Diabetic patient education and motivation. Available in 2 volumes.

Diabetes mellitus is a condition which requires a high degree of patient cooperation in self-management to achieve optimal glycaemic control. The concept of patient education, to enhance the treatment and management of diabetes, is well recognised. Several diabetes education programmes have already been described, but increased knowledge of diabetes did not necessarily result in improved self-mangement or glycaemic control. Other factors, such as attitudes and motivations, may therefore be particuarly important. The aims of the present study were to investigate the influence of patients' attitudes to diabetes, and to develop motivational aspects which enable the application of knowledge to enhance self-management and compliance with treatment. Thirty-one insulin-dependent diabetic (IDD) patients entered into a 12 month educational programme, particularly designed to increase motivation. Patients' attitudes to diabetes, their knowledge and self-management skills were assessed using questionnaires and practical tests, and parameters of glycaemic control were measured. The progress of these patients was compared at intervals with a close matched group of 25 control IFF patients who continued to receive routine clinic care. Patients completing the educational programme achieved better glycaemic control (p< 0.05), greater knowledge (p< 0.001), more favourable attitudes (p< 0.03) and increased competence in management skills (p< 0.02) compared with the control group. Evaluation procedures indicated that the programme was acceptable to the patients, and was successful in terms of increasing patient motivation. Six months after completion of the programme, glycaemic control deteriorated, although knowledge, attitudes and management skills were unchanged. This might reflect the withdrawal of extrinsic motivation, attention and supervision provided during the programme. It is recommended that consideration be given to the development of patients' intrinsic motivation to achieve maximum benefit from diabetes education programmes.

The influence of patient and doctor gender on diagnosing coronary heart disease

Using novel methods, this paper explores sources of uncertainty and gender bias in primary care doctors' diagnostic decision-making about coronary heart disease (CHD). Claims about gendered consultation styles and quality of care are re-examined, along with the adequacy of CHD models for women. Randomly selected doctors in the UK and the US (n=112, 56 per country, stratified by gender) were shown standardised videotaped vignettes of actors portraying patients with CHD. Patients' age, gender, ethnicity and social class were varied systematically. During interviews, doctors gave free-recall accounts of their decision-making, which were analysed to determine patient and doctor gender effects. We found differences in male and female doctors' responses to different types of patient information. Female doctors recall more patient cues overall, particularly about history presentation, and particularly amongst women. Male doctors appear less affected by patient gender but both male and especially female doctors take more account of male patients' age, and consider more age-related disease possibilities for men than women. Findings highlight the need for better integration of knowledge about female presentations within accepted CHD risk models, and do not support the contention that women receive better-quality care from female doctors.

How well do the theory of reasoned action and theory of planned behaviour predict intentions and attendance at screening programmes? A meta-analysis

Meta-analysis was used to quantify how well the Theories of Reasoned Action and Planned Behaviour have predicted intentions to attend screening programmes and actual attendance behaviour. Systematic literature searches identified 33 studies that were included in the review. Across the studies as a whole, attitudes had a large-sized relationship with intention, while subjective norms and perceived behavioural control (PBC) possessed medium-sized relationships with intention. Intention had a medium-sized relationship with attendance, whereas the PBC-attendance relationship was small sized. Due to heterogeneity in results between studies, moderator analyses were conducted. The moderator variables were (a) type of screening test, (b) location of recruitment, (c) screening cost and (d) invitation to screen. All moderators affected theory of planned behaviour relationships. Suggestions for future research emerging from these results include targeting attitudes to promote intention to screen, a greater use of implementation intentions in screening information and examining the credibility of different screening providers.

Research cultures and the pragmatic functions of humor in academic research presentations:A corpus-assisted analysis

Based on a corpus of English, German, and Polish spoken academic discourse, this article analyzes the distribution and function of humor in academic research presentations. The corpus is the result of a European research cooperation project consisting of 300,000 tokens of spoken academic language, focusing on the genres research presentation, student presentation, and oral examination. The article investigates difference between the German and English research cultures as expressed in the genre of specialist research presentations, and the role of humor as a pragmatic device in their respective contexts. The data is analyzed according to the paradigms of corpus-assisted discourse studies (CADS). The findings show that humor is used in research presentations as an expression of discourse reflexivity. They also reveal a considerable difference in the quantitative distribution of humor in research presentations depending on the educational, linguistic, and cultural background of the presenters, thus confirming the notion of different research cultures. Such research cultures nurture distinct attitudes to genres of academic language: whereas in one of the cultures identified researchers conform with the constraints and structures of the genre, those working in another attempt to subvert them, for example by the application of humor. © 2012 Elsevier B.V.

Communities, centres, connections, disconnections:some reflections on the riots in Birmingham

This paper presents key ideas from fieldwork conducted in Birmingham between 2009 and 2011. This work examined identity in 'white' neighbourhoods, and attitudes to politics and understandings of poverty in more mixed ones. This work revealed that many Birmingham residents were concerned about a perceived loss of values, the impact of 'unrespectable' households and individuals in their areas and the apparent disconnect between political representatives and local residents. In the aftermath of the disturbances of August 2011 across England, including in Birmingham, we revisit these themes and examine the implications for understanding disorder in the city of Birmingham.

Can incident reporting improve safety? Healthcare practitioners' views of the effectiveness of incident reporting

OBJECTIVE: Recent critiques of incident reporting suggest that its role in managing safety has been over emphasized. The objective of this study was to examine the perceived effectiveness of incident reporting in improving safety in mental health and acute hospital settings by asking staff about their perceptions and experiences. DESIGN: /st>Qualitative research design using documentary analysis and semi-structured interviews. SETTING: /st>Two large teaching hospitals in London; one providing acute and the other mental healthcare. PARTICIPANTS: /st>Sixty-two healthcare practitioners with experience of reporting and analysing incidents. RESULTS: /st>Incident reporting was perceived as having a positive effect on safety, not only by leading to changes in care processes but also by changing staff attitudes and knowledge. Staff discussed examples of both instrumental and conceptual uses of the knowledge generated by incident reports. There are difficulties in using incident reports to improve safety in healthcare at all stages of the incident reporting process. Differences in the risks encountered and the organizational systems developed in the two hospitals to review reported incidents could be linked to the differences we found in attitudes to incident reporting between the two hospitals. CONCLUSION: /st>Incident reporting can be a powerful tool for developing and maintaining an awareness of risks in healthcare practice. Using incident reports to improve care is challenging and the study highlighted the complexities involved and the difficulties faced by staff in learning from incident data.

Evaluating the skills strategy through a Graduate Certificate in Management:an experiential learning theory approach

Purpose – The purpose of this paper is to evaluate how a UK business school is addressing the Government's skills strategy through its Graduate Certificate in Management, and to identify good practice and development needs and to clarify how the Graduate Certificate is adapting to the needs of Generation X and Millennial students. The paper also aims to test Kolb and Kolb's experiential learning theory (ELT) in a business school setting. Design/methodology/approach – A case study methodology was adopted. In order to get a cross-section of views and triangulate the data, three focus groups were held, supported by reading documentation about the programme of study. Findings – The skills strategy is not just an ambition for some business schools, but is already part of the curriculum. Generation X and the Millennials have more in common with the positive attitudes associated with older generations than stereotyped views might allow. ELT provides a useful theoretical framework for evaluating a programme of study and student attitudes. Research limitations/implications – The research findings from one case study are reported, limiting the generalisability of the study. Practical implications – Good practice and development needs are identified which support the implementation of the Government's skills strategy and address employer concerns about student skills. Originality/value – New empirical data are reported which supports the use of ELT in evaluating programmes of study and student attitudes to work.

Quality management and performance:a comparison between the UK and Turkey

Purpose: The aim of this article is to detail the correlation between quality management, specifically its tools and critical success factors, and performance in terms of primary operational and secondary organisational performances. Design/methodology/approach: Survey data from the UK and Turkey were analysed using exploratory factor analyses, structural equation modelling and regression analysis. Findings: The results show that quality management has a significant and positive impact on both primary and secondary performances; that Turkish and UK attitudes to quality management are similar; and that quality management is widely practised in manufacturing and service industries but has more statistical emphasis in the manufacturing sector. The main challenge for making quality management practice more effective lies in an appropriate balanced use of the different sorts of the tools and critical success factors. Originality/value: This study takes a novel approach by: (i) exploring the relationship between primary operational and secondary organisational performances, (ii) using service and manufacturing data and (iii) making a cross-country comparison between the UK (a developed economy) and Turkey (a developing economy). Limitations: Detailed contrast provided between only two countries. © 2013 Copyright Taylor and Francis Group, LLC.

Models, Techniques and Applications of e-Learning Personalization

In recent years Web has become mainstream medium for communication and information dissemination. This paper presents approaches and methods for adaptive learning implementation, which are used in some contemporary web-interfaced Learning Management Systems (LMSs). The problem is not how to create electronic learning materials, but how to locate and utilize the available information in personalized way. Different attitudes to personalization are briefly described in section 1. The real personalization requires a user profile containing information about preferences, aims, and educational history to be stored and used by the system. These issues are considered in section 2. A method for development and design of adaptive learning content in terms of learning strategy system support is represented in section 3. Section 4 includes a set of innovative personalization services that are suggested by several very important research projects (SeLeNe project, ELENA project, etc.) dated from the last few years. This section also describes a model for role- and competency-based learning customization that uses Web Services approach. The last part presents how personalization techniques are implemented in Learning Grid-driven applications.

Did they ‘Read before burning’? The Coalition and quangos

Attitudes to quangos are paradoxical. On the one hand they are perceived to be undemocratic, unaccountable organisations, while on the other they are seen to improve effectiveness, limit political interference and increase public confidence in government. This paradox is reflected in the behaviour of political parties, which generally adopt a harsh line towards quangos in opposition, but come to rely on these bodies in office. Ahead of the 2010 general election it was, however, noticeable that the Conservative party rejected this dynamic by promising to pursue ‘a more sophisticated approach’. This article explores the Coalition government's subsequent ‘public bodies reform programme’, assessing its progress against recommendations contained within the Institute for Government's Read before Burning report of July 2010. It concludes that while the Coalition has addressed long-standing concerns about the day-to-day governance of public bodies, it has failed to resolve a set of broader and strategic (metagovernance) issues.

Double jeopardy:subordinates' worldviews and poor performance as predictors of abusive supervision

Purpose - To test a moderated mediation model where a positive relationship between subordinates’ perceptions of a dangerous world—the extent to which an individual views the world as a dangerous place—and supervisory abuse is mediated by their submission to authority figures, and that this relationship is heightened for more poorly performing employees. Design/Methodology/Approach - Data were obtained from 173 subordinates and 45 supervisors working in different private sector organizations in Pakistan. Findings - Our model was supported. It appears that subordinates’ dangerous worldviews are positively associated with their perceptions of abusive supervision and that this is because such views are likely to lead to greater submission to authority figures. But this is only for those employees who are performing more poorly. Implications - We highlight the possibility that individual differences (worldviews, attitudes to authority figures, and performance levels) may lead employees to become victims of abusive supervision. As such, our research informs organizations on how they may better support supervisors in managing effectively their subordinate relationships and, in particular, subordinate poor performance. Originality/Value - We add to recent work exploring subordinate-focused antecedents of abusive supervision, finding support for the salience of the previously untested constructs of individual worldviews, authoritarian submission, and individual job performance. In so doing we also extend research on dangerous worldviews into a new organizational setting. Finally, our research takes place within a new Pakistani context, adding to the burgeoning non-US based body of empirical work into the antecedents and consequences of abusive supervision.

The network structure of Hungarian business clusters

This article investigates the attitudes to inter-firm co-operation in Hungary by analysing a special group of business networks: the business clusters. Following an overview of cluster policy, a wide range of selfproclaimed business clusters are identified. A small elite of these business networks evolves into successful, sustainable innovative business clusters. However, in the majority of cases, these consortia of interfirm co-operation are not based on a mutually satisfactory model, and as a consequence, many clusters do not survive in the longer term. The paper uses the concepts and models of social network theory in order to explain, why and under what circumstances inter-firm co-operation in clusters enhances the competitiveness of the network as a whole, or alternatively, under what circumstances the cluster remains dependent on Government subsidies. The empirical basis of the study is a thorough internet research about the Hungarian cluster movement; a questionnaire based expert survey among managers of clusters and member companies and a set of in-depth interviews among managers of self-proclaimed clusters. The last chapter analyises the applicability of social network theory in the analysis of business networks and a model involving the value chain is recommended.

Police is Dead: On the Birth of Economism

Police is Dead is an historiographic analysis whose objective is to change the terms by which contemporary humanist scholarship assesses the phenomenon currently termed neoliberalism. It proceeds by building an archeology of legal thought in the United States that spans the nineteenth and twentieth centuries. My approach assumes that the decline of certain paradigms of political consciousness set historical conditions that enable the emergence of what is to follow. The particular historical form of political consciousness I seek to reintroduce to the present is what I call “police:” a counter-liberal way of understanding social relations that I claim has particular visibility within a legal archive, but that has been largely ignored by humanist theory on account of two tendencies: first, an over-valuation of liberalism as Western history’s master signifier; and second, inconsistent and selective attention to law as a cultural artifact. The first part of my dissertation reconstructs an anatomy of police through close studies of court opinions, legal treatises, and legal scholarship. I focus in particular on juridical descriptions of intimate relationality—which police configured as a public phenomenon—and slave society apologetics, which projected the notion of community as an affective and embodied structure. The second part of this dissertation demonstrates that the dissolution of police was critical to emergence of a paradigm I call economism: an originally progressive economic framework for understanding social relations that I argue developed at the nexus of law and economics at the turn of the twentieth century. Economism is a way of understanding sociality that collapses ontological distinctions between formally distinct political subjects—i.e., the state, the individual, the collective—by reducing them to the perspective of economic force. Insofar as it was taken up and reoriented by neoliberal theory, this paradigm has become a hegemonic form of political consciousness. This project concludes by encouraging a disarticulation of economism—insofar as it is a form of knowledge—from neoliberalism as its contemporary doctrinal manifestation. I suggest that this is one way progressive scholarship can think about moving forward in the development of economic knowledge, rather than desiring to move backwards to a time before the rise of neoliberalism. Disciplinarily, I aim to show that understanding the legal historiography informing our present moment is crucial to this task.

A nobreza doutural da bruzundanga: Profissionais liberais e fetiche do coutoramento no Brasil

Analisa-se, a partir da obra Os Bruzundangas (1922) de Lima Barreto, o fascínio brasileiro pelo título de doutor, e a necessidade de ostentá-lo demonstrada por alguns profissionais liberais. Inicialmente, sintetiza-se a obra limabarretiana, enfatizando-se o tratamento e a sátira feita pelo autor aos doutores e à doutorice dos anos 1910. Em seguida, discute-se a construção histórica da associação entre o título e o valor social do poder e do prestígio, destacando, de um lado, a tradição lusitana do bacharelismo, e, de outro, a bacharelização promovida por D. Pedro II. Discorre-se, então, acerca das tentativas contemporâneas de apropriação e/ou manutenção do doutoramento pelos advogados, juízes, médicos e outros profissionais de saúde. Por fim, aborda-se a problemática do ponto de vista discursivo, levantando-se algumas questões linguísticas e ideológicas envolvidas.

Commentary on Henrician Proclamation 1538:A Proclamation Prohibiting Unlicensed Printing of Scripture (1538)

Royal Proclamation prohibiting the printing and publishing of ecclesiastical and other books without prior licence, as well as the importation, sale and publication of English language texts printed on the continent. This Proclamation established the precedent for the pre-publication licensing of literary works in England.
The commentary describes the background to the Proclamation, in particular the significance of the English Reformation, and Henry VIII's increasing interest in regulating and censuring the press. The commentary suggests that while this early instance of press intervention influenced governmental attitudes to censorship throughout the next 150 years, one of the crucial differences between this and later models of ideological control was that the 1538 Proclamation sought to censure print materials in a manner that was decoupled from the economic ownership and exploitation of such works.