Professors rely upon expertise. As management scholars and teachers, we need to know our stuff. Our relationship with expertise, however, is tricky. Observers have expressed frustration with our ...field's epistemological perspective and wondered why existing ways of knowing and teaching are so resistant to change. One plausible explanation is that how we enact expertise in management studies makes sense-literally. That is, prevailing forms of expert behavior help professors construct and protect sensical understandings of self in relation to others. Drawing on constructive-developmental theory, I treat scholarship and teaching as meaning-making activities. Subject–object fusion in the context of the professor–expertise relationship means that many of us do not so much have our expertise as we are our expertise. This essay explores how meaning-making structures interact with the demands of academia to sustain disciplinary commitments to traditional ways of knowing and teaching. We are limited by commitments to expertise we have ourselves enacted. Many professors feel stuck; this essay outlines a path toward getting unstuck. I explain how a distinct double-loop learning methodology designed to promote subject–object separation can enhance our capacity to make meaning in more expansive ways, such that we have our expertise without it having us.
This study introduces Flock Leadership, a framework for understanding and influencing emergent collective behavior in the context of human organizing. Collective capacities emerge when interactions ...between individuals enact divergent and convergent ways of perceiving and responding to reality. An agent-based flocking model is employed to represent these interactive dynamics and emergent processes. This study explicates the model's constructs, translating its algorithms into behavioral norms at the individual level and its outcomes into collective behaviors at the group level. Phenomena-based simulation modeling links two collective states—technical capacity and adaptive capacity—to the specific underlying norm configurations from which they emerge. Flock Leadership provides a unique theoretical framing of emergent collective behavior in organizational settings, a new methodology for analyzing relationships between those emergent behavioral patterns and the interaction norms underlying them, and a useful means for identifying leadership opportunities.
Summary
This study describes the use of a simple charcoal product (DOAC‐RemoveTM) to allow haemostasis assays on patients taking direct oral anticoagulants (DOAC). In the proposed algorithm, patients ...taking DOAC are screened using the dilute thrombin time (dTT) and anti‐Xa assay. If either are positive then DOAC‐Remove is utilised. In a validation, DOAC‐Remove did not interfere with coagulation testing in normal plasma or in patients on DOAC with a known lupus anticoagulant (LA). Of 1566 routine patient samples tested, 125 (8%) had evidence of anti‐Xa activity (>0·1 iu/ml) or prolonged dTT suggestive of either a direct/indirect Xa inhibitor or direct thrombin inhibitor. All of these 125 patients had a prolonged dilute Russell viper venom time (dRVVT) screening test and 106 had a LA detected by dRVVT after phospholipid correction. After DOAC‐Remove, 91 patients (73%) had a negative dRVVT screen. After further investigation only 9 (7%) had a positive LA. DOAC‐Remove prevented 5% of patients having a LA inappropriately detected. DOAC did not significantly affect the LA activated partial thromboplastin time (aPTT) ratio, protein S antigen or protein C activity. DOAC cause low intrinsic factor assays, high prothrombin time/aPTT and high activated protein C sensitivity ratio, which DOAC‐Remove reversed (P < 0·05). Despite recommendations, haemostasis testing for patients on DOAC continues; this algorithm aids diagnostic accuracy. Further validation and research are warranted.
Bleeding of unknown cause (BUC), also known as unclassified bleeding disorders (UBD), has been defined as a clear bleeding tendency in the presence of normal haemostatic tests. There are challenges ...in the diagnosis and management of these patients. BUC/UBD encompasses a heterogenous group of disorders which may include undiagnosed rare monogenic diseases, polygenic reasons for bleeding; and patients without a clear bleeding disorder but with a previous bleeding event. Nevertheless, these patients may have heavy menstrual bleeding or be at risk of bleeding when undergoing surgical procedures, or childbirth; optimizing haemostasis and establishing a mode of inheritance is important to minimize morbidity. The bleeding score has been used to clinically assess and describe these patients, but its value remains uncertain. In addition, accurate distinction between normal and pathological bleeding remains difficult. Several studies have investigated cohorts of these patients using research haemostasis tests, including thrombin generation and fibrinolytic assays, yet no clear characteristics have consistently emerged. Thus far, detailed genetic analysis of these patients has not been fruitful in unravelling the cause of bleeding. There is a need for standardization of diagnosis and management guidelines for these patients. This review gives an overview of this field with some suggestions for future research.
Purpose
As part of their inspection of care homes in England, the statutory inspector (the Care Quality Commission CQC) makes a judgement on the quality of the home’s leadership. Their view is ...critical as it is intended to inform consumer choice and because the statutory nature of inspection means these views hold considerable authority. The purpose of this paper is to look at the content of a selection of reports and seek to determine what the CQC understands by the concept of “good leadership”.
Design/methodology/approach
A purposive sample of recent CQC inspection reports was selected and subjected to a qualitative content analysis. Inspections are structured around five main questions. The resulting themes describe areas of focus within the section of reports that feature the question “Are they well-led?”.
Findings
Inspection reports were found to focus on four main themes: safety and quality of care; day-to-day management of staff; governance and training in the home; and integration and partnership working. In the discussion section, the authors reflect on these themes and suggest that the CQC’s view of leadership is rather limited. In particular, while an emphasis is placed within the literature and policy on the importance of leadership in delivering change and quality improvement, little attention is paid to this within the leadership section of inspection reports.
Research limitations/implications
The authors’ research is based on a small-scale sample of inspection reports; nevertheless, it suggests a number of avenues for further research into the way in which leadership and management capabilities are developed and monitored in the sector.
Originality/value
The analysis in this report offers a view of how the inspection regime implements its own guidance and how it assesses leadership. The reports, as public-facing documents, are artefacts of the inspection regime and critical not just as evidence of the practice of inspection but as influence on care home operations and the choices of care home residents and their families.
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