Hymn Sheet Research Articles

Are we practising what we preach and are we all singing from the same hymn sheet? An exploration of teaching in paediatric caries management across UK dental schools.

The evidence underpinning caries management for children has progressed dramatically over the past 20 years. Anecdotally, this is not reflected in the teaching provided to undergraduate dental students, with the ongoing teaching of outdated methods within some dental schools. To capture the current undergraduate teaching provision and clinical treatment experience requirement relative to caries management in paediatric dentistry in UK dental schools. Cross-sectional analysis of current teaching methods on paediatric caries management was obtained using a piloted online data collection form. Question content included current caries teaching methods, assessment of student exposure and competence. The results were analysed descriptively. Of the 16 UK dental schools, 14 participated. Discrepancy in teaching content was apparent. Many schools (n = 9) taught biological caries management through therapeutic fissure sealants, yet this was not reflected in assessment and clinical requirements. Some schools (n = 4) taught amalgam placement in children, and most (n = 12) operatively taught treatments that would no longer be routinely provided in general dental practice in the UK, including primary tooth pulpotomy. There is substantial variation in the paediatric caries management techniques that are taught across UK dental schools, demonstrating a need for a national consensus to address these disparities.

Singing from the same hymn sheet: are the chair and CEO ‘on the same page’ in their annual letters to shareholders?

PurposeThe purpose of this study is to explore whether the level of language content matching (LCM) between the chair and the CEO varies with their firm's financial performance.Design/methodology/approachThis study examines a sample of 119 Australian firms and 476 annual letters to shareholders produced by the firms' chairs and CEOs over a four-year period. Chair–CEO LCM is measured by calculating the similarity score between the chair's and CEO's written text to shareholders within each firm year, while firm profitability is measured by return on assets. Univariate analysis of variance (ANOVA) tests as well as three multivariate linear models are used to examine the research question.FindingsThe results show that the profitability of the firm is significantly associated with the level of chair–CEO LCM. When a firm is profitable, there is a lower level of chair–CEO LCM than when the firm is unprofitable and that profitability is related to a lower level of chair–CEO LCM. Firm size is positively and significantly related to the level of chair–CEO LCM. These findings are supportive of the view that the written communications of the chair and CEO are the outcome of strategic considerations and depend on a firm's specific economic situation.Research limitations/implicationsFuture studies may consider alternative approaches to measure textual similarity.Social implicationsLCM may provide insights into management techniques that may be used to explain firm performance and provide a signal to external stakeholders, such as shareholders and fund managers.Originality/valueThis study provides new insights into the letters written by the chair and the CEO to explain or justify their firm's financial performance. Rather than focus on a single letter, this study examines the level of LCM between the shareholder letters of two different people in a firm (the chair and CEO) and finds that the extent of chair–CEO LCM is varying with firm performance and size. The findings of this study suggest that LCM is an important dimension of the communications of a firm's chair and CEO.

Singing off the same hymn sheet? Examining coherence in a talent development pathway (part 2)

ABSTRACT Existing literature highlights the common characteristics of successful talent development environments, notably the need for long-term development, individual athlete attention, communication, alignment, and psycho-behavioural development. Little is known however about the complex talent development environment of an international sport organisation where multiple contexts and various stakeholders exist. Considering the lack of research relating to females in talent development, we examined a female national hockey talent development environment and more specifically the level of coherence that existed within the talent development environment from different stakeholder perspectives. Twenty-seven international female hockey players and fourteen pathway staff members from across the talent development pathway participated in semi-structured focus groups. An inductive–deductive thematic analysis was conducted. Results suggest that the talent development environment provides a long-term development experience supplemented with individual athlete attention at international level. However, a general lack of coherence and systematic development was evident across the talent development environment contexts with varying levels of coherence found within the higher-order themes of appropriate development, not early success, individualised and ongoing development, and wide-ranging coherent messages and support. This highlights a need for improved direction from the National Governing Body if systematic coherence towards talent development is to be achieved.

Nursing people diagnosed with Borderline Personality Disorder: 'We all need to be on the same hymn sheet'.

The diagnosis of borderline personality disorder (BPD) has been found to carry stigma and poor hope of recovery. More recently, it has been regarded as a treatable condition through psychotherapy. Despite this, patients often experience lengthy hospitalizations, limited access to treatment, and poor outcomes. This paper describes the experiences of psychiatric nurses working with people diagnosed with BPD in acute mental health in-patient settings in Ireland. Seven nurses were interviewed, and the transcripts were analysed using a reflective and inductive approach. Overall, the nurses did not feel confident that their interventions were effective or valued by the wider service or patients. The nurses articulated their invidious professional circumstances, whereby they were required to act in ways, which ran counter to their vision of therapeutic or recovery-focused work. These views and perceptions that in-patient care is often ineffectual are widely echoed in the literature. We contend that the effect of this circumstance for these nurses approaches moral distress. The nurses were aware of more effective methods of care and treatment for BPD but perceived that they were unable to influence the culture of in-patient care.

Singing off the same hymn sheet? Examining coherence in a talent development pathway (part 1)

ABSTRACT Although there is research available into successful Talent Development Environments (TDEs), the data mostly reflects TDEs in elite academies, national groups or in a single successful club. This literature provides insight into the positive characteristics that are commonplace in these effective TDEs. However, little is known about the TDE surrounding an entire amateur national organization where athletes regularly compete across multiple teams, simultaneously representing at both domestic and international level. Importantly this added complexity increases the number of stakeholders across the pathway (e.g., school, club, international) creating a need for coherence throughout the TDE. Additionally considering the lack of research relating to females in talent development, we were interested from a pragmatic view, in examining the TDE of an amateur national hockey organization where young female athletes must navigate the pathway while simultaneously playing on multiple teams, contending with various coaches and contexts. The results suggest that the TDE provides a long term development experience supplemented with a good support network across all contexts. However, the alignment of expectations across contexts and the quality preparation of athletes in this TDE requires more attention to facilitate effective holistic athlete development.

In response to: Laparoscopic surgery and the coronavirus disease 2019 pandemic: A word from a different hymn sheet.

Tebala, Giovanni D. MD, MS, FRCS, FACS; Lami, Mariam MBBS, MRCS; Bond-Smith, Giles MBBS, MSc, FRCS(Ed) Author Information

Editors’ Letter

Editors’ Letter

Legal aspects of COVID-19 pandemic management for community nurses.

Legal aspects of COVID-19 pandemic management for community nurses.

Why projects go wrong

Purpose Reviews the latest management developments across the globe and pinpoints practical implications from cutting-edge research and case studies. Design/methodology/approach This briefing is prepared by an independent writer who adds their own impartial comments and places the articles in context. Findings What is risk? Within an organization, risk itself can pose a number of challenges if it is not understood or defined consistently. For example, a typical risk might be disruptors entering the main market a firm operates in. For an owner, they may dismiss the risk as they do not see the disruptor as a direct rival due to their different approach. For a sales director, they may see the risk as real but remote until data tells them otherwise. For a product manager, they may see the risk as potentially disastrous unless they pivot in some way to mitigate the threat it poses. Unless there is a hymn sheet people can all sing from, there is a very real “risk” that a lack of joined up thinking can lead to a very muddled response to the disruptive threat and a distinct lack of strategic direction. Practical implications Provides strategic insights and practical thinking that have influenced some of the world’s leading organizations. Original/value The briefing saves busy executives and researchers hours of reading time by selecting only the very best, most pertinent information and presenting it in a condensed and easy-to-digest format.

“I think we should all be singing from the same hymn sheet” – English and Swedish midwives’ views of advising pregnant women about alcohol

Many countries have adopted abstinence guidelines for pregnant women, due to uncertainty around the risk of harm caused by small amounts of alcohol. There is a lack of research exploring frontline midwives’ attitudes towards alcohol use during pregnancy and comparisons of practices in different countries. Sixteen semi-structured interviews were conducted with midwives working in Liverpool, England (n = 7) and Örebro County, Sweden (n = 9). Data were analysed inductively, using thematic analysis with thematic networks. The findings show that all midwives believed pregnant women should be advised not to consume any alcohol during pregnancy and there is a need to tailor their approach to the individual. A key concern among midwives in both countries was how to advise about alcohol exposure that occurs before the pregnancy is known to the woman. English midwives discussed the uncertainty around the risk of consuming small amounts of alcohol, whereas Swedish midwives believed any amount of alcohol was associated with risk. Discussing alcohol was viewed as part of the health professional’s role, but routine questions for all women were perceived to aid discussions about alcohol. Future research should further explore the impact of wider social and political environment on midwives’ attitudes around risks with prenatal alcohol use.

Singing from the same hymn sheet: Rising Indian nationalism is creating a repressive state where non-conformity is deemed unpatriotic

Singing from the same hymn sheet: Rising Indian nationalism is creating a repressive state where non-conformity is deemed unpatriotic

Tu1075 - Management of Constipation in Secondary Care. Is Everyone Singing from the Same HYMN Sheet?

Introduction Chronic constipation is a common problem within the general population and can have a negative impact on quality of life. Patients referred to secondary care with this symptom often undergo a colonoscopy, which is often normal. There are American Gastroenterological Association (AGA) and NICE guidelines on the investigation and management of constipation. We hypothesised that there is variability in how patients with constipation are assessed and managed, and that patients with chronic constipation are often discharged following a normal colonoscopy without a clear diagnosis or plan. Our aim was to observe current practice in the management of patients with symptoms of constipation and a normal colonoscopy. Method This was a single centre, retrospective study of patients with constipation who had a normal colonoscopy within a large London District General Hospital. Data was collected from patients with constipation and a normal colonoscopy using the ‘Unisoft GI reporting tool’ and electronic patient records. Data was collected on 50 patients and scrutinised for subgroup analysis to include demographic data, investigations performed, type of clinic, diagnosis in clinic and further management. Results Mean age 51. Female 74%. In terms of further investigations 28% had imaging, 32% had a thyroid function test, 20% had a calcium blood test, 16% had a colon transit study and 6% had anorectal manometry. 10% of patients had biofeedback therapy. 58% of patients were discharged or never followed up following a normal colonoscopy. Of those that were followed up, 38% had other diagnosis or gastrointestinal co-morbidities unrelated to the constipation. 70% of patients had no clear diagnosis documented in relation to their constipation. 44% of patients had no clear documented management plan for their constipation. 64% of patients were under the care of surgical specialties. Conclusion There is clear variability in how patients with chronic constipation are assessed and managed in secondary care. The majority of patients are discharged following a normal colonoscopy back to the GP without further investigations of potentially reversible causes of their symptoms (only a third had TFTs checked, only 20% had calcium assessment) and no clear diagnosis or long-term management plan. In this study only a small number of patients in secondary care have investigations to categorise the subgroup of constipation disorders (only 16% had colon transit study) into normal transit, slow transit and defecation disorder by way of colon transit study. We conclude that more awareness and implementation of guidelines such as those from AGA in assessment and management of constipation is required. We also conclude that the assessment and management of constipation in secondary care is substandard. Disclosure of Interest None Declared

Juvenile Nation: Youth, Emotions and the Making of the Modern British Citizen, 1880–1914 By StephanieOlson, London: Bloomsbury, 2014, xi + 238 pp.

Juvenile Nation: Youth, Emotions and the Making of the Modern British Citizen, 1880–1914 By StephanieOlson, London: Bloomsbury, 2014, xi + 238 pp.

Marking Skin Cancer Excisions - Are we all singing from the same hymn sheet?

Marking Skin Cancer Excisions - Are we all singing from the same hymn sheet?

Singing from the Same Hymn Sheet? What the Differences between the Strasbourg and Luxembourg Courts Tell Us about Religious Freedom, Non-Discrimination, and the Secular State

This article considers how the approach of the European Union (EU) and its Court of Justice to religion maps on to that of the European Court of Human Rights (ECtHR). It will show that there is a high degree of convergence but that the broader remit of the Luxembourg Court means that its approach to religion will not be restricted to following that of the ECtHR. In particular, there is scope for significant differences between the two courts on the question of a ‘ministerial exemption’ in relation to the protection of the rights of employees of religious bodies and the question of indirect discrimination on grounds of religion or belief. These differences highlight the degree to which restricting indirect discrimination on religious grounds draws on ideas of collective disadvantage which are distinct from (and somewhat in tension with) the right to freedom of religion and belief as interpreted by the ECtHR which has seen religious freedom as primarily an individual right that applies equally to all forms of belief. The article closes by assessing what these potential differences tell us about the nature of the EU legal system, and the limits of role of rights in providing the basis for defining the relationship between religion, the state, and the law more generally.

Orthognathic audit: are we getting it right?

As clinicians we all know what a positive impact orthognathic surgery can have on a patient’s wellbeing and quality of life but how can we ‘bottle this feeling’ and demonstrate it to significant non-clinicians such as our paymasters and health commissioners? It may not be as easy as it sounds but one issue is indisputable: as a small nation, we all need to be singing from the same hymn sheet with respect to the type and timing of orthognathic outcomes data being collected.

Active inference, communication and hermeneutics

Hermeneutics refers to interpretation and translation of text (typically ancient scriptures) but also applies to verbal and non-verbal communication. In a psychological setting it nicely frames the problem of inferring the intended content of a communication. In this paper, we offer a solution to the problem of neural hermeneutics based upon active inference. In active inference, action fulfils predictions about how we will behave (e.g., predicting we will speak). Crucially, these predictions can be used to predict both self and others – during speaking and listening respectively. Active inference mandates the suppression of prediction errors by updating an internal model that generates predictions – both at fast timescales (through perceptual inference) and slower timescales (through perceptual learning). If two agents adopt the same model, then – in principle – they can predict each other and minimise their mutual prediction errors. Heuristically, this ensures they are singing from the same hymn sheet. This paper builds upon recent work on active inference and communication to illustrate perceptual learning using simulated birdsongs. Our focus here is the neural hermeneutics implicit in learning, where communication facilitates long-term changes in generative models that are trying to predict each other. In other words, communication induces perceptual learning and enables others to (literally) change our minds and vice versa.

The loneliest doctor.

The loneliest doctor.

Investigation: Do health professionals sing from the same hymn sheet? Part 1

Investigation: Do health professionals sing from the same hymn sheet? Part 1

Singing from the same hymn sheet? Commissioning of preventative services from the third sector

Purpose – The purpose of this paper is to explore the delivery of preventative services for older people from third sector organisations (TSOs) and the extent to which current commissioning arrangements enables the aspirations of policy to be achieved. Design/methodology/approach – Semi-structured interviews with key-contacts within a sample of TSOs which had been identified by directors of Adult Social Services as delivering one of the top three preventative interventions in their local authority area. Findings – There was evidence of considerable trust between local authorities and TSOs and as a consequence TSOs were given autonomy to develop holistic and integrated models of delivery that supported rather than diverted the TSOs’ core missions. Both sectors found it difficult to set target outcomes and connected performance frameworks for preventative services. As a consequence a major element of the commissioning cycle is not being completed and TSOs cannot be confident that they are using their resour...