Leadership development programme: a multi-method evaluation

This report investigates findings arising from a variety of forms of feedback provided by the first cohort of participants (2012-2013) in Cumbria Partnership Foundation Trust’s “Leadership Development” Programme (LDP). The report summarises both quantitative and qualitative feedback, and synthesises findings to provide a more three-dimensional overview of participant experience and systemic impact. Feedback reflects, throughout, the diversity of the participating cohort in terms of professional roles and levels of seniority

Learning Leaders: a multi-method evaluation, final report

This report investigates findings arising from a variety of forms of feedback on Cumbria Partnership Foundation Trust’s “Learning Leaders” Programme (henceforth LLP) running from 2012-2013

Personhood and the Fetus: Settling the Dispute

The concept of personhood and its relationship to health care has long been examined and debated. The working definition of personhood holds great power over many life-altering decisions, particularly in the realm of medical ethics. This article examines the very idea of personhood, current concept definitions and their impact on society, and poses an alternative view and definition for the concept. The final portion of the manuscript discusses potential areas of affect should the new definition be embraced. Information was gathered via historical research and literature review

Abandoning Anonymity

In the arena of bioethics and reproductive science, anonymity among sperm donors has been a hot topic. Currently, donors are granted anonymity in an attempt to protect autonomy and shield privacy. But at what cost? This article examines the other side of the debate: the children that, as a result, have little to no access to literally half of their family. Not only does this have serious mental and emotional implications, it also represents a serious ethical dilemma in terms of the autonomy, health, and well-being of the child

Criterion-Related Validity of Knee Joint-Position-Sense Measurement Using Image Capture and Isokinetic Dynamometry

Context: Clinicians require portable, valid, and cost-effective methods to monitor knee joint-position-sense (JPS) ability. Objective: To examine the criterion-related validity of image-capture JPS measures against an isokinetic-dynamometer (IKD) procedure. Design: Random crossover design providing a comparison of knee JPS measures from image capture and IKD procedures. Participants: 10 healthy participants, 5 female, age 28.0 ± 13.29 y, mass 60.3 ± 9.02 kg, height 1.65 ± 0.07 m, and 5 male, 29.6 ± 10.74 y, mass 73.6 ± 5.86 kg, height 1.75 ± 0.07 m. Main Outcome Measures: The dependent variables were absolute error scores (AES) provided by 2 knee directions (flexion and extension). The independent variables were the method (image capture and IKD). Results: There was no significant difference between clinical and IKD AES into knee-flexion data (P = .263, r = 0.55). There was a significant difference between clinical and IKD AES into knee-extension data (P = .016, r = .70). Conclusions: Analysis of photographic images to assess JPS measurements using knee flexion is valid against an IKD positioning method, but JPS measurements using knee extension may not be valid against IKD techniques. However, photo-analysis measurements provided a lower error score using knee-extension data and thus may provide an optimal environment to produce maximal knee JPS acuity. Therefore, clinicians do not need expensive equipment to collect representative JPS ability

The Effect of Conservatively Treated ACL Injury on Knee Joint Position Sense.

BACKGROUND: Proprioception is critical for effective movement patterns. However, methods of proprioceptive measurement in previous research have been inconsistent and lacking in reliability statistics making it applications to clinical practice difficult. Researchers have suggested that damage to the anterior cruciate ligament (ACL) can alter proprioceptive ability due to a loss of functioning mechanoreceptors. The majority of patients opt for reconstructive surgery following this injury. However, some patients chose conservative rehabilitation options rather than surgical intervention. PURPOSE: The purpose of this study was to determine the effect of ACL deficiency on knee joint position sense following conservative, non-operative treatment and return to physical activity. A secondary purpose was to report the reliability and measurement error of the technique used to measure joint position sense, (JPS) and comment on the clinical utility of this measurement. STUDY DESIGN: Observational study design using a cross-section of ACL deficient patients and matched uninjured controls. METHODS: Twenty active conservatively treated ACL deficient patients who had returned to physical activity and twenty active matched controls were included in the study. Knee joint position sense was measured using a seated passive-active reproductive angle technique. The average absolute angle of error score, between 10 °-30 ° of knee flexion was determined. This error score was derived from the difference between the target and repositioning angle. RESULTS: The ACL deficient patients had a greater error score (7.9 °±3.6) and hence poorer static proprioception ability that both the contra-lateral leg (2.0 °±1.6; p = 0.0001) and the control group (2.6 °±0.9; p = 0.0001). The standard error of the mean (SEM) of this JPS technique was 0.5 ° and 0.2 ° and the minimum detectable change (MDC) was 1.3 ° and 0.4 ° on asymptomatic and symptomatic subjects respectively. CONCLUSION: This study confirms a static proprioceptive deficiency exists in the knee joint following ACL injury and rehabilitation, potentially due to a reduction in functioning mechanoreceptors in the ligament over time. The differences between the ACL deficient knee and the control group were above the SEMs and MDCs of the measurement which suggests clinical relevance. Longitudinal studies are needed to evaluate if patients who return to activity with a joint position sense deficiency develop secondary injuries. LEVELS OF EVIDENCE: Individual Cohort Study (2b