Type 2 diabetes and dog walking:patients' longitudinal perspectives about implementing and sustaining physical activity

Background - Physical activity is particularly important for people with type 2 diabetes, as evidence suggests that any reduction in sedentary time is good for metabolic health. Aim - To explore type 2 diabetes patients' talk about implementing and sustaining physical activity. Design of study - Longitudinal, qualitative study using repeat in-depth interviews with 20 patients over 4 years following clinical diagnosis. Setting - Patients were recruited from 16 general practices and three hospitals across Lothian, Scotland. Results - Discussion, and salience, of physical activity was marginal in patient accounts of their diabetes management. Patients claimed to have only received vague and non-specific guidance about physical activity from health professionals, and emphasised a perceived lack of interest and encouragement. Aside from walking, physical activities which were adopted tended to attenuate over time. Patients' accounts revealed how walking a dog assisted this kind of activity maintenance over time. Three main themes are highlighted in the analysis: 1) incidental walking; 2) incremental physical activity gains; and 3) augmenting physical activity maintenance. The problems arising from walking without a dog (for example, lack of motivation) are also examined. Conclusion - Asking patients about pet preferences might seem tangential to medical interactions. However, encouraging dog walking or identifying another interest that promotes a regular commitment to undertake physical activity may yield long-term health benefits.

L'unité de l'imparfait:vues théoriques et perspectives pour les apprenants du français, langue étrangère

Given the diversity of uses of the French imparfait, there is no unanimity about the nature – or even the existence – of a semantic invariant that may characterize it. The present article aims on the one hand at recapitulating the attempted temporal, aspectual and discursive descriptions of the imparfait found in contemporary research. A personal description of that tense based on the concepts of time, aspect and Aktionsart is then proposed ; it is thought such description may account for that tense multiplicity of uses. On the other hand, because of the necessity of a dialogue between theoretical and applied linguistics, this article will also consider the potential contribution of the suggested invariant to the teaching of French as a foreign language.

Becoming pregnant: exploring the perspectives of women living with diabetes

Background The risk of adverse pregnancy outcome for women with type 1 diabetes is reduced through tight diabetes control. Most women enter pregnancy with inadequate blood glucose control. Interview studies with women suggest the concept of ‘planned’ and ‘unplanned’ pregnancies is unhelpful. Aim To explore women's accounts of their journeys to becoming pregnant while living with type 1 diabetes. Design of study Semi-structured interviews with 15 women living with pre-gestational type 1 diabetes, between 20 and 30 weeks gestation and with a normal pregnancy ultrasound scan. Setting Four UK specialist diabetes antenatal clinics. Method Interviews explored women's journeys to becoming pregnant and the impact of health care. Analysis involved comparison of women's accounts of each pregnancy and a thematic analysis. Results Women's experiences of becoming pregnant were diverse. Of the 40 pregnancies described, at least one positive step towards becoming pregnant was taken by 11 women in 23 pregnancies but not in the remaining 17 pregnancies, with variation between pregnancies. Prior to and in early pregnancy, some women described themselves as experts in their diabetes but most described seeking and/or receiving advice from their usual health professionals. Three women described pre-conception counselling and the anxiety this provoked. Conclusion For women living with type 1 diabetes each pregnancy is different. The concept of planned and unplanned pregnancy is unhelpful for designing health care. Formal preconception counselling can have unintended consequences. Those providing usual care to women are well positioned to provide advice and support to women about becoming pregnant, tailoring it to the changing needs and situation of each woman.

The essentials of teamworking:international perspectives

The team, rather than the individual, is increasingly seen as the building block of organizations and a key source of competitive advantage. Despite this, not enough is understood about how to build successful teams in modern organizations. The Essentials of Teamworking broadens this understanding by offering a selection of key chapters on teamwork from the International Handbook of Organizational Teamwork and Cooperative Working. This concise paperback edition reveals the complexity of teamwork and offers empirically based guidance on how teamwork can be effectively developed in modern organizations. Bringing together leading international scholars, The Essentials of Teamworking offers challenging perspectives on teamwork that will inform future research and practice. It is an invaluable resource for professionals, researchers and students alike.

Self monitoring of blood glucose in type 2 diabetes:Longitudinal qualitative study of patients' perspectives

Objective: To explore views of patients with type 2 diabetes about self monitoring of blood glucose over time. Design: Longitudinal, qualitative study. Setting: Primary and secondary care settings across Lothian, Scotland. Participants: 18 patients with type 2 diabetes. Main outcome measures: Results from repeat in-depth interviews with patients over four years after clinical diagnosis. Results: Analysis revealed three main themes - the role of health professionals, interpreting readings and managing high values, and the ongoing role of blood glucose self monitoring. Self monitoring decreased over time, and health professionals' behaviour seemed crucial in this: participants interpreted doctors' focus on levels of haemoglobin A1c, and lack of perceived interest in meter readings, as indicating that self monitoring was not worth continuing. Some participants saw readings as a proxy measure of good and bad behaviour - with women especially, chastising themselves when readings were high. Some participants continued to find readings difficult to interpret, with uncertainty about how to respond to high readings. Reassurance and habit were key reasons for continuing. There was little indication that participants were using self monitoring to effect and maintain behaviour change. Conclusions: Clinical uncertainty about the efficacy and role of blood glucose self monitoring in patients with type 2 diabetes is mirrored in patients' own accounts. Patients tended not to act on their self monitoring results, in part because of a lack of education about the appropriate response to readings. Health professionals should be explicit about whether and when such patients should self monitor and how they should interpret and act upon the results, especially high readings.

Blood glucose self-monitoring in non-insulin-treated type 2 diabetes:a qualitative study of patients' perspectives

Background: Self-monitoring of blood glucose is controversial in the management of type 2 diabetes. Some research suggests that self-monitoring improves glycaemic control, whereas other research is sceptical about its value for people with type 2 diabetes who are not on insulin. Although blood glucose meters are widely available and used by this group, patients' own views are absent from the debate. Aim: To explore the pros and cons of glucose monitoring from the patients' perspectives. Design of study: Qualitative repeat-interview study. Setting: Patients were recruited from 16 general practices and three hospital clinics within four local healthcare cooperatives in Lothian, Scotland. Method: Interview data from 40 patients diagnosed with type 2 diabetes within the previous 6 months were analysed using thematic analysis informed by grounded theory. We report findings from round 1 and round 2 interviews. Results: Glucose monitoring can heighten patients' awareness of the impact of lifestyle; for example, dietary choices, on blood glucose levels. Glucose monitoring amplifies a sense of 'success' or 'failure' about self-management, often resulting in anxiety and self-blame if glucose readings remain consistently high. Moreover, monitoring can negatively effect patients' self-management when readings are counter-intuitive. Conclusion: Our analysis highlights the importance of understanding the meanings that newly diagnosed patients attach to glucose self-monitoring. To maximise the positive effects of self-monitoring, health professionals should ensure that patients understand the purpose of monitoring and should clarify with patients how readings should be interpreted. © British Journal of General Practice.

Le prix de l'individualité. Maine de Brian, Samuel Taylor Coleridge et la volonté: Deux postétités distinctes

This thesis is concerned with Maine de Biran’s and Samuel Taylor Coleridge’s conceptions of will, and the way in which both thinkers’ posterities have been affected by the central role of these very conceptions in their respective bodies of thought. The research question that animates this work can therefore be divided into two main parts, one of which deals with will, while the other deals with its effects on posterity. In the first pages of the Introduction, I make the case for a comparison between two philosophers, and show how this comparison can bring one closer to truth, understood not in objective, but in subjective terms. I then justify my choice by underlining that, in spite of their many differences, Maine de Biran and Samuel Taylor Coleridge followed comparable paths, intellectually and spiritually, and came to similar conclusions concerning the essential activity of the human mind. Finally, I ask whether it is possible that this very focus on the human will may have contributed to the state of both thinkers’ works and of the reception of those works. This prologue is followed by five parts. In the first part, the similarities and differences between the two thinkers are explored further. In the second part, the connections between philosophy and singularity are examined, in order to show the ambivalence of the will as a foundation for truth. The third part is dedicated to the traditional division between subject and object in psychology, and its relevance in history and in moral philosophy. The fourth part tackles the complexity of the question of influence, with respect to both Maine de Biran’s and Coleridge’s cases, both thinkers being indebted to many philosophers of all times and places, and having to rely heavily on others for the publication, or the interpretation of their own works. The fifth part is concerned with the different aspects of the faculty of will, and primarily its relationship with interiority, as incommensurability, and actual, conditioned existence in a certain historical and spatial context. It ends with a return to the question of will and posterity and an announcement of what will be covered in the main body of the thesis. The main body is divided into three parts:‘L’émancipation’, ‘L’affirmation, and ‘La projection’. The first part is devoted to the way Maine de Biran and Samuel Taylor Coleridge extricated themselves from one epistemological paradigm to contribute to the foundation of another. It is divided in four chapters. The first chapter deals with the aforementioned change of paradigm, as corresponding to the emergence of two separate but associated movements, Romanticism and what the French philosopher refers to as ‘The Age of History’. The second chapter concerns the movement that preceded them, i.e. the Enlightenment, its main features according to both of our thinkers, and the two epistemological models that prevailed under it and influenced them heavily in their early years: Sensationism (Maine de Biran) and Associationism (Coleridge). The third chapter is about the probable influence of Immanuel Kant and his followers on Maine de Biran and Coleridge, and the various facts that allow us to claim originality for both thinkers’ works. In the fourth chapter, I contrast Maine de Biran and Coleridge with other movements and thinkers of their time, showing that, contrary to their respective thoughts, Maine de Biran and Coleridge could not but break free from the then prevailing systematic approach to truth. The second part of the thesis is concerned with the first part of its research question, namely, Maine de Biran’s and Coleridge’s conceptions of the will. It is divided into four chapters. The first chapter is a reflection on the will as a paradox: on the one hand, the will cannot be caused by any other phenomenon, or it is no longer a will; but it cannot be left purely undetermined, as if it is, it is then not different from chance. It thus needs, in order to be, to be contradictorily already moral. The second chapter is a comparison between Maine de Biran’s and Coleridge’s accounts of the origin of the will, where it is found that the French philosopher only observes that he has a will, whereas the English philosopher postulates the existence of this will. The comparison between Maine de Biran’s and Coleridge’s conceptions of the will is pursued in the third chapter, which tackles the question of the coincidence between the will and the self, in both thinkers’ works. It ends with the fourth chapter, which deals with the question of the relationship between the will and what is other to it, i.e. bodily sensations, passions and desires. The third part of the thesis focuses on the second part of its research question, namely the posterity of Maine de Biran’s and Coleridge’s works. It is divided into four chapters. The first chapter constitutes a continuation of the last chapter of the preceding part, in that that it deals with Maine de Biran’s and Coleridge’s relations to the ‘other’, and particularly their potential and actual audience, and with the way these relations may have affected their writing and publishing practices. The second chapter is a survey of both thinkers’ general reception, where it is found that, while Maine de Biran has been claimed by two important movements of thoughts as their initiator, Coleridge has been neglected by the only real movement he could have, or may indeed have pioneered. The third chapter is more directly concerned with the posterities of Maine de Biran’s and Coleridge’s conceptions of will, and attempts to show that the approach to, and the meaning of the will have evolved throughout the nineteenth century, and in the French Spiritualist and the British Idealist movements, from an essentially personal one to a more impersonal one. The fourth chapter is a partial conclusion, whose aim is to give a precise idea of where Maine de Biran and Coleridge stand, in relation to their century and to the philosophical movements and matters we are concerned with. The conclusion is a recapitulation of what has been found, with a particular emphasis on the dialogue initiated between Maine de Biran and Coleridge on the will, and the relation between will and posterity. It suggests that both thinkers have to pay the price of a problematic reception for the individuality that pervades their respective works, and goes further in suggesting that s/he who chooses to found his individuality on the will is bound to feel this incompleteness in his/her own personal life more acutely than s/he who does not. It ends with a reflection on fixedness and movement, as the two antagonistic states that the theoretician of the will paradoxically aspires to.

Organization studies as an applied science:the generation and use of academic knowledge about organizations : introduction to the special issue

The relationship between theory and practice has been discussed in the social sciences for generations. Academics from management and organization studies regularly lament the divide between theory and practice. They regret the insufficient academic knowledge of managerial problems and their solutions, and criticize the scholarly production of theories that are not relevant for organizational practice (Hambrick 1994). Despite the prevalence of this topic in academic discourse, we do not know much about what kind of academic knowledge would be useful to practice, how it would be produced and how the transfer of knowledge between theory and practice actually works. In short, we do not know how we can make academic work more relevant for practice or even whether this would be desirable. In this introduction to the Special Issue, we apply philosophical, theoretical and empirical perspectives to examine the challenges of studying the generation and use of academic knowledge. We then briefly describe the contribution of the seven papers that were selected for this Special Issue. Finally, we discuss issues that still need to be addressed, and make some proposals for future avenues of research.

Structural limits and teachers' perspectives

This thesis is about the relationship between schooling and the economic and political structures which constrain its institutional framework. It focusses on teachers, as mediators of structural constraints, and on middle schools, as institutions which occupy a functionally transitional place between the primary and secondary traditions. In approaching the problem of linking the different perspectives of macro and micro sociologies, I argue the view that the individual mediates the contradictions between the socially cooperative processes of production and the competitive individualism which legitimates the private appropriation of wealth and income. The link is observable in the schooling process as a pattern of contradictions and tensions mediated by the rhetoric of equality of opportunity. In order to elucidate the link, the processes within the boundaried institutions must be viewed in the context of those changing tensions within the state administrative systems, which reverberate into schools as economic and political constraints. Framed within the ideology of the Flowden Report (1967), middle schooling was set within a discourse which stressed cooperative relationships rather than competitive standards. Since the mid-1970s, administrative policies have heightened the competitive battle for declining resources and attacked the Plowden ideology. Focussing the fieldwork on six middle schools in one local authority, T use an eclectic methodology to relate economic and political policies, generated in the state administrative system, to the situation in the schools between 1979 and 1981. The methodology incorporates a time dimension in order to highlight the tensions as they play upon teachers' changing definitions of the changing situation. I conclude that the intersubjective socio-cultural relations of schooling cannot be properly explained without making explicit the changing tensions in the rule/resource relationships which teachers mediate through their particular institutions.

Political radicalism in France:perspectives on a protean concept

This introductory article reflects on the new momentum that political radicalism has taken on in France. The ebb and flow of radical aspiration featured regularly in French politics under the Fourth and early Fifth Republics, before the failure of the "Socialist experiment" in the early 1980s brought about a paradigm shift. In the wake of this failure and with the "end of ideology" supposedly in sight, political leaders and parties tempered their appeals to radical solutions and conspired, not least through recurrent power-sharing, to vacate mainstream political discourse of much of its former radicalism. Since the presidential election of 2007, however, there has been a marked return to promises of radical change as the common currency of political discourse across the full left-right spectrum in France. This article introduces a special issue of French Politics, Culture & Society that brings together scholars from France, Britain, and Canada to discuss some of the meanings, expressions, and prospects of political radicalism in France today.

An exploration of the perspectives of help-seekers prescribed hearing aids

Aim - This pilot study uses qualitative methods to learn about the psycho-social needs of people who seek help with hearing loss. Background - There has been some emphasis in health policy to reduce the number of appointments required between assessment of hearing loss and fitting of hearing aids. This may respond to audiological needs but may not address the psycho-social needs. This study piloted a phenomenological approach to identify the patient's perspective. Methods - A phenomenological approach was taken to provide description of patient perspectives. Findings - Six patients reported that help-seeking was primarily influenced by the need to appease social partners and to improve hearing performance. Hearing aids were not regarded as acceptable treatments. Conclusions - Service providers need to consider the psycho-social consequences of hearing-aid issue alongside audiological needs.

What can practitioner perceptions tell us about our subject?

Part of the challenge of fostering learning is to open up learner minds to new possibilities or ways of thinking but is what we are encouraging learners to think really that different from the current practitioner conceptions? Having been uncomfortable with the focus of textbooks for the teaching of the core concept, the nature of a program, in the teaching of object-­oriented programming, we sought to discover how practitioner’s conceived the concept. Our findings provide a framework for understanding the different ways of conceiving the concept and the features that distinguish these conceptions. How could these conceptions and their critical features influence the focus in teaching especially in relation to computational thinking?