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.

Majority versus minority influence:the role of message processing in determining resistance to counter-persuasion

Two experiments examined the extent to which attitudes changed following majority and minority influence are resistant to counter-persuasion. In both experiments participants' attitudes were measured after being exposed to two messages, delayed in time, which argued opposite positions (initial message and counter-message). In the first experiment, attitudes following minority endorsement of the initial message were more resistant to a second counter-message only when the initial message contained strong versus weak arguments. Attitudes changed following majority influence did not resist the second counter-message and returned to their pre-test level. Experiment 2 varied whether memory was warned (i.e., message recipients expected to recall the message) or not, to manipulate message processing. When memory was warned, which should increase message processing, attitudes changed following both majority and minority influence resisted the second counter-message. The results support the view that minority influence instigates systematic processing of its arguments, leading to attitudes that resist counter-persuasion. Attitudes formed following majority influence yield to counter-persuasion unless there is a secondary task that encourages message processing.

The role of self-regulation as a meta-competency in developing leaders: a longitudinal field experimental study

The question of how to develop leaders so that they are more effective in a variety of situations, roles and levels has inspired a voluminous amount of research. While leader development programs such as executive coaching and 360-degree feedback have been widely practiced to meet this demand within organisations, the research in this area has only scratched the surface. Drawing from the past literature and leadership practices, the current research conceptualised self-regulation, as a metacompetency that would assist leaders to further develop the specific competencies needed to perform effectively in their leadership role, leading to an increased rating of leader effectiveness and to enhanced group performance. To test this conceptualisation, a longitudinal field experimental study was conducted across ten months with a pre- and two post-test intervention designs with a matched control group. This longitudinal field experimental compared the difference in leader and team performance after receiving self-regulation intervention that was delivered by an executive coach. Leaders in experimental group also received feedback reports from 360-degree feedback at each stage. Participants were 40 leaders, 155 followers and 8 supervisors. Leaders’ performance was measured using a multi-source perceptual measure of leader performance and objective measures of team financial and assessment performance. Analyses using repeated measure of ANCOVA on pre-test and two post-tests responses showed a significant difference between leader and team performance between experimental and control group. Furthermore, leader competencies mediated the relationship between self-regulation and performance. The implications of these findings for the theory and practice of leadership development training programs and the impact on organisational performance are discussed.

Leadership development: the role of developmental readiness, personality dispositions, and individual values

Increased awareness of the crucial role of leadership as a competitive advantage for organisations (McCall, 1998; Petrick, Scherer, Brodzinski, Quinn, & Ainina, 1999) has led to billions spent on leadership development programmes and training (Avolio & Hannah, 2008). However, research reports confusing and contradictory evidence regarding return on investment and developmental outcomes, and a lot of variance has been observed across studies (Avolio, Reichard, Hannah, Walumbwa, & Chan, 2009). The purpose of this thesis is to understand the mechanisms underlying this variability in leadership development. Of the many factors at play in the process, such as programme design and delivery, organisational support, and perceptions of relevance (Mabey, 2002; Day, Harrison, & Halpin, 2009), individual differences and characteristics stand out. One way in which individuals differ is in their Developmental Readiness (DR), a concept recently introduced in the literature that may well explain this variance and which has been proposed to accelerate development (Avolio & Hannah, 2008, 2009). Building on previous work, DR is introduced and conceptualised somewhat differently. In this study, DR is construed of self-awareness, self-regulation, and self-motivation, proposed by Day (2000) to be the backbones of leadership development. DR is suggested to moderate the developmental process. Furthermore, personality dispositions and individual values are proposed to be precursors of DR. The empirical research conducted uses a pre-test post-test quasi-experimental design. Before conducting the study, though, both a measure of Developmental Readiness and a competency profiling measure are tested in two pilot studies. Results do not find evidence of a direct effect of leadership development programmes on development, but do support an interactive effect between DR and leadership development programmes. Personality dispositions Agreeableness, Conscientiousness, and Openness to Experience and value orientations Conservation, Open, and Closed Orientation are found to significantly predict DR. Finally, the theoretical and practical implications of findings are discussed.

An investigation into the nature and consequences of teachers' implicit philosophies of science

The aims of this study were to investigate the beliefs concerning the philosophy of science held by practising science teachers and to relate those beliefs to their pupils' understanding of the philosophy of science. Three philosophies of science, differing in the way they relate experimental work to other parts of the scientific enterprise, are described. By the use of questionnaire techniques, teachers of four extreme types were identified. These are: the H type or hypothetico-deductivist teacher, who sees experiments as potential falsifiers of hypotheses or of logical deductions from them; the I type or inductivist teacher, who regards experiments mainly as a way of increasing the range of observations available for recording before patterns are noted and inductive generalisation is carried out; the V type or verificationist teacher, who expects experiments to provide proof and to demonstrate the truth or accuracy of scientific statements; and the 0 type, who has no discernible philosophical beliefs about the nature of science or its methodology. Following interviews of selected teachers to check their responses to the questionnaire and to determine their normal teaching methods, an experiment was organised in which parallel groups were given H, I and V type teaching in the normal school situation during most of one academic year. Using pre-test and post-test scores on a specially developed test of pupil understanding of the philosophy of science, it was shown that pupils were positively affected by their teacher's implied philosophy of science. There was also some indication that V type teaching improved marks obtained in school science examinations, but appeared to discourage the more able from continuing the study of science. Effects were also noted on vocabulary used by pupils to describe scientists and their activities.

An investigation into the effects of processing instruction on the acquisition of English relative clauses by Syrian learners

The purpose of this research was to investigate the effects of Processing Instruction (VanPatten, 1996, 2007), as an input-based model for teaching second language grammar, on Syrian learners’ processing abilities. The present research investigated the effects of Processing Instruction on the acquisition of English relative clauses by Syrian learners in the form of a quasi-experimental design. Three separate groups were involved in the research (Processing Instruction, Traditional Instruction and a Control Group). For assessment, a pre-test, a direct post-test and a delayed post-test were used as main tools for eliciting data. A questionnaire was also distributed to participants in the Processing Instruction group to give them the opportunity to give feedback in relation to the treatment they received in comparison with the Traditional Instruction they are used to. Four hypotheses were formulated on the possible effectivity of Processing Instruction on Syrian learners’ linguistic system. It was hypothesised that Processing Instruction would improve learners’ processing abilities leading to an improvement in learners’ linguistic system. This was expected to lead to a better performance when it comes to the comprehension and production of English relative clauses. The main source of data was analysed statistically using the ANOVA test. Cohen’s d calculations were also used to support the ANOVA test. Cohen’s d showed the magnitude of effects of the three treatments. Results of the analysis showed that both Processing Instruction and Traditional Instruction groups had improved after treatment. However, the Processing Instruction Group significantly outperformed the other two groups in the comprehension of relative clauses. The analysis concluded that Processing Instruction is a useful tool for instructing relative clauses to Syrian learners. This was enhanced by participants’ responses to the questionnaire as they were in favour of Processing Instruction, rather than Traditional Instruction. This research has theoretical and pedagogical implications. Theoretically, the study showed support for the Input hypothesis. That is, it was shown that Processing Instruction had a positive effect on input processing as it affected learners’ linguistic system. This was reflected in learners’ performance where learners were able to produce a structure which they had not been asked to produce. Pedagogically, the present research showed that Processing Instruction is a useful tool for teaching English grammar in the context where the experiment was carried out, as it had a large effect on learners’ performance.

Controlled study into the effectiveness of individual client-centred counselling for young offenders in residential care

This study is toe first documented account in the British Isles of an evaluation of the effectiveness of client-centred counselling with young offenders in secure residential care. It is a test of Rogers' (1957) position on the 'necessary and sufficient' conditions of therapeutic personality change within a counselling relationship. Forty teenage male offenders, the subjects of Training School Orders, were randomly allocated in equal numbers to either an experimental or control group. Boys in the experimental group received weekly individual sessions of client-centred counselling over a seven month period. Boys in the control group received no formal counselling but were shown to have similar intellectual, personality, socio-economic and criminal backgrounds to those in the experimental group. It was hypothesised that counselled subjects would show more positive outcomes than control subjects over a range of measures relating to criminal behaviour and self-conception. The results indicated that the counselled subjects had a significantly lower rate of offending and a srnaller range of offences over a mean follow-up period of 2.5 years. They were also licensed from the institution significantly earlier and spent less time in custody during a one year follow-up after counselling was completed. Self-conception measures gave less clear-cut results. The direction of change towards better adjustment favoured the counselled subjects but the magnitude was often small. Those counselled subjects with most positive behaviour change tended to have significantly improved self-evaluation, less self/ideal self discrepancy and more variation on 'actual' self concept compared to pre-counselling. The results are discussed in the context of client-centred theory, methodological adequacy of the experimental design, and their application to the future treatment of young offenders in secure residential care.

A pre-post test evaluation of the impact of the PELICAN MDT-TME development programme on the working lives of colorectal cancer team members

Background - The PELICAN Multidisciplinary Team Total Mesorectal Excision (MDT-TME) Development Programme aimed to improve clinical outcomes for rectal cancer by educating colorectal cancer teams in precision surgery and related aspects of multidisciplinary care. The Programme reached almost all colorectal cancer teams across England. We took the opportunity to assess the impact of participating in this novel team-based Development Programme on the working lives of colorectal cancer team members. Methods - The impact of participating in the programme on team members' self-reported job stress, job satisfaction and team performance was assessed in a pre-post course study. 333/568 (59%) team members, from the 75 multidisciplinary teams who attended the final year of the Programme, completed questionnaires pre-course, and 6-8 weeks post-course. Results - Across all team members, the main sources of job satisfaction related to working in multidisciplinary teams; whilst feeling overloaded was the main source of job stress. Surgeons and clinical nurse specialists reported higher levels of job satisfaction than team members who do not provide direct patient care, whilst MDT coordinators reported the lowest levels of job satisfaction and job stress. Both job stress and satisfaction decreased after participating in the Programme for all team members. There was a small improvement in team performance. Conclusions - Participation in the Development Programme had a mixed impact on the working lives of team members in the immediate aftermath of attending. The decrease in team members' job stress may reflect the improved knowledge and skills conferred by the Programme. The decrease in job satisfaction may be the consequence of being unable to apply these skills immediately in clinical practice because of a lack of required infrastructure and/or equipment. In addition, whilst the Programme raised awareness of the challenges of teamworking, a greater focus on tackling these issues may have improved working lives further.

Liberalization and the public sector:the pre-eminent role of governments in the ‘sale’ of higher education abroad

Much recent scholarship concerning liberalization has emphasized the role of regulatees, rather than governments, in promoting liberalization. This article examines such scholarship in the light of an important development in the British and French public sectors—the creation of new agencies (the Education Counselling Service and EduFrance) to ‘sell’ British and French higher education to potential international students. The new agencies attempted to induce two things: competition amongst higher education institutions for the recruitment of international students from developed and emerging economy countries, and the commodification of these students. This article shows that, contrary to existing theories of liberalization, governments were pre-eminent in pushing forward this liberalization, while higher education institutions attempted to hold it back.

Is randomisation necessary for measuring defocus curves in pre-presbyopes?

Purpose: Defocus curves are used to evaluate the subjective range of clear vision of presbyopic corrections such as in eyes implanted with accommodating intraocular lenses (IOLs). This study determines whether letter sequences and/or lens presentation order ought to be randomised when measuring defocus curves. Methods: Defocus curves (range +2.00DS to -2.00DS) were measured on 18 pre-presbyopic subjects (mean age 24.1 ± 4.2 years) for six combinations of sequential or randomised positive or negative lens progression and non-randomised or randomised letter sequences. The letters were presented on a computerised logMAR chart at 6 m. Results: Overall there was a statistically significant difference between the six combinations (ANOVA, p < 0.05) attributable to the combination of non-randomised letters with non-randomised lens progression from negative to positive defocus (p < 0.01). There was no statistically significant difference in defocus curve measurements if both letters and lens order were randomised compared to if only one of these variables was randomised (p > 0.05). Non-randomised letters, with a sequential lens progression from negative to positive, was significantly different to all other combinations when compared individually (Student's T-test, p < 0.003 on all comparisons), and was confirmed as the sole source of the overall significant difference. There was no statistically significant difference if both lens presentation order and letter sequences were randomised compared to if only one or the other of these variables was randomised. Conclusion: Non-randomised letters and non-randomised lens progression on their own did not affect the subjective amplitude of accommodation as measured by defocus curves, although their combination should be avoided. © 2007 British Contact Lens Association.