Ambiguity, complexity and dynamics in the membership of collaboration

This paper is concerned with the role that membership structures of inter-organizational collaborations have on the achievement of collaborative advantage in the context of tackling social issues. Based on action research involving participants in a wide variety of collaborative situations, the paper aims to explore the nature of the membership of collaborations in practice. A picture of membership is built up from two perspectives. The first considers the structure of collaboration, and argues that ambiguity and complexity in structure may be demonstrated over many dimensions. The second adds another layer of complication through exploring the dynamics of the way in which membership structures change over time. The paper concludes by examining the implications for practitioners and policy makers of this picture in terms of its effect on the design of collaborations and on the factors which tend to lead to collaborative inertia instead of collaborative advantage

Integrating modes of policy analysis and strategic management practice : requisite elements and dilemmas

There is a need to bring methods to bear on public problems that are inclusive, analytic, and quick. This paper describes the efforts of three pairs of academics working from three different though complementary theoretical foundations and intervention backgrounds (i.e., ways of working) who set out together to meet this challenge. Each of the three pairs had conducted dozens of interventions that had been regarded as successful or very successful by the client groups in dealing with complex policy and strategic problems. One approach focused on leadership issues and stakeholders, another on negotiating competitive strategic intent with attention to stakeholder responses, and the third on analysis of feedback ramifications in developing policies. This paper describes the 10 year longitudinal research project designed to address the above challenge. The important outcomes are reported: the requisite elements of a general integrated approach and the enduring puzzles and tensions that arose from seeking to design a wide-ranging multi-method approach

Exploring leadership in multi-sectoral partnerships

This article explores some critical aspects of leadership in the context of multi-sectoral partnerships. It focuses on leadership in practice and asks the question, `How do managers experience and perceive leadership in such partnerships?' The study contributes to the debate on whether leadership in a multi-sectoral partnership context differs from that within a single organization. It is based on the accounts of practising managers working in complex partnerships. The article highlights a number of leadership challenges faced by those working in multi-sectoral partnerships. Partnership practitioners were clear that leadership in partnerships was more complex than in single organizations. However, it was more difficult for them to agree a consensus on the essential nature of leadership in partnership. We suggest that a first-, second- and third-person approach might be a way of better interpreting leadership in the context of partnerships

Cognitive loading affects motor awareness and movement kinematics but not locomotor trajectories during goal-directed walking in a virtual reality environment.

The primary purpose of this study was to investigate the effects of cognitive loading on movement kinematics and trajectory formation during goal-directed walking in a virtual reality (VR) environment. The secondary objective was to measure how participants corrected their trajectories for perturbed feedback and how participants' awareness of such perturbations changed under cognitive loading. We asked 14 healthy young adults to walk towards four different target locations in a VR environment while their movements were tracked and played back in real-time on a large projection screen. In 75% of all trials we introduced angular deviations of ±5° to ±30° between the veridical walking trajectory and the visual feedback. Participants performed a second experimental block under cognitive load (serial-7 subtraction, counter-balanced across participants). We measured walking kinematics (joint-angles, velocity profiles) and motor performance (end-point-compensation, trajectory-deviations). Motor awareness was determined by asking participants to rate the veracity of the feedback after every trial. In-line with previous findings in natural settings, participants displayed stereotypical walking trajectories in a VR environment. Our results extend these findings as they demonstrate that taxing cognitive resources did not affect trajectory formation and deviations although it interfered with the participants' movement kinematics, in particular walking velocity. Additionally, we report that motor awareness was selectively impaired by the secondary task in trials with high perceptual uncertainty. Compared with data on eye and arm movements our findings lend support to the hypothesis that the central nervous system (CNS) uses common mechanisms to govern goal-directed movements, including locomotion. We discuss our results with respect to the use of VR methods in gait control and rehabilitation

Innovation in assessment: building student confidence in preparation for unfamiliar assessment methods

Innovative assessment methods in which students are active participants promote deeper learning. A group debate and a webfolio were implemented as methods of assessment in the 2015 undergraduate midwifery curriculum, with the assessment tools being evaluated by students. Thematic analysis of the evaluations showed students enjoyed undertaking innovative methods of assessment, they developed confidence and engaged meaningfully with the content to be assessed. Students also commented they developed multiple skills required for future professional practice as a midwife. Thorough preparation of students to undertake an innovative method of assessment however is vital in fostering student confidence

Managing cultural diversity in collaborations: a focus on management tensions

This article explores the management of cultural diversity in public and not-for-profit collaborations spanning organizational, professional and national boundaries. Through the framing of a culture paradox, it identifies three interrelated tensions pertaining to the management of cultural diversity towards collaborative advantage. These tensions address: interactions between organizations within a collaboration; interactions between individual actors and their orientation towards the collaboration and their host organization; and the quantity and extent of cultural diversity within a collaboration. The culture paradox and its inherent management tensions provide theoretical and practical conceptualizations that are relevant to management and governance of collaboration

Assessing public leadership styles for innovation:A comparison of Copenhagen, Rotterdam and Barcelona

This article explores which leadership qualities public managers regard as important for public innovation. It is based on a survey of 365 senior public managers in Copenhagen, Rotterdam and Barcelona. Five perspectives on leadership were identified and tested using a number of items. Some of these proved to be more robust than others. Analysis of the three cities reveals a nuanced set of leadership styles, which include a transformational style, and one that is more dedicated to motivating employees, risk-taking and including others in decision-making. This suggests the need for more research on leadership and public-sector innovation

Effects of self-management, education and specific exercises, delivered by health professionals, in patients with osteoarthritis of the knee

<p>Abstract</p> <p>Background</p> <p>An education self-management program for people with osteoarthritis (OA) of the knee was designed to be delivered by health professionals, incorporating their knowledge and expertise. Improvement in quality of life, health status and pain in response to this program has previously been demonstrated in an uncontrolled pilot study. To more rigorously test the effectiveness of the program we will undertake a randomised controlled trial of people with OA of the knee offering specific self-administered exercises and education, in accordance with the principles of self-management.</p> <p>Aim: To determine whether an education self management program for subjects with Osteoarthritis (OA) of the knee (OAK program) implemented by health professionals in a primary health care setting can achieve and maintain clinically meaningful improvements compared standard medical management in a control group.</p> <p>Methods</p> <p>The effects of standard medical management will be compared with the effects of the OAK program in a single-blind randomized study.</p> <p><it>Participants: </it>146 male and female participants with established OA knee will be recruited. Volunteers with coexistent inflammatory joint disease or serious co-morbidities will be excluded.</p> <p><it>Interventions: </it>Participants will be randomized into either intervention or control groups (delayed start). The intervention group will complete the OA knee program and both groups will be followed for 6 months.</p> <p><it>Measurements: </it>Assessments will be at baseline, 8 weeks and 6 months. SF-36, WOMAC and VAS pain questionnaires will be completed. Isometric quadriceps and hamstring strength will be measured using a dynamometer; knee range of movement using a goniometer; and physical function will be determined by a modified timed up and go test. Data will be analysed using repeated measures ANOVA.</p> <p>Discussion</p> <p>While there is evidence to support the effectiveness of SM programs for people with hypertension, diabetes and asthma, the evidence available for treatment of arthritis remains equivocal. The aim of this study is to determine the effectiveness of a disease specific self-management program for people with OA knee.</p> <p>The study design includes all the important features of a clinical experimental study to minimize bias so the results of the study will provide a high level of evidence. People with OA of the knee have identified pain and problems with daily activities as the most important problems associated with their condition. The outcome measures selected specifically address these issues and have demonstrated validity and are responsive within the range of change expected in response to the intervention. Hence the results of the study will reflect their priorities.</p> <p>The results of the study will provide evidence to guide clinicians and funding bodies seeking to establish priorities regarding the provision of this disease specific program.</p> <p>Trial registration</p> <p>ACTR number: 12607000080426</p

Interprofessional education through shadowing experiences in multi-disciplinary clinical settings

The World Health Organization has recently added Interprofessional Education (IPE) to its global health agenda recognizing it as a necessary component of all health professionals' education. We suggest mandatory interprofessional shadowing experiences as a mechanism to be used by chiropractic institutions to address this agenda. IPE initiatives of other professions (pharmacy and medicine) are described along with chiropractic. This relative comparison of professions local to our jurisdiction in Ontario, Canada is made so that the chiropractic profession may take note that they are behind other health care providers in implementing IPE

Trust in governance networks: Its impacts on outcomes

__Abstract__ Governance networks are characterized by complex interaction and decision making, and much uncertainty. Surprisingly, there is very little research on the impact of trust in achieving results in governance networks. This article asks two questions: (a) Does trust influence the outcomes of environmental projects? and (b) Does active network management improve the level of trust in networks? The study is based on a Web-based survey of respondents involved in environmental projects. The results indicate that trust does matter for perceived outcomes and that network management strategies enhance the level of trust