Engaging junior doctors:evidence from "open spaces" in England

Purpose: This paper aims to report on a project undertaken in order to identify, develop and reflect on the leadership and managerial skills of clinicians. The main aim of the project was to design, plan, organise and deliver a learning session for Foundation Year 2 Doctors within the premises of one of the largest NHS Foundation Trusts in the UK. The key theme of the learning session was the introduction of the notion of competent medical leadership in the NHS. A leadership role has been traditionally seen as the task of managers and as such clinicians have seemed reluctant to engage. Design/methodology/approach: A two hour workshop was designed and delivered with the use of Open Space Technology. Foundation Year 2 doctors were invited to consider the importance of leadership in their everyday roles. An awareness of the Medical Leadership Competency Framework had been a key aspect of the learning session. Findings: The project's outcome can be identified as being the encouragement of Foundation Year 2 doctors in considering their roles as leaders in their everyday tasks. Originality/value: Design, planning, organisation and delivery of a two hour Open Space learning session with the Foundation Year 2 doctors portrays the session's learning potentials and the potential for such sessions to provide a platform for difficult discussions in the NHS. This is particularly beneficial where a cultural shift is needed in order to see a way forward, notably when facing significant change. © Emerald Group Publishing Limited.

Stem cell therapies for ischemic cardiovascular diseases

Myocardial infarction results in loss of cardiac muscle and deficiency in cardiac performance. Likewise, peripheral artery disease can result in critical limb ischemia leading to reduced mobility, non-healing ulcers, gangrene and amputation. Both of these common conditions diminish quality of life and enhance risk of mortality. Successful advances in treatment have led to more people surviving incidences of myocardial infarction or living with peripheral artery disease. However, the current treatments are inadequate in repairing ischemic tissue. Over the last 5 years, a vast number of patents have been submitted concerning the use of stem cells, which correlates with the exponential growth in stem cell publications. Exploiting stem cell therapy offers a real potential in replacing ischemic tissue with functional cells. In this paper, we review recent patents concerning stem cell therapy that have the potential to provide or potentiate novel treatment for ischemic cardiovascular disease. In addition, we evaluate the promise of the inventions by describing some clinical trials that are currently taking place, as well as considering how current research on ischemic cardiovascular disease may change the patent landscape in the future.

How authentic leadership influences team performance:the mediating role of team reflexivity

This study examines how authentic leadership influences team performance via the mediating mechanism of team reflexivity. Adopting a self-regulatory perspective, we propose that authentic leadership will predict the specific team regulatory process of reflexivity, which in turn will be associated with two outcomes of team performance; effectiveness and productivity. Using survey data from 53 teams in three organizations in the United Kingdom and Greece and controlling for collective trust, we found support for our stated hypotheses with the results indicating a significant fully mediated relationship. As predicted the self-regulatory behaviors inherent in the process of authentic leadership served to collectively shape team behavior, manifesting in the process of team reflexivity, which, in turn, positively predicted team performance. We conclude with a discussion of how this study extends theoretical understanding of authentic leadership in relation to teamwork and delineate several practical implications for leaders and organizations.

Women’s adaptation to STEM domains promotes resilience and a lesser reliance on heuristic thinking

Experiences that compel people to challenge social stereotypes can promote enhanced cognitive flexibility on a range of judgmental domains. Women in STEM (science, technology, engineering, and math) fields are chronically exposed to such experiences and may therefore also demonstrate these benefits. Two studies examined the differential effects of counterstereotypical experiences on women from STEM and non-STEM fields. Results showed that imagining or recollecting these experiences led women from STEM fields to exhibit a lesser reliance on heuristic thinking compared to women from non-STEM fields, and this difference was mediated by self-perceived resilience to the negative impact of gender stereotyping. Implications for psychologists’ and educators’ understanding of the relationship between counterstereotypical experiences and heuristic thinking are discussed.

Domestic and foreign isolationism in an interdependent world

Since Plato's Republic and Aristotle's Politics established the basis for Western political thought almost 2500 years ago, the discipline of international relations has evolved substantially. However, most of the literature revolves around state interaction within the system, and there is little discussion of countries that opt out of the international states system and become isolationist. Given the interdependent nature of the modern international system, this study elaborates on domestic and foreign isolationism by expounding upon the reasons and consequences of states opting out of the international system. The empirical case studies utilized to explore isolationism are Albania, North Korea, and Burma. By empirically verifying the components, motivations, and consequences of isolationism in an interdependent world, this study provides insight into why and how states resist engagement with the global socioeconomic and political state system. ^ Using historical, comparative, and inductive analysis, this study explains why states choose to isolate themselves both domestically and internationally. Specifically, comparative historical analysis highlights isolationism as a concept and practice. This study maintains that extreme forms of self-imposed isolation in an interdependent international system, while perhaps serving the immediate interests of a ruling regime, harms the long-term national interests of the state and the populace. Although the leadership in an isolationist state gains a significant amount of power and control over the people within its borders, the state as a whole experiences profound negative effects. In the long term, a state loses power, stability, prestige, and suffers a decline in overall economic prosperity. ^ States that withdraw from the international system, therefore, provide insight into an unexplored area of international relations when considering notions of rationality, self-interest, power politics, cooperation, and alliances. In short, isolationism in an interdependent state system goes against the logic of the modern society/system of states, resulting in deleterious consequences to the wellbeing of the state. ^

Could Relatedness Help Explain Why Individuals Lead in Bottlenose Dolphin Groups?

In many species, particular individuals consistently lead group travel. While benefits to followers often are relatively obvious, including access to resources, benefits to leaders are often less obvious. This is especially true for species that feed on patchy mobile resources where all group members may locate prey simultaneously and food intake likely decreases with increasing group size. Leaders in highly complex habitats, however, could provide access to foraging resources for less informed relatives, thereby gaining indirect benefits by helping kin. Recently, leadership has been documented in a population of bottlenose dolphins (Tursiops truncatus) where direct benefits to leaders appear unlikely. To test whether leaders could benefit indirectly we examined relatedness between leader-follower pairs and compared these levels to pairs who associated but did not have leader-follower relationship (neither ever led the other). We found the average relatedness value for leader-follower pairs was greater than expected based on chance. The same was not found when examining non leader-follower pairs. Additionally, relatedness for leader-follower pairs was positively correlated with association index values, but no correlation was found for this measure in non leader-follower pairs. Interestingly, haplotypes were not frequently shared between leader-follower pairs (25%). Together, these results suggest that bottlenose dolphin leaders have the opportunity to gain indirect benefits by leading relatives. These findings provide a potential mechanism for the maintenance of leadership in a highly dynamic fission-fusion population with few obvious direct benefits to leaders.

The relationship of managers' self -reported leadership practices and their spirituality

The role of spirituality in leadership in business and other organizations has gained growing recognition. The purpose of this study was to explore the relationship between spirituality and nine selected transformational leadership practices. Community leaders (N = 138) in business, education, and other professions who were graduates of a 10-week leadership program, Leadership Fort Lauderdale, from 1994 to 2004 completed the Spirituality Assessment Scale (SAS), the Leadership Practices Inventory (LPI), and four transformational leadership items of the Multifactor Leadership Questionnaire (MLQ). ^ The predictor variables were participants' scores on the LPI and MLQ. The criterion variable was their score on the SAS. Stepwise multiple regression analysis was used to test the hypothesis: Is there a combination of nine selected transformational leadership practices that would account for a significant portion of the variance of each of two spirituality measures? The Definitive and Correlated dimensions and Total spirituality score of the SAS were used in the analysis. ^ Results showed that two of the LPI leadership practices were significantly related to spirituality. The variable Inspiring a Shared Vision accounted for 10% of the variance of the SAS Definitive dimension. The variable Encouraging the Heart accounted for 30% of the variance of the Correlated dimension. For the Total spirituality score, two models were revealed. In the first model, Encouraging the Heart accounted for 28% of the variance of the total spirituality score. In the second model, Encouraging the Heart and Inspiring a Shared Vision together accounted for 31% of the total spirituality score. None of the transformational leadership practices from the MLQ were significantly related to spirituality. ^ The data partially support the hypothesis: two of the nine leadership variables did in combination correlate with leaders' spirituality. The results also support at least a partial relationship between spirituality and certain transformational leadership practices among leaders in various spheres, such as education, business, and other professions. ^

A study of the relationship between employee virtuality and technology deviance as mediated by leadership and employee perceptions

Recent studies found that organizations have been investing significant capital in developing teams and employees in geographic areas where labor and resources are considerably cheaper. Furthermore, organizations are moving core operational activities such as research and development and back-office processes to globally distributed teams. ^ However, several factors that are inherent to these virtual teams can have a negative impact on employee perceptions and engagement; specifically, the physical and temporal differences between employees and their supervisors, the lack of meaningful social interaction intrinsic to working relationships, and cultural biases that can be fostered when close, daily interactions is not there to help bridge the dissimilarity. ^ When strategies are not in place to mitigate these deficiencies, it can cause virtual employees to disengage emotionally and intellectually from the organization, or lead them to feel justified in working against the best interest of the company. ^ Past research indicates that although deviant behavior in the workplace is not new, transgressions committed by employees have been increasing significantly every year. Beyond the focus of why employees are motivated to act against the organization, to what extent do the recent changes to the organization’s structure influence this type of behavior through their actions at the macro (organizational) and micro level (leadership). ^ In addition, there is a related phenomenon that has aided the transformation of the workplace—namely, the ubiquity of technology. In the context of workplace deviance, established research has documented an increasing trend of employees utilizing company technology as a medium and amplifier when harming the organization. It is important to understand whether technology has facilitated or hindered workplace deviance by virtue of the technology itself (as a means), and as part of the new employee roles created by the evolving technology (i.e., virtual employees). Therefore, it is important to identify how individual attitudes and behaviors can be affected by an employee’s degree of virtuality. ^ This study will add to the understanding of how social interaction and physical proximity, leadership and other perception factors contribute to the changes organizations are experiencing as their structure evolves and adapts to compete in the new global environment. ^

The relationship between selected standardized test scores and performance in advanced placement math and science exams: Analyzing the differential effectiveness of scores for course identification and placement

There is a national need to increase the STEM-related workforce. Among factors leading towards STEM careers include the number of advanced high school mathematics and science courses students complete. Florida's enrollment patterns in STEM-related Advanced Placement (AP) courses, however, reveal that only a small percentage of students enroll into these classes. Therefore, screening tools are needed to find more students for these courses, who are academically ready, yet have not been identified. The purpose of this study was to investigate the extent to which scores from a national standardized test, Preliminary Scholastic Assessment Test/ National Merit Qualifying Test (PSAT/NMSQT), in conjunction with and compared to a state-mandated standardized test, Florida Comprehensive Assessment Test (FCAT), are related to selected AP exam performance in Seminole County Public Schools. An ex post facto correlational study was conducted using 6,189 student records from the 2010 - 2012 academic years. Multiple regression analyses using simultaneous Full Model testing showed differential moderate to strong relationships between scores in eight of the nine AP courses (i.e., Biology, Environmental Science, Chemistry, Physics B, Physics C Electrical, Physics C Mechanical, Statistics, Calculus AB and BC) examined. For example, the significant unique contribution to overall variance in AP scores was a linear combination of PSAT Math (M), Critical Reading (CR) and FCAT Reading (R) for Biology and Environmental Science. Moderate relationships for Chemistry included a linear combination of PSAT M, W (Writing) and FCAT M; a combination of FCAT M and PSAT M was most significantly associated with Calculus AB performance. These findings have implications for both research and practice. FCAT scores, in conjunction with PSAT scores, can potentially be used for specific STEM-related AP courses, as part of a systematic approach towards AP course identification and placement. For courses with moderate to strong relationships, validation studies and development of expectancy tables, which estimate the probability of successful performance on these AP exams, are recommended. Also, findings established a need to examine other related research issues including, but not limited to, extensive longitudinal studies and analyses of other available or prospective standardized test scores.

A Study of the Relationship between Employee Virtuality and Technology Deviance as Mediated by Leadership and Employee Perceptions

Recent studies found that organizations have been investing significant capital in developing teams and employees in geographic areas where labor and resources are considerably cheaper. Furthermore, organizations are moving core operational activities such as research and development and back-office processes to globally distributed teams. However, several factors that are inherent to these virtual teams can have a negative impact on employee perceptions and engagement; specifically, the physical and temporal differences between employees and their supervisors, the lack of meaningful social interaction intrinsic to working relationships, and cultural biases that can be fostered when close, daily interactions is not there to help bridge the dissimilarity. When strategies are not in place to mitigate these deficiencies, it can cause virtual employees to disengage emotionally and intellectually from the organization, or lead them to feel justified in working against the best interest of the company. Past research indicates that although deviant behavior in the workplace is not new, transgressions committed by employees have been increasing significantly every year. Beyond the focus of why employees are motivated to act against the organization, to what extent do the recent changes to the organization’s structure influence this type of behavior through their actions at the macro (organizational) and micro level (leadership). In addition, there is a related phenomenon that has aided the transformation of the workplace – namely, the ubiquity of technology. In the context of workplace deviance, established research has documented an increasing trend of employees utilizing company technology as a medium and amplifier when harming the organization. It is important to understand whether technology has facilitated or hindered workplace deviance by virtue of the technology itself (as a means), and as part of the new employee roles created by the evolving technology (i.e, virtual employees). Therefore, it is important to identify how individual attitudes and behaviors can be affected by an employee’s degree of virtuality. This study will add to the understanding of how social interaction and physical proximity, leadership and other perception factors contribute to the changes organizations are experiencing as their structure evolves and adapts to compete in the new global environment.

A THEOLOGICAL NORMATIVE TO THE UNDERSTANDING OF FATHERHOOD IN THE AFRICAN AMERICAN COMMUNITY

ABSTRACT

This thesis examines the theological correlation between the role of the church, the identity and role of the African American male, and the effectiveness of fatherhood. The study begins with an in-depth analysis of how absentee fathers cause a crisis in the family. The absence of fathers from the home causes children to suffer financially, socially and psychologically, and therefore causes a disruption in the community as a whole. Focus on the Family founder and leader, Dr. James Dobson, confirms that “our very survival as a people will depend upon the presence or absence of masculine leadership in millions of homes.” In person interviews of African American Christian males and interpretation of the scriptures are just two of the methods used in this study to explore the theological norm of fatherhood. Collectively, the case studies and statistical data within this study explore attempts to remedy the crisis through governmental policies and networking within the community. The final chapter examines the role of urban churches and clergy in teaching effective fatherhood practices. Within the conclusion, it is made clear that the church is responsible for establishing the theological framework and principles for understanding the intended role of being a father. Another conclusion of this study is the acknowledgement of the African American community’s role in shaping and reforming the identity and role of the African American male as a father in the home. The African American community and the church must continue working in tandem to encourage organic social networks that will promote a model for effective fatherhood practices.

Leading from the Edge: Marginal Leadership at Cultural Crossroads

If a church reflects its larger community, it will have more dynamic interactions among different people. Current U.S. communities consist of very diverse people who have different socioeconomic and cultural backgrounds. Since the mid 20th century, various immigrant communities who have dissimilar cultural, religious, and linguistic traditions have accelerated the need of change in American churches. The drastic cultural change has demanded churches to equip their lay and clergy leaders with multicultural competencies for effective ministries.

My thesis explores imaginative leadership in cultural crossroads. Emphasizing the leadership imagination of cross-cultural ministry, I approach it in biblical, theological, and missional perspectives. In this dynamic cultural milieu, the study topic may help the church renew its ecclesial purpose by seeing cross-cultural ministry as a creative opportunity to reach out to more diverse people of God. I begin with a conceptual framework for cross-cultural ministry and cultural intelligence. Then I explain why cross-cultural ministry is significant and how it enhances the spirit of Christ Jesus. As I develop the thesis, I discuss leadership challenge and development in the cross-cultural ministry context. This thesis may contribute to equipping lay and clergy leaders by overcoming the homogeneous ‘in-group’ mindset in the church.

The primary focus is on developing marginal leadership of church in the post-Christendom era. Church leaders must creatively hold the tension between the current church context and Christian faith resources and seek a hopeful resolution as a third way through integrative thought process. While conventional leadership emphasizes a better choice out of the given options, marginal leadership takes time for integrative thought process to seek a new direction for the future. Conventional leaders take the center with their power, status, and prestige, but marginal leaders position themselves on the edge. Leading from the edge is a distinctive cross-cultural leadership and is based on the servant leadership of Jesus Christ who put himself as a servant for the marginalized. By serving and relating to others on the margin, this imaginative leadership may make appropriate changes desired in today’s American churches.

In addition to academic research, I looked into the realities of cross-cultural leadership in the local churches through congregational studies. I speculated that church leadership involves both laity and clergy and that it can be enhanced. All Christians are called to serve the Lord according to their gifts, and it is crucial for lay and clergy persons to develop their leadership character and skills. In particular, as humans are contextualized with their own cultures, church leaders often confront great challenges in cross-cultural or multicultural situations. Through critical thoughts and imaginative leadership strategies, however, they can overcome intrinsic human prejudice and obstacles.

Through the thesis project, I have reached four significant conclusions. First, cultural intelligence is an essential leadership capacity for all church leaders. As the church consists of more diverse cultural people today, its leaders need to have cultural competencies. In particular, cross-cultural leaders must be equipped with cultural intelligence. Cross-cultural ministry is not a simple byproduct of social change, but a creative strategy to open a door to bring God’s reconciliation among diverse people. Accordingly, church leaders are to be well prepared to effectively cope with the challenges of cultural interactions. Second, both lay and clergy leaders’ imaginative leadership is crucial for leading the congregation. While conventional leadership puts an emphasis on selecting a better choice based on the principle of opportunity cost, imaginative leaders critically consider the present church situations and Christian faith values together in integrative thoughts and pursue a third way as the congregation’s future hope. Third, cross-cultural leadership has a unique characteristic of leading from the edge and promotes God’s justice and peaceable relationships among different people. By leading the congregation from the edge, church leaders may experience the heart of Christ Jesus who became the friend of the marginalized. Fourth, the ‘homogeneous unit principle’ theory has its limit for today’s complex ‘inter-group’ community context. The church must be a welcoming and embracing faith community for all people. Cross-cultural ministry may become an entrance door for a more peaceable and reconciling life among different people. By building solidarity with others, the church may experience a kingdom reality.

This thesis focuses on the mission of the church and marginal leadership of church leaders in ever-changing cultural crossroads. The church becomes a hope in the broken and apathetic world, and Christians are called to build relationships inside and beyond the church. It is significant for church leaders to be faithfully present on the margin and relate to diverse people. By consistently positioning themselves on the margin, they can build relationships with new and diverse people and shape a faithful life pattern for others.

The Didache and Traditioned Innovation: Shaping Christian Community in the First Century and the Twenty-First Century

Church leaders, both lay and clergy, shape Christian community. Among their central tasks are: building communal identity, nurturing Christian practices, and developing faithful structures. When it comes to understanding the approach of the earliest Christian communities to these tasks, the Didache might well be the most important text most twenty-first century church leaders have never read. The Didache innovated on tradition, shaping the second generation of Christians to meet the crises and challenges of a changing world.

Most likely composed in the second half of the first century, the Didache served as a training manual for gentile converts to Christianity, preparing them for life in Christian community. This brief document, roughly one third the length of Mark’s gospel, developed within early Jewish-Christian communities. It soon found wide usage throughout the Mediterranean region, and its influence endured throughout the patristic and into the medieval period.

The Didache outlines emerging Christian practices that were rooted in both Jewish tradition and early Jesus material, yet were reaching forward in innovative ways. The Didache adopts historical teachings and practices and then adapts them for an evolving context. In this respect, the writers of the Didache, as well as the community shaped by its message, exemplify the pattern of thinking described by Greg Jones as “traditioned innovation.”

The Didache invites reflection on the shape and content of Christian community and Christian leadership in the twenty-first century. As churches and church leaders engage a rapidly changing world, the Didache is an unlikely and yet important conversation partner from two millennia ago. A quick read through its pages – a task accomplished in less than half an hour – brings the reader face to face with a brand of Christianity both very familiar and strikingly dissimilar to modern Christianity. Such dissonance challenges current assumptions about the church and creates a space in which to re-imagine our situation in light of this ancient Christian tradition. The Didache provides a window through which we might re-examine current conceptualizations of Christian life, liturgy, and leadership.

This thesis begins with an exploration of the form and function of the Didache and an examination of a number of important background issues for the informed study of the Didache. The central chapters of this thesis exegete and explore select passages in each of the three primary sections of the Didache – the Two Ways (Didache 1-6), the liturgical section (Didache 7-10), and the church order (Didache 11-15). In each instance, the composers of the Didache reach back into a cherished and life-giving aspect of the community’s heritage and shape it anew into a fresh and faithful approach to living the Christian life in a drastically different context.

The thesis concludes with three suggestions of how the Didache may provide a resource for the way the Church in the present thinks about training disciples, shaping community, and developing leadership structures. These conversation starters offer beginning points for a richer, fuller discussion of traditioned innovation in our current church context. The Didache provides a source of wisdom from our spiritual forebears that modern Christian leaders would do well not to ignore. With a look through the first century window of the Didache, twenty-first century Christians can discover fresh insights for shaping Christian community in the present.

Targeting treatment resistant breast cancer stem cells with FKBPL and its peptide derivative, AD-01

FKBPL and its peptide derivative, AD-01, have already demonstrated well-established inhibitory effects on breast cancer growth and CD44 dependent anti-angiogenic activity1, 2, 3. Since breast cancer stem cells (BCSCs) are CD44 positive, we wanted to explore if AD-01 could specifically target BCSCs. FKBPL stable overexpression or AD-01 treatment were highly effective at reducing the BCSC population measured by inhibiting mammosphere forming efficiency (MFE) in cell lines and primary breast cancer samples from both solid breast tumours and pleural effusions. Flow cytometry, to assess the ESA+/CD44+/CD24- subpopulation, validated these results. The ability of AD-01 to inhibit the self-renewal capacity of BCSCs was confirmed across three generations of mammospheres, where mammospheres were completely eradicated by the third generation (p<0.001). Clonogenic assays suggested that AD-01 mediated BCSC differentiation, with a significant decrease in the number of holoclones and an associated increase in meroclones/paraclones. In support of this, the stem cell markers, Nanog and Oct4 were significantly reduced following AD-01 treatment, whilst transfection of FKBPL-targeted siRNAs led to an increase in these markers and in mammosphere forming potential, highlighting the endogenous role of FKBPL in stem cell signalling. The clinical relevance of this was confirmed using a publically available microarray data set (GSE7390), where, high FKBPL and low Nanog expression were independently associated with improved overall survival in breast cancer patients (log rank test p=0.03; hazard ratio=3.01). When AD-01 was combined with other agents, we observed synergistic activity with the Notch inhibitor, DAPT and AD-01 was also able to abrogate a chemo- and radiotherapy induced enrichment in BCSCs. Importantly, using ‘gold standard’ in vivo limiting dilution assays we demonstrated a delay in tumour initiation and reoccurrence in AD-01 treated xenografts. In summary, AD-01 appears to have dual anti-angiogenic and anti-BCSC activity which will be advantageous as this agent enters clinical trial.