Malignant Chondroblastoma of the Os Calcis

Patient. We describe a case of chondroblastoma of the os calcis which metastasized to the tibia, soft tissues and lung. A complete response of the lung lesions was noted with chemotherapy

Clear Cell Chondrosarcoma of Bone

Purpose. Clear cell chondrosarcoma is a rare variant of chondrosarcoma. Six cases are herein reported

Developing lab activities for an introductory anatomy course: Reflections and recommendations from a faculty/student partnership.

Students “as partners” challenges the notion that students simply consume knowledge, but rather, they are viewed as co-producers of knowledge (Green, 2019). This approach used in curriculum development is illustrated in this research project. Five undergraduate students and one graduate student collaborated with a faculty member to develop ten lab activities for a first-year anatomy course in Kinesiology. All student partners had taken the course previously and had expressed their passion for the subject matter. With guidance and support from the course instructor, students utilized the knowledge and experiences they had acquired in the course to design lab experiences that aligned with the course content. This approach is consistent with other studies in which students worked with faculty members to adapt curriculum for future students (Spencer et al., 2021). Once the lab activities were created, the students were asked to reflect upon their experience. The instructor encouraged the discussion of various elements in the reflections, such as how the students felt working in the partnership, and their discoveries related to curriculum development. The students were also asked to consider the impact of the partnership on both their well-being and on higher education in general. The analysis revealed seven themes which will be shared in the presentation. Several recommendations, including the importance of maintaining effective communication, fostering group cohesion, and developing a knowledge transfer plan, will also be offered to help inform other students and faculty members who wish to engage in a similarly effective partnership. Bibliography: Green, W. (2019). Engaging “Students as Partners” in global learning: Some possibilities and provocations. Journal of Studies in International Education, 23(1), 10–29. https://doi.org/10.1177/1028315318814266 Spencer, B., Tori, K., & Campbell, R. (2021). Undergraduates as course creators: Reflections on starting and sustaining a student-faculty partnership. International Journal for Students as Partners, 5(1), 138-145. https://doi.org/10.15173/ijsap.v5i1.439

Re-Imagining Images of Organization: A Conversation With Gareth Morgan

In this article, we review the metaphors presented by Morgan in Images of Organization and highlight how they simultaneously act as “relatively static reflections” (i.e., they provide a history of organization theory) and “relatively dynamic projections” (i.e., stimulating the formulation of further organizational images). We also discuss the potential for new organizational metaphors and consider two specific metaphors (i.e., the “global brain” and “organization as media”). We also challenge the established punctuated metaphorical process (i.e., a transfer from a metaphorical source domain to an organizational target domain), propose a dynamic perspective of interchange (i.e., source domain to target domain to source domain and so on), and develop the notion of multidirectionality (i.e., two-way projections between target and source domains)

Effectiveness of Provider and Community Interventions to Improve Treatment of Uncomplicated Malaria in Nigeria: A Cluster Randomized Controlled Trial

The World Health Organization recommends that malaria be confirmed by parasitological diagnosis before treatment using Artemisinin-based Combination Therapy (ACT). Despite this, many health workers in malaria endemic countries continue to diagnose malaria based on symptoms alone. This study evaluates interventions to help bridge this gap between guidelines and provider practice. A stratified cluster-randomized trial in 42 communities in Enugu state compared 3 scenarios: Rapid Diagnostic Tests (RDTs) with basic instruction (control); RDTs with provider training (provider arm); and RDTs with provider training plus a school-based community intervention (provider-school arm). The primary outcome was the proportion of patients treated according to guidelines, a composite indicator requiring patients to be tested for malaria and given treatment consistent with the test result. The primary outcome was evaluated among 4946 (93%) of the 5311 patients invited to participate. A total of 40 communities (12 in control, 14 per intervention arm) were included in the analysis. There was no evidence of differences between the three arms in terms of our composite indicator (p = 0.36): stratified risk difference was 14% (95% CI -8.3%, 35.8%; p = 0.26) in the provider arm and 1% (95% CI -21.1%, 22.9%; p = 0.19) in the provider-school arm, compared with control. The level of testing was low across all arms (34% in control; 48% provider arm; 37% provider-school arm; p = 0.47). Presumptive treatment of uncomplicated malaria remains an ingrained behaviour that is difficult to change. With or without extensive supporting interventions, levels of testing in this study remained critically low. Governments and researchers must continue to explore alternative ways of encouraging providers to deliver appropriate treatment and avoid the misuse of valuable medicines

Who Controls the Looking Glass? Towards a Conversational Understanding of Organizational Theatre

This paper presents a longitudinal study of interactive organizational theatre. Managers of a large home care organization used 30 instances of organizational theatre over a one year period to effect organizational change. We found that neither management, who had hoped that employees would accept and internalize the messages accompanying the play, nor employees, who used the liminal spaces to express their own take on the organization’s issues, achieved their aims directly. Yet a year later, organizational performance and satisfaction were significantly improved—much of this was attributed to the play. To explain this, we develop a conversational theory of change, one where ‘conversation pieces’ are central. We also speculate on the properties that conversation pieces and conversational systems like organizational theatre must have if they are to effect change.N/

Making sense of theory construction: Metaphor and disciplined imagination

This article draws upon Karl Weick’s insights into the nature of theorizing, and extends and refines his conception of theory construction as ‘disciplined imagination’. An essential ingredient in Weick’s ‘disciplined imagination’ involves his assertion that thought trials and theoretical representations typically involve a transfer from one epistemic sphere to another through the creative use of metaphor. The article follows up on this point and draws out how metaphor works, how processes of metaphorical imagination partake in theory construction, and how insightful metaphors and the theoretical representations that result from them can be selected. The paper also includes a discussion of metaphors-in-use (organizational improvisation as jazz and organizational behavior as collective mind) which Weick proposed in his own writings. The whole purpose of this exercise is to theoretically augment and ground the concept of ‘disciplined imagination’, and in particular to refine the nature of thought trials and selection within it. In doing so, we also aim to provide pointers for the use of metaphorical imagination in the process of theory construction

Differences in antiretroviral scale up in three South African provinces: the role of implementation management

BACKGROUND: South Africa's antiretroviral programme is governed by defined national plans, establishing treatment targets and providing funding through ring-fenced conditional grants. However, in terms of the country's quasi-federal constitution, provincial governments bear the main responsibility for provision of health care, and have a certain amount of autonomy and therefore choice in the way their HIV/AIDS programmes are implemented. METHODS: The paper is a comparative case study of the early management of ART scale up in three South African provincial governments--Western Cape, Gauteng and Free State--focusing on both operational and strategic dimensions. Drawing on surveys of models of ART care and analyses of the policy process conducted in the three provinces between 2005 and 2007, as well as a considerable body of grey and indexed literature on ART scale up in South Africa, it draws links between implementation processes and variations in provincial ART coverage (low, medium and high) achieved in the three provinces. RESULTS: While they adopted similar chronic disease care approaches, the provinces differed with respect to political and managerial leadership of the programme, programme design, the balance between central standardisation and local flexibility, the effectiveness of monitoring and evaluation systems, and the nature and extent of external support and programme partnerships. CONCLUSIONS: This case study points to the importance of sub-national programme processes and the influence of factors other than financing or human resource capacity, in understanding intervention scale up

The Astropy Problem

The Astropy Project (http://astropy.org) is, in its own words, "a community effort to develop a single core package for Astronomy in Python and foster interoperability between Python astronomy packages." For five years this project has been managed, written, and operated as a grassroots, self-organized, almost entirely volunteer effort while the software is used by the majority of the astronomical community. Despite this, the project has always been and remains to this day effectively unfunded. Further, contributors receive little or no formal recognition for creating and supporting what is now critical software. This paper explores the problem in detail, outlines possible solutions to correct this, and presents a few suggestions on how to address the sustainability of general purpose astronomical software

The practice of 'doing' evaluation: Lessons learned from nine complex intervention trials in action

Background: There is increasing recognition among trialists of the challenges in understanding how particular 'real-life' contexts influence the delivery and receipt of complex health interventions. Evaluations of interventions to change health worker and/or patient behaviours in health service settings exemplify these challenges. When interpreting evaluation data, deviation from intended intervention implementation is accounted for through process evaluations of fidelity, reach, and intensity. However, no such systematic approach has been proposed to account for the way evaluation activities may deviate in practice from assumptions made when data are interpreted.Methods: A collective case study was conducted to explore experiences of undertaking evaluation activities in the real-life contexts of nine complex intervention trials seeking to improve appropriate diagnosis and treatment of malaria in varied health service settings. Multiple sources of data were used, including in-depth interviews with investigators, participant-observation of studies, and rounds of discussion and reflection.Results and discussion: From our experiences of the realities of conducting these evaluations, we identified six key 'lessons learned' about ways to become aware of and manage aspects of the fabric of trials involving the interface of researchers, fieldworkers, participants and data collection tools that may affect the intended production of data and interpretation of findings. These lessons included: foster a shared understanding across the study team of how individual practices contribute to the study goals; promote and facilitate within-team communications for ongoing reflection on the progress of the evaluation; establish processes for ongoing collaboration and dialogue between sub-study teams; the importance of a field research coordinator bridging everyday project management with scientific oversight; collect and review reflective field notes on the progress of the evaluation to aid interpretation of outcomes; and these approaches should help the identification of and reflection on possible overlaps between the evaluation and intervention.Conclusion: The lessons we have drawn point to the principle of reflexivity that, we argue, needs to become part of standard practice in the conduct of evaluations of complex interventions to promote more meaningful interpretations of the effects of an intervention and to better inform future implementation and decision-making. © 2014 Reynolds et al.; licensee BioMed Central Ltd