Effectiveness of IT-based diabetes management interventions: a review of the literature

Background : Information technology (IT) is increasingly being used in general practice to manage health care including type 2 diabetes. However, there is conflicting evidence about whether IT improves diabetes outcomes. This review of the literature about IT-based diabetes management interventions explores whether methodological issues such as sample characteristics, outcome measures, and mechanisms causing change in the outcome measures could explain some of the inconsistent findings evident in IT-based diabetes management studies.

Methods : Databases were searched using terms related to IT and diabetes management. Articles eligible for review evaluated an IT-based diabetes management intervention in general practice and were published between 1999 and 2009 inclusive in English. Studies that did not include outcome measures were excluded.

Results : Four hundred and twenty-five articles were identified, sixteen met the inclusion criteria: eleven GP focussed and five patient focused interventions were evaluated. Nine were RCTs, five non-randomised control trials, and two single-sample before and after designs. Important sample characteristics such as diabetes type, familiarity with IT, and baseline diabetes knowledge were not addressed in any of the studies reviewed. All studies used HbA1c as a primary outcome measure, and nine reported a significant improvement in mean HbA1c over the study period; only two studies reported the HbA1c assay method. Five studies measured diabetes medications and two measured psychological outcomes. Patient lifestyle variables were not included in any of the studies reviewed. IT was the intervention method considered to effect changes in the outcome measures. Only two studies mentioned alternative possible causal mechanisms.

Conclusion : Several limitations could affect the outcomes of IT-based diabetes management interventions to an unknown degree. These limitations make it difficult to attribute changes solely to such interventions.

What I ‘know’: Literary studies and the teaching of English

This essay unfolds through a series of juxtapositions, involving storytelling and writing of a more analytical nature. In thinking about what I ‘know’ as an English teacher, my aim has been to present my ideas in a form that might do justice to the contradictions and complexities of my professional life, including my continuing efforts to negotiate a pathway between the rich particularities of the educational settings in which I have worked and my knowledge and values as an English teacher. My primary focus is on how my literary education has shaped and been shaped by my work as an English teacher vis-à-vis a devaluing of teachers’ disciplinary knowledge that has occurred through standards-based reforms. I attempt to make the standpoint from which I am writing an object of scrutiny, thus producing an account of what I ‘know’ that arises out of my work as an English teacher and returns to it as a necessary dimension of a politically committed praxis.

Comparing alternate teaching styles to teach computing skills to girls in their English classes

Low female participation rates in computing are a current concern of the education sector. To address this problem an intervention was developed — computing skills were introduced to girls in their English classes using three different teaching styles: peer tutoring, cross-age tutoring and teacher instruction (control). The sample comprised 136 girls from Years 8 and 10 from a single-sex government school. A pre-test post-test quantitative design was used. To describe the students perspectives, qualitative data were collected from six focus groups conducted with 8–10 students — one from each of the six classes. It was predicted that cross-age tutoring would yield more positive effects than peer tutoring which, in turn, would yield more positive effects than traditional teacher instruction as assessed by achievement on class tasks and attitudes towards computing. The hypothesis was not supported by the quantitative analysis, however in the qualitative data cross-age tutoring was appraised more favourably than peer tutoring or teacher instruction. The latter was the least preferred condition due to: (1) inefficiency; (2) difficulty understanding teachers' explanations; and (3) lack of teacher knowledge. Problems with the implementation of the intervention identified in the focus groups were teacher differences, system failures, missed classes, lack of communication, and selection of computing activities. Practical suggestions were provided relevant to the introduction of cross-age tutoring and the use of computers within secondary level English classes.

Assessment of online reflections : engaging English second language (ESL) students

Online discussion boards are being used increasingly by tertiary educators as a tool for encouraging greater student interaction and developing learning communities. In particular, educators who have adopted a learner centered, socio-constructivist approach to teaching have sought to facilitate collaborative learning in which students reflect upon and share their experiences and perspectives, and construct knowledge together through developing shared meanings. This paper presents the findings of an electronic survey of the perceptions of 70 distance education EFL and ESL students concerning a compulsory assessment item involving contribution to an online course discussion board. The study revealed that the majority of the students enjoyed the assessment item and agreed that posting to the online course discussion board had allowed them to achieve a range of cognitive and social learning outcomes, as well as to develop some important graduate skills. In particular, ESL students reported the benefits of posting to the discussion board in terms of sharing their experiences with others and reducing the feeling of isolation. Further, when considering social outcomes, ESL students perceive the discussion board provided them with an opportunity to meet and develop a closer relationship with other students in the course and encouraged them to keep up with their studies.

Reciprocal mentoring across generations: sustaining professional development for english teachers

This article draws on a collaborative research project entitled Teachers Investigate Unequal Literacy Outcomes: Cross-generational Perspectives, funded by the Australian Research Council 2002-2004 and awarded to Barbara Comber, University of South Australia and Barbara Kamler, Deakin University. The university researchers invited early career teachers in their first five years of teaching, and late career teachers with at least twenty-five years experience, to collaboratively explore the problem of unequal outcomes in literacy. Over a period of three years, the teacher researchers conducted audits of their classroom literacy programs and the effects on different children; case studies of students they were most concerned about; and redesigns of their literacy curriculum and pedagogy.  Bev Maney and Ivan Boyer collaborated as research partners in the context of their work together as English teachers at Portland Secondary College, Victoria. This paper is based on transcripts of their many conversations with one other and the research team and is represented as an interrupted conversation with the university researchers. Here they critique current models of professional development and the effects of standardised testing and argue for the importance of serious teacher conversations and ongoing school-based research.

Women exposed to intimate partner violence : expectations and experiences when they encounter health care professionals : a meta-analysis of qualitative studies

Background The appropriate response of health care professionals to intimate partner violence is still a matter of debate. This article reports a meta-analysis of qualitative studies that answers 2 questions: (1) How do women with histories of intimate partner violence perceive the responses of health care professionals? and (2) How do women with histories of intimate partner violence want their health care providers to respond to disclosures of abuse?

Methods Multiple databases were searched from their start to July 1, 2004. Searches were complemented with citation tracking and contact with researchers. Inclusion criteria included a qualitative design, women 15 years or older with experience of intimate partner violence, and English language. Two reviewers independently applied criteria and extracted data. Findings from the primary studies were combined using a qualitative meta-analysis.

Results Twenty-nine articles reporting 25 studies (847 participants) were included. The emerging constructs were largely consistent across studies and did not vary by study quality. We ordered constructs by the temporal structure of consultations with health care professionals: before the abuse is discussed, at disclosure, and the immediate and further responses of the health care professional. Key constructs included a wish from women for responses from health care professionals that were nonjudgmental, nondirective, and individually tailored, with an appreciation of the complexity of partner violence. Repeated inquiry about partner violence was seen as appropriate by women who were at later stages of an abusive relationship.

Conclusion Women’s perceptions of appropriate and inappropriate responses partly depended on the context of the consultation, their own readiness to address the issue, and the nature of the relationship between the woman and the health care professional.

Annotated bibliography of research in the teaching of English

Twice a year, in the May and November issues, RTE publishes a selected bibliography of recent research in the teaching of English and related fields. Most of the studies appeared during the six-month period preceding the compilation of the bibliography (July through December 2001 for the present bibliography), but some studies that appeared earlier are occasionally included. The listing is selective; we make no attempt to include all research and research-related articles that appeared in the period under review. Comments on the bibliography and suggestions about items for inclusion may be directed to the bibliography editors. We encourage you to send your suggestions to djbrown@ucok.edu, cathxx@deakin.edu.au, kalman@data.net.mx, stinsona@uwwvax.uww.edu, or melissa.whiting@usm.edu. You may also submit comments or recommend publications through the Annotated Bibliography page of RTE's World Wide Web site at http://www.ncte.org/rte/.

Comprehension strategies of above average English as a foreign language (EFL) readers

The study reported in this thesis is a single-shot case study, which aims to provide a detailed description ofthe reading comprehension strategies used by fifteen student teachers ofEnglish from Indonesian- and Javanese-speaking backgrounds in the last year of their four-year Strata-One study at a university In Yogyakarta, Indonesia. These readers were above average among their peers in that their average indexes of grades in Reading and Speaking classes were 3.22 and 3,34 respectively, while the average indexes ofthe peer group were 271 and 2.63, respectively, out ofa scale of 0 to 400. In addition, while students in this university may complete their study by course work or by research, these readers were all enrolled as research students. As studying comprehension strategies involves complex issues, a multi-method approach is required, not only for breadth of coverage, but also to allow for a check on the validity of individual methods. To achieve the goal of the study, thinka1oud tasks, retellings, a reading comprehensIon test, indepth interviews and observations were employed to explore the strategies used. An analysis of the recorded data indicates that these readers used thirty strategies classified under five clusters: infomiation gathering, information processing, text interpretation, comprehension monitoring, and comprehension utilisation. In general, readers started gathering information by silent reading, interpreted the text by an inference or a paraphrase, and ended the task by making selfreflections relevant to the text. Most readers managed to identify problems when they occurred, and monitored their comprehension when they doubted their interpretation, as could be seen from their rereading the text or vocalising its pail(s). When direct interpretation was difficult, readers associated the text with prior knowledge or interrelated parts of the text, The readers in this study share characteristics of both poor and good native readers, in the sense that there was evidence ofgood strategy use butthe readers did not manage to maintain it consistently. As a result, even the successful readers were not able to maximise their potential. The implication is that in order to develop students into independent readers, strategy instruction should be part of and appropriately embedded in, the reading instruction. There is a need not merely to teach strategies as such, but rather to teach flexibility in strategy use. While there was sufficient evidence that thinkaloud tasks and their complementary methods worked to achieve the goals ofthe present study, similar studies with different cohorts are suggested for crosschecks.

Improving English language teaching in Thailand

The teaching of English in Thailand is a matter of national concern. The national government believes that the ability of Thai people to use English for effective communication is very important for the continuing economic development of Thailand. However many students who have had primary, secondary and university exposure to English find it difficult to conduct a conversation with a native speaker of English. The reasons for this include lack of student motivation and contextual support, large classes, the dominating effects of assessment on what is taught, and the English language competency of the teachers. The research in this thesis focuses on the teaching of English as a foreign language in secondary schools in Khon Kaen. The research reported here consists of one major and three minor studies. In the major study some of the principles of action research were used to explore strategies that would improve the teaching of English in a number of secondary schools in Khon Kaen in Thailand. In the first phase of the major study I worked with two teachers to design and implement a series of classroom activities that encouraged lower secondary students to use English. In the second phase I worked with a group of teachers to design and deliver a professional development program for twenty school teachers interested in improving their English language teaching. In the third phase I used data from the first two phases to design five new activities that were used in classrooms by two teachers. Findings from the three phases indicated that working collaboratively with school teachers can be a mutually beneficial professional experience and can improve student interest and learning. In the first minor study I used interview-conversations to investigate the perceptions that subject co-ordinators and teachers have towards English language teaching. The conversations covered the merits of detailed curricula and curricula frameworks, professional development, assessment, resources, and integration of English language with other subjects. It was clear that the teachers were aware of the national government s policies for the improving English language teaching and accepted the need for change. It was equally clear that the preparation of teachers and the resources available were major limiting factors in schools to teacher effectiveness. In the second minor study I examined the teaching of Mandarin in an Australian school that suffered from some of the same resource problems as Thai schools. Although there was only one teacher available for all of the Mandarin classes in the school she was extremely effective. Her teaching was an example of best practice. It included thorough preparation, the ability to manage lessons at the pace of the learners, active classes and individual attention, detailed assessment records, and the integration of language and culture. Some or all of these could be used in Thai schools. The third minor study was an investigation of the professional development experiences of English language teachers in Thai schools. In most schools there are consultative and administrative mechanisms, acceptable to principals and teachers, in place to support professional development. Access to native speakers was seen as very important. However, the schools in Khon Kaen province have little or no access to native speakers of English. Even if they were available, the schools do not have the funds to employ them. Findings from the four studies indicate that it is quite possible to use interactive, participatory or student-centred pedagogies to teach English as a foreign language in Thai classrooms. However, one cannot expect teachers to adopt such pedagogies unless they are convinced of their value. This can be achieved most effectively through a systematic and sustained program of professional development.

Knowing practice in English teaching? Research challenges in representing the professional practice of English teachers

This article problematises representations of professional practice. It investigates assumptions behind received accounts of professional practice, including professional standards that purportedly capture what accomplished English teachers “should know and be able to do”, “scientific” studies that construct accounts of classrooms from the standpoint of academic researchers, and narratives written by teachers that claim to explore dimensions of classroom teaching that elude outside observers. Especially significant are attempts by practitioner researchers to develop accounts of their professional practice vis-a-vis constructions of their work from other standpoints. We argue that it is timely for practitioner researchers to reflexively examine the conditions for producing such accounts, and to address the question of the validity of their knowledge claims. Yet this is also – crucially – more than an epistemological issue, but one that requires acknowledging the primacy of practice for engaging with the complexities of classroom settings. This article gives an account of our ongoing efforts to develop forms of representation that might begin to do justice to the complexities of practice in comparison with accepted accounts of what English teachers know and do. We intend it to be read as a position paper which outlines a framework for research on English teaching as a dynamic culture practice.