Collaboration in academic medicine:Reflections on gender and advancement

Purpose: Collaboration in academic medicine is encouraged, yet no one has studied the environment in which faculty collaborate. The authors investigated how faculty experienced collaboration and the institutional atmosphere for collaboration. Method: In 2007, as part of a qualitative study of faculty in five disparate U.S. medical schools, the authors interviewed 96 medical faculty at different career stages and in diverse specialties, with an oversampling of women, minorities, and generalists, regarding their perceptions and experiences of collaboration in academic medicine. Data analysis was inductive and driven by the grounded theory tradition. Results: Female faculty expressed enthusiasm about the potential and process of collaboration; male faculty were more likely to focus on outcomes. Senior faculty experienced a more collaborative environment than early career faculty, who faced numerous barriers to collaboration: the hierarchy of medical academe, advancement criteria, and the lack of infrastructure supportive of collaboration. Research faculty appreciated shared ideas, knowledge, resources, and the increased productivity that could result from collaboration, but they were acutely aware that advancement requires an independent body of work, which was a major deterrent to collaboration among early career faculty. Conclusions: Academic medicine faculty have differing views on the impact and benefits of collaboration. Early career faculty face concerning obstacles to collaboration. Female faculty seemed more appreciative of the process of collaboration, which may be of importance for transitioning to a more collaborative academic environment. A reevaluation of effective benchmarks for promotion of faculty is warranted to address the often exclusive reliance on individualistic achievement. © 2009 The Association of American Medical Colleges.

Nurse practitioner and physician collaboration in long-term care homes:Survey results

This survey assessed the extent of and satisfaction with collaboration between physicians and nurse practitioners (NPs) working in Ontario long-term care homes. Questionnaires, which included the Measure of Current Collaboration and Provider Satisfaction with Current Collaboration instruments, were mailed to NPs and physicians with whom the NP most frequently worked. The 14 matched-pairs of NPs and physicians reported similar levels of collaboration; however, physicians were significantly more satisfied with collaboration than were NPs (z = -2.67, p = 0.008). The majority of physicians (85%) and NPs (86%) indicated that collaboration was occurring, and 96 per cent of physicians and 79 per cent of NPs were satisfied with their collaboration. About one third of physicians reported that the NP had a negative effect on their income, but their satisfaction with collaboration did not differ from those who reported a positive effect. Overall, these physicians and NPs collaborate in delivering care and are satisfied with their collaboration. © 2009 Canadian Association on Gerontology.

Mental health needs of children and youth with learning disabilities:Overview of a community needs assessment

The purpose of the present report is to describe a community needs assessment that puts the process and choice of a suitable approach into a context. The study examined the mental health needs of children and youth with learning disabilities and their families and how they fit within the continuum of services in Metropolitan Toronto. A series of recommendations was developed for the Ministry of Community and Social Services. The recommendations emphasize: prevention, training and consultation, and research. The study illustrates the importance of involving relevant constituencies in both the planning of a needs assessment and the formulation and implementation of recommendations based on the investigation.

Physical rehabilitation interventions for adult patients during critical illness: an overview of systematic reviews

Background Physical rehabilitation interventions aim to ameliorate the effects of critical illness-associated muscle dysfunction in survivors. We conducted an overview of systematic reviews (SR) evaluating the effect of these interventions across the continuum of recovery.

Methods Six electronic databases (Cochrane Library, CENTRAL, DARE, Medline, Embase, and Cinahl) were searched. Two review authors independently screened articles for eligibility and conducted data extraction and quality appraisal. Reporting quality was assessed and the Grading of Recommendations Assessment, Development and Evaluation approach applied to summarise overall quality of evidence.

Results Five eligible SR were included in this overview, of which three included meta-analyses. Reporting quality of the reviews was judged as medium to high. Two reviews reported moderate-to-high quality evidence of the beneficial effects of physical therapy commencing during intensive care unit (ICU) admission in improving critical illness polyneuropathy/myopathy, quality of life, mortality and healthcare utilisation. These interventions included early mobilisation, cycle ergometry and electrical muscle stimulation. Two reviews reported very low to low quality evidence of the beneficial effects of electrical muscle stimulation delivered in the ICU for improving muscle strength, muscle structure and critical illness polyneuropathy/myopathy. One review reported that due to a lack of good quality randomised controlled trials and inconsistency in measuring outcomes, there was insufficient evidence to support beneficial effects from physical rehabilitation delivered post-ICU discharge.

Conclusions Patients derive short-term benefits from physical rehabilitation delivered during ICU admission. Further robust trials of electrical muscle stimulation in the ICU and rehabilitation delivered following ICU discharge are needed to determine the long-term impact on patient care. This overview provides recommendations for design of future interventional trials and SR.

Senior Managers’ Perspectives of Leading and Managing Effective, Sustainable and Successful Partnerships

Formal and informal partnerships have become key features of education policy and practice in many countries and managing such collaborative arrangements is an important dimension of the role(s) of leaders of educational organizations. Recent research has shown both the tensions and conflict that can develop in partnerships as well as the opportunities and benefits of partnership working for organizations and individuals. This article focuses on the characteristics of partnerships that contribute to their effectiveness, sustainability and success, filling a gap in the literature on educational partnerships. The research data emanate from a qualitative study of partnership working in England. The study used a grounded approach and inductively linked characteristics of partnerships found in the partnership literature with empirical data from a case study of a subregional partnership of education and training organizations. This combined evidence is used to conceptualize partnership as a continuum of weak to strong forms of partnership and to develop a table of characteristics which underpin such partnerships. The findings reveal the extent to which trust, networks, norms and values support effective, sustained and successful partnerships. These characteristics are differentiated and may fluctuate during the lifecourse of a partnership but remain fundamental features of partnership working and significantly contribute to the strength and effectiveness of partnerships.

How enterprise 2,0 firms take advantage of emergent social software platforms to manage knowledge

This research aims to provide a better understanding on how firms stimulate knowledge sharing through the utilization of collaboration tools, in particular Emergent Social Software Platforms (ESSPs). It focuses on the distinctive applications of ESSPs and on the initiatives contributing to maximize its advantages. In the first part of the research, I have itemized all types of existing collaboration tools and classify them in different categories according to their capabilities, objectives and according to their faculty for promoting knowledge sharing. In the second part, and based on an exploratory case study at Cisco Systems, I have identified the main applications of an existing enterprise social software platform named Webex Social. By combining a qualitative and quantitative approach, as well as combining data collected from survey’s results and from the analysis of the company’s documents, I am expecting to maximize the outcome of this investigation and reduce the risk of bias. Although effects cannot be universalized based on one single case study, some utilization patterns have been underlined from the data collected and potential trends in managing knowledge have been observed. The results of the research have also enabled identifying most of the constraints experienced by the users of the firm’s social software platform. Utterly, this research should provide a primary framework for firms planning to create or implement a social software platform and for firms willing to increase adoption levels and to promote the overall participation of users. It highlights the common traps that should be avoided by developers when designing a social software platform and the capabilities that it should inherently carry to support an effective knowledge management strategy.

Evolution of reputation in networks: A mean field game approach

This work models the competitive behaviour of individuals who maximize their own utility managing their network of connections with other individuals. Utility is taken as a synonym of reputation in this model. Each agent has to decide between two variables: the quality of connections and the number of connections. Hence, the reputation of an individual is a function of the number and the quality of connections within the network. On the other hand, individuals incur in a cost when they improve their network of contacts. The initial value of the quality and number of connections of each individual is distributed according to an initial (given) distribution. The competition occurs over continuous time and among a continuum of agents. A mean field game approach is adopted to solve the model, leading to an optimal trajectory for the number and quality of connections for each individual.

Quest/ion of Identities in African American Feminist Postmodern Drama: A Study of Selected Plays by Suzan-Lori Parks

Innovative and unconventional, Pulitzer Prize-winning playwright Suzan-Lori Parks belongs to the continuum of African American playwrights who have contributed to the quest/ion – the quest for and question – of identities for African Americans. Her plays are sites in which the quest/ion of identities for African Americans is pursued, raised and enacted. She makes use of both page and stage to emphasize the exigency of reshaping African Americans’ identities through questioning the dominant ideologies and metanarratives, delegitimizing some of the prevailing stereotypes imposed on them, drawing out the complicity of the media in perpetuating racism, evoking slavery, lynching and their aftereffects, rehistoricizing African American history, catalyzing reflections on the various intersections of sex, race, class and gender orientations, and proffering alternative perspectives to help readers think more critically about issues facing African Americans. In my dissertation, I approach three plays by Parks – The Death of the Last Black Man in the Whole Entire World (1990), Venus (1996) and Fucking A (2000) – from the standpoints of postmodern drama and African American feminism with a focus on the terrains that reflect the quest/ion of identities for African Americans, especially African American women. I argue that postmodern drama and African American feminism provide the ground for Parks to promote the development of a political agenda in order to call into question a number of dominant ideologies and metanarratives with regard to African Americans and draw upon the roles of those metanarratives as a powerful apparatus of racial and sexual oppressions. I also explore how Parks engages with postmodern drama and African American feminism to incorporate her own mininarratives in the dominant discourses. I argue that Parks in these plays uses postmodern drama and African American feminism to encourage reflections on intersectionality in order to reveal the concerns of African Americans, particularly African American women. Her plays challenge the dominant order of hierarchy and patriarchy, while in some cases urging unity and solidarity between African American men and women by showing how unity and solidarity can help them confront race, class and gender oppressions. Furthermore, I discuss how the utilization of postmodern techniques and devices helps Parks to transform the conventional features of playwriting, to create incredulity toward the dominant systems of oppression and to incorporate her mininarratives within the context of dominant discourses.

A comprehensive examination of adolescent gambling

The purposes of this study were: a) to examine the prevalence and consequences associated with adolescent gambling, b) to examine the factors which influence adolescent gambling,. c) to detennine what factors discriminate among four groups of gamblers (no-risk/non-gamblers, low-risk gamblers, at-risk gamblers, and high-risk/problematic gamblers), and d) to examine the relation of gambling to nine other risk behaviours (i.e., alcohol use, smoking, marijuana use, hard drug use, sexual activity, minor delinquency, major delinquency, direct aggression, and indirect aggression). Adolescents (N = 3,767) from 25 secondary schools completed a twohour survey that assessed involvement in risk be~aviours as well as potential predictors from a wide range of contexts (school, neighbourhood, family, peer, and intrapersonal). The majority of adolescents reported gambling, although the frequency of gambling participation was low. The strongest predictors/discriminators of gambling involvement were gender, unstructured activities, structured activities, and risk attitudes/perceptions. In addition, the examination of the co-occurrence of gambling with other risk behaviours revealed that for high-risk/problem gamblers, the top three most frequent co-occurring high-risk behaviours were direct aggression, minor delinquency and alcohol. This study was the first to examine the continuum of gambling involvement (i.e., non-gambling to high risk/problematic gambling) using a comprehensive set ofpotential predictors with a large sample of secondary school students. The findings of this study support past research and theories (e.g., Theory of Triadic Influence) which suggest the importance ofproximal variables in predicting risk behaviors. The next step, however, will be to examine the direct and indirect 1 effects of the ultimate (e.g., temperament), distal (e.g., parental relationship), and proximal variables (e.g., risk attitudes/perceptions) on gambling involvement in a longitudinal study.

The social consequences of mild head injury and executive dysfunction /

Mild head injury (MHI) is a serious cause of neurological impairment as is evident by the substantial percentage (15%) of individuals who remain symptomatic at least 1-year following "mild" head trauma. However, there is a paucity of research investigating the social consequences following a MHI. The first objective of this study was to examine whether measures of executive functioning were predictive of specific forms of antisocial behaviour, such as reactive aggression, impulsive antisocial behaviour, behavioural disinhibition, and deficits in social awareness after controlling for the variance accounted for by sex differences. The second objective was to investigate whether a history of MHI was predictive of these same social consequences after controlling for both sex differences and executive functioning. Ninety university students participated in neuropsychological testing and filled out self-report questionnaires. Fifty-two percent of the sample self-reported experiencing a MHI. As expected, men were more reactively aggressive and antisocial than women. Furthermore, executive dysfunction predicted reactive aggression and impulsive antisocial behaviour after controlling for sex differences. Finally, as expected, MHI status predicted reactive aggression, impulsive antisocial behaviour, and behavioural disinhibition after controlling for sex and executive fimctioning. MHI status and executive functioning did not predict social awareness or sensitivity to reward or punishment. These results suggest that incurring a MHI has serious social consequences that mirror the neurobehavioural profile following severe cases of brain injury. Therefore, the social sequelae after MHI imply a continuum of behavioural deficits between MHI and more severe forms of brain injury.

Evolution of an Archean greenstone belt in the Stormy Lake - Kawashegamuk Lake area (stratigraphy, structure and geochemistry) - Western Wabigoon Subprovince, Northwest Ontario /

330 km 2 of the easter-n part of the Archean Manitou Lakes - Stormy Lake metavolcanic - metasedimentary belt have been mapped and sampled. A large number of rocks ~.vere analyzed for the major and trace constituents including the rare-earth elements (REE). The Stormy Lake - Kawashegamuk Lake area may be subdivided into four major lithological groups of supracrustal rocks 1) A north-facing mafic assemblage, consisting of pillowed tholeiitic basalts and gabbro sills characterized by flat REE profiles, is exposed in the south part of the map area and belongs to a 8000 m thick homoclinal assemblage outside the map area. Felsic pyroclastic rocks believed to have been issued from a large central vent conformably overlie the tholeiites. 2) A dominantly epiclastic group facing to the north consists of terrestrial deposits interpreted to be an alluvial fan deposit ; a submarine facies is represented by turbiditic sediments. 3) The northeastern part of the study area consists of volcanic rocks belonging to two mafic - felsic cycles facing to the southuest ; andesitic flows with fractionated REE patterns make up a large part of the upper cycle, whereas the lower cycle has a stronger chemical polarity being represented by tholeiitic flows, with flat REE, which a r e succeeded by dacitic and rhyolitic pyroclasti cs. iii 4) A thick monotonous succession of tholeiitic pillmled basalt f lows and gabbro sills with flat REE represent the youngest supracrustal rocks. TIle entire belt underwent folding, faulting and granitic plutonism during a tectono-thermal event around 2700 Ma ago. Rocks exposed in the map area were subjected to regional greenschist facies metamorphism, but higher metamorphic grades are present near late granitic intrusions. Geochemical studies have been useful in 1) distinguishing the various rock units ; 2) relating volcanic and intrusive rocks 3) studying the significance of chemical changes due to post magmatic processes 4) determining the petrogenesis of the major volcanic rock types. In doing so, two major volcanic suites have been recognized : a) a tholeiitic suite, mostly represented by mafic rocks, was derived from partial melting of upper mantle material depleted in Ti, K and the light REE ; b) a calc-alkalic suite which evolved from partial melting of amphibolite in the lower crust. The more differentiated magma types have been produced by a multistage process involving partial melting and fractional crystallization to yield a continuum of compos i t i ons ranging from basaltic andesite to rhyolite. A model for the development of the eastern part of the Manitou Lakes - Stormy Lake belt has been proposed.

Assessment done write : using collaboration to reculture teacher learning

This study examined the impact that collaborative learning had on the assessment and evaluation of writing practices of a group of teachers as they engaged in a community of learners. The study explored the development of teacher knowledge and perceptions as well as the implementation of effective assessment strategies in writing for students in grades 4 to 8 that could be achieved through collaboration. Teachers' perceptions of the value of collaboration were also embedded within the study. Multiple methods of data collection were used to gather rich and descriptive data. Those methods included interviews, observation, and documentation of meetings and of participants' perceptions of their assessment and evaluation practices. Five preexisting themes describing desired outcomes of change were used to analyze the data. These themes included: knowledge, attitude, skill, aspiration, and behaviour. While it was difficult to identify definitively the degree oflearning achieved by the participants, conclusions can be drawn that the participants experienced learning and some change in the areas of knowledge and skill, attitude, aspiration, and behaviour. What was notable was the continued belief on the part of the participants of the value of collaboration as a means of learning.

A Study of One Living School Partnership

Abstract The purpose of this paper was to explore the ways one partnership evaluated its partners and relationships using Gray‟s model of collaboration (2000). The model consists of five approaches that are made up of: problem-focused, relational, cognitive, structural, and political. These approaches were tested at one „Living School‟ partnership that was constituted by a school, a public health department, the City‟s Park and Recreation Department, commercial enterprises, and organizations from the non-profit sector. Eight pre-arranged interviews were conducted using conversational interview technique, with three additional interviews on-site. The results of the research revealed that based on Gray‟s five approaches, this one Living School partnership was found to be successful. Consistent with partnership research, trust, social capital and structure were found to be key ingredients, as well as new themes of leadership, role clarity, and a shared vision were also found to be vital.

Educational Leadership: Exploring the Influence of Managed and Living Systems in Educational Leadership Discourse

A conceptual analysis of educational leadership explored the influence of managed and living systems on 21st century leadership discourse. Drawing on a detailed understanding of managed and living systems theory compiled from the work of Capra (2002), Morgan (1997), Mitchell and Sackney (2009), and Wheatley (2007), this study draws attention to the managed systems systemic concepts of efficiency, control, and standardization, and the living systems concepts of collaboration, shared meaning, change, and interconnection as markers of systems theory that find resonance within leadership literature. Using these systemic concepts as a framework, this study provides important insights into the espousal of managed and living systems concepts within the leadership discourse.

Ribbed moraines and subglacial geomorphological signatures of interior-sector palaeo-ice sheet dynamics

Transverse, subglacial bedforms (ribbed moraines) occur frequently in southern Keewatin, Nunavut, Canada, where they record a complex glacial history, including shifting centers of ice dispersal and fluctuating basal thermal regimes. Comprehensive mapping and quantitative morphometric analysis of the subglacial bedform archive in this sector reveals that ribbed moraines are spatially clustered by size and assume a broad range of visually distinct forms. Results suggest that end-member morphologies are consistent with a dichotomous polygenetic origin, and that a continuum of forms emerged through subsequent reshaping processes of variable intensity and duration. Translocation of mobile, immobile and quasi-mobile beds throughout the last glacial cycle conditioned the development of a subglacial deforming bed mosaic, and is likely responsible for the patchy zonation of palimpsest and inherited landscape signatures within this former core region of the Laurentide Ice Sheet. Comparison against field evidence collected from central Norway suggests that bedforming processes can be locally mediated by pre-existing topography.