhineland Magdalenian and Federmesser groups and their material culture. The changes in environment and available subsistence resources between the Magdalenian and Federmesser groups were accompanied by radical shifts in material technology, the internal spatial organisation of settlements and the manifestation of artistic expression. By contrast with these well-defined groups, the •cultures” intermediate between the Magdalenian hunter-gatherers of the open loess steppe and the Federmesser groups of the interstadial woodlands are scarcely known. The only evidence for this interval comes from the southwestern part of the Gönnersdorf site and from the burials at Bonn-Oberkassel and Neuwied-Irlich.Depuis les travaux pionniers d’Hermann Schaaffhausen en 1883 au Martinsberg à Andernach, et grâce au recouvrement de la région à la fin de l’Allerød par des amas de cendres déposées au cours de l’éruption du Laacher See, la Rhénanie centrale est connue comme une région prometteuse pour l’abondance des sites tardiglaciaires et pour leur qualité de préservation. Aujourd’hui, plus de 120 ans après les premières fouilles de Schaaffhausen, deux grands sites magdaléniens •Andernach et Gönnersdorf •ainsi que six gisements des groupes à Federmesser ont été découverts dans cette région. Les sites à Federmesser se trouvent à Andernach (horizon supérieur), à Boppard, à Niederbieber (le plus vaste d’entre tous), à Kettig et à Urbar, cinq gisements dont l’occupation précède l’éruption du Laacher See, ainsi qu’à Bad Breisig, occupé après l’éruption. En outre, plusieurs découvertes de foyers isolés informent sur des activités humaines qui se sont déroulées dans les paysages de l’Allerød, à l’écart des plus grands campements. Les données archéologiques apportent des informations précises à la fois sur l’environnement et sur le mode de vie ainsi que sur la culture matérielle des Magdaléniens et des groupes à Federmesser en Rhénanie centrale. D’un moment à l’autre, en parallèle des changements environnementaux et de leurs conséquences en termes de ressources disponibles, on observe des transformations radicales dans le domaine des techniques, dans l’organisation des campements et dans les manifestations artistiques. Par contraste avec ces sociétés bien étudiées (le Magdalénien des steppes loessiques et les groupes à Federmesser des milieux boisés de l’interstade), les «cultures» intermédiaires sont mal connues. Les seules évidences pour cette transition proviennent du secteur sud-ouest de Gönnersdorf, des inhumations de Bonn-Oberkassel ainsi que de Neuwied-Irlich.Street Martin, Gelhausen Frank, Grimm Sonja, Moseler Frank, Niven Laura, Sensburg Martina, Turner Elaine, Wenzel Stefan, Jöris Olaf. L'occupation du bassin de Neuwied (Rhénanie centrale, Allemagne) par les Magdaléniens et les groupes à Federmesser (aziliens). In: Bulletin de la Société préhistorique française, tome 103, n°4, 2006. pp. 753-780