A psychological approach to providing self-management education for people with type 2 diabetes : the diabetes manual

Background: The objectives of this study were twofold (i) to develop the Diabetes Manual, a selfmanagement educational intervention aimed at improving biomedical and psychosocial outcomes (ii) to produce early phase evidence relating to validity and clinical feasibility to inform future research and systematic reviews. Methods: Using the UK Medical Research Council's complex intervention framework, the Diabetes Manual and associated self management interventions were developed through preclinical, and phase I evaluation phases guided by adult-learning and self-efficacy theories, clinical feasibility and health policy protocols. A qualitative needs assessment and an RCT contributed data to the pre-clinical phase. Phase I incorporated intervention development informed by the preclinical phase and a feasibility survey. Results: The pre-clinical and phase I studies resulted in the production in the Diabetes Manual programme for trial evaluation as delivered within routine primary care consultations. Conclusion: This complex intervention shows early feasibility and face validity for both diabetes health professionals and people with diabetes. Randomised trial will determine effectiveness against clinical and psychological outcomes. Further study of some component parts, delivered in alternative combinations, is recommended

The Use of Combinations of Chemosensitisers to Reverse Chloroquine Resistance in Mice infected with Malaria

Although several dozen different compounds are able to transiently alter chloroquine resistance via chemosensitisation, the phenomenon has never evolved beyond laboratory practice as a result of in vivo difficulties. Chemosensitising compounds either need to be administered at doses which are toxic to the host in order to reverse resistance, or the drug is so highly bound to serum proteins that there is an insufficient circulating quantity available to restore sensitivity. Nine chemosensitisers were evaluated in vitro against several resistant isolates of the malaria parasite in order to develop a cocktail treatment of three compounds which could reverse resistance additively or synergistically when used at low doses with chloroquine. This would bypass any toxicity issues which might arise from the use of a high dose of a single agent. Six of the chemosensitisers were selected for combination into six different cocktails which were tested in vitro. Each cocktail contained one antidepressant, one antihistamine and one antipsychotic. Low doses of each drug were able to alter resistance to a small extent singly and in combination; this was shown by determining the effect of drugs and cocktails on both chloroquine transport using radiolabelled chloroquine, and chloroquine efficacy using the lactate dehydrogenase assay for parasite viability. The reversal activity was shown to be additive in the cocktail treatments and not synergistic, and was highly dose-dependent. There was no direct correlation between the change in chloroquine transport and the extent of resistance reversal. The chemosensitisers' effect on chloroquine transport was evaluated in a mouse model of malaria and shown to be similar to that seen against cultured human parasites; following this, the cocktails were tested for efficacy in mice infected with chloroquine-resistant malaria. Five of the six cocktails were able to significantly alter parasite survival in the mice in conjunction with a low dose of chloroquine. Drug levels in the mice were quantified via mass spectrometry and liquid chromatography in order to correlate the efficacy data. One of the compounds in the failed treatment was shown to circulate at low levels in the animals and this is possibly why that treatment, although effective in vitro, did not yield a result in vivo

Becoming a science teacher: narratives and conceptions

Thesis (Ph.D.)--University of the Witwatersrand, Faculty of Humanities, School of Education, 2013.This research project explored the classroom practices, and the conceptions and identities which informed those practices, of early career physical science teachers who qualified through the four year initial teacher preparation programme in which I was involved. Taking the view that education is a complex system, where both the agency of the individual and her past and present contexts affect learning, implies that individual histories fundamentally affect the way student teachers make sense of and appropriate their initial training. Moreover what counts as good science teaching is contested and context dependent. I spent two days in the classrooms of eight of my past students, writing narratives of their lessons, and talking to them about their lessons and about what they saw as having influenced their practice. Narrative inquiry was used to explore the teachers’ identities and phenomenography to explore their conceptions of teaching. The threat of classroom reactivity was addressed by reducing it and by accounting for it by asking teachers afterwards what they thought the effect of the observer had been. The threat of researcher subjectivity was addressed by rich data, teacher and peer feedback, the use of established methods of analysis, and transparency. A grounded analysis revealed that the activities in the lessons could be classified according to the teachers’ underlying purpose (the introduction of new subject matter content, the application of that content, feedback on learners’ work, or revision of work done previously) and the mode of engagement (exposition, question and answer, or conversation). Some teachers had strong preferences for particular modes of engagement while others worked with a wider repertoire. For lessons where the purpose of the lesson was the introduction of new physics or chemistry content, the ‘content object’ (the propositional and procedural science knowledge and the transformation thereof) was identified and assessed using a rubric with three dimensions (the accuracy of the content, the appropriateness of the content and the transformation of that content to make it accessible to learners) which was developed in working with the data. The best lessons were those where good transformation of mostly accurate content took place. The study shows how learners contribute significantly to the quality of the subject matter content of a lesson by their questions, answers and silences. A conversation mode of engagement is useful for promoting learner contributions. The sample became teachers for a variety of reasons, and their professional identities reflect diverse influences, many of which are outside their initial teacher education. However for three of the teachers in this study, their teacher education programme was a defining experience, core to their current identities as teachers. Thus an initial teacher education programme can have a major influence on teachers, particularly teachers who know their own school experiences of science teaching to be deficient. Small inputs in teacher education may lever up large but unpredictable ‘butterfly’ effects. Despite the challenges involved, it seems there are still young people who want to become teachers, but bursaries are key to making this a reality. A mentoring programme may support teachers in township schools in their vision of making a difference. A phenomenographic analysis revealed four conceptions of teaching science, with two dimensions: whether the science knowledge to be taught is seen as problematic or not, and the nature of the mediation of that knowledge, either by transferring the knowledge from the teacher to the learners or by creating space for learners to acquire the knowledge. Since the subject matter content of a lesson is key to the overall success of a lesson, conceptions of teaching which recognise that subject matter knowledge can be problematic may be more powerful. The results of this study speak back to the vision of teacher educators about the kinds of teachers they want to produce

Making Meaning of IB Approaches to Teaching and Learning: A Phenomenological Study of Teachers’ Experiences Implementing the International Baccalaureate Diploma Programme

The purpose of this qualitative phenomenological study was to explore how teachers perceive, make meaning of, and implement the International Baccalaureate Diploma Programme (IBDP). Best practices for effectively implementing the IBDP were also explored. A total of 10 teachers and coordinators who were new to IBDP and had implemented the program since 2015 were interviewed. These educators were outside their home countries in Macao, Malaysia, Qatar, and Turkey. The study was designed to answer two research questions. RQ 1 asked, How do teachers perceive, make meaning of, and individually construct their implementation of the IBDP according to Knowles et al.’s (2015) principles of andragogy? RQ 2 asked, What factors do teachers believe best contribute to their implementation of the IBDP? Nine themes emerged from the data analysis: value of the IBDP, understanding assessment, mentoring, collaboration, effective training, continuous reading, insecurity of assessment, applying and refining new knowledge through practice, and time. The strong need for collaboration and mentoring has been clearly articulated by the participants. There is a definite need for more research about the topic of IBDP implementation. However, this study begins to explore the elements of perceiving and making meaning of the IBDP, and suggests strategies for effectively implementing the IBDP while giving voice to the practitioners who do already implement the IBDP

Making Meaning of IB Approaches to Teaching and Learning: A Phenomenological Study of Teachers’ Experiences Implementing the International Baccalaureate Diploma Programme

The purpose of this qualitative phenomenological study was to explore how teachers perceive, make meaning of, and implement the International Baccalaureate Diploma Programme (IBDP). Best practices for effectively implementing the IBDP were also explored. A total of 10 teachers and coordinators who were new to IBDP and had implemented the program since 2015 were interviewed. These educators were outside their home countries in Macao, Malaysia, Qatar, and Turkey. The study was designed to answer two research questions. RQ 1 asked, How do teachers perceive, make meaning of, and individually construct their implementation of the IBDP according to Knowles et al.’s (2015) principles of andragogy? RQ 2 asked, What factors do teachers believe best contribute to their implementation of the IBDP? Nine themes emerged from the data analysis: value of the IBDP, understanding assessment, mentoring, collaboration, effective training, continuous reading, insecurity of assessment, applying and refining new knowledge through practice, and time. The strong need for collaboration and mentoring has been clearly articulated by the participants. There is a definite need for more research about the topic of IBDP implementation. However, this study begins to explore the elements of perceiving and making meaning of the IBDP, and suggests strategies for effectively implementing the IBDP while giving voice to the practitioners who do already implement the IBDP

A Scanning Electron Microscopic Study of the Infection of Water Oak (Quercus nigra) by Taphrina Caerulescens

The fungal pathogen Taphrina caerulescens was isolated from leaves of water oak (Quercus nigra) exhibiting symptoms of oak leaf blister. Healthy leaves were inoculated with a suspension of cells from pure culture in order to examine the infection process. Scanning electron microscopy was used to monitor budding of T. caerulescens cells, formation of germ tubes, and indirect penetration of leaf tissue through stomata, which occurred within 48 h post-inoculation. Direct penetration was not observed

A cluster randomised controlled trial of the efficacy of a brief walking intervention delivered in primary care : study protocol

Background: The aim of the present research is to conduct a fully powered explanatory trial to evaluate the efficacy of a brief self-regulation intervention to increase walking. The intervention will be delivered in primary care by practice nurses (PNs) and Healthcare Assistants (HCAs) to patients for whom increasing physical activity is a particular priority. The intervention has previously demonstrated efficacy with a volunteer population, and subsequently went through an iterative process of refinement in primary care, to maximise acceptability to both providers and recipients. Methods/ Design: This two arm cluster randomised controlled trial set in UK general practices will compare two strategies for increasing walking, assessed by pedometer, over six months. Patients attending practices randomised to the self-regulation intervention arm will receive an intervention consisting of behaviour change techniques designed to increase walking self-efficacy (confidence in ability to perform the behaviour), and to help people translate their “good” intentions into behaviour change by making plans. Patients attending practices randomised to the information provision arm will receive written materials promoting walking, and a short unstructured discussion about increasing their walking. The trial will recruit 20 PN/HCAs (10 per arm), who will be trained by the research team to deliver the selfregulation intervention or information provision control intervention, to 400 patients registered at their practices (20 patients per PN/HCA). This will provide 85% power to detect a mean difference of five minutes/day walking between the self-regulation intervention group and the information provision control group. Secondary outcomes include health services costs, and intervention effects in sub-groups defined by age, ethnicity, gender, socioeconomic status, and clinical condition. A mediation analysis will investigate the extent to which changes in constructs specified by the Theory of Planned Behaviour lead to changes in objectively assessed walking behaviour. Discussion: This trial addresses the current lack of evidence for interventions that are effective at increasing walking and that can be offered to patients in primary care. The intervention being evaluated has demonstrated efficacy, and has been through an extensive process of adaptation to ensure acceptability to both provider and recipient, thus optimising fidelity of intervention delivery and treatment receipt. It therefore provides a strong test of the hypothesis that a self-regulation intervention can help primary care patients increase their walking

Preliminary Investigation of Continuous Self-Improvement, Confidence, & Resilience

https://fuse.franklin.edu/ss2018/1039/thumbnail.jp