Intricacies of Professional Learning in Health Care: The Case of Supporting Self-Management in Paediatric Diabetes

This thesis offers a rethinking of the role for education as critical workplace pedagogy in complex problems of health care. Taking the case of paediatric diabetes, the study explored how health-care professionals learn the work of supporting children, and their parents, to self-manage the condition. By reconceptualising work problems as sociomaterial learning struggles, this research contributes new understandings of informal professional learning in everyday health-care provision. Data were generated through fieldwork in an outpatient clinic. Particular challenges of supporting self-management in this case were the difficulties of balancing policy aspirations for empowerment with biomedical knowledge about risks to immediate and long-term health. Tracing the materialisation of learning as it unfolded in moments of health-care practice showed professionals handling multiple and contradictory flows of information. Particular challenges were posed by insulin-pump technologies, which have specific implications for professional roles and responsibilities, and introduce new risks. A key insight is that professionals were concerned primarily with the highly complicated perpetual discernment of safe parameters within which children and their parents might reasonably be allowed to contribute to self-management. Such discernment does not readily correspond to the notion of empowerment circulating in the policies and guidelines intended to enable professionals to accomplish this work. As a result, this thesis argues that the work of discernment is obscured. Learning strategies evolve, but could be supported and extended by explicit recognition of the important work of learning as it unfolds in everyday practices of supporting self-management in paediatric diabetes. Most importantly, workplace pedagogies could be developed in ways that attune to the profound challenges and uncertainties that are at stake in these practices

REMOTELY MAPPING SURFACE ROUGHNESS ON ALLUVIAL FANS: AN APPROACH FOR UNDERSTANDING DEPOSITIONAL PROCESSES

A technique using multiple images from a single year to find surface roughness-based differences in directional radiance across sparsely-vegetated surfaces has been developed to help efficiently map and understand depositional processes on active, alluvial fan surfaces in Death Valley, CA. Surface roughness on the scales of grain size and topography on alluvial fan surfaces is expected to vary with depositional processes, including fluvial and mass movement events, as well as surface runoff and eolian processes. The Bidirectional Reflectance Distribution Function (BRDF) describes changes in reflectance based on changes in the angle of irradiance and radiation-scattering effects of a surface. Using Landsat 7 satellite imagery, the changes in observed surface reflectance, resulting from seasonal changes in the angle of incoming, solar radiation, can be classified and interpreted to show differences in surface roughness. Observations of grain size and topography, and other variables that affect reflectance (e.g. vegetation, composition) from field sites on eastern, alluvial fan surfaces in Death Valley show that seasonal changes in surface radiation are related to surface shadowing that result from grain size primarily, but also topography. Statistical tests show that the total amount of sand found on the land surface is the most correlated variable with the remote sensing method. Spatial relationships of surface features provide further interpretation of depositional process in addition to surface roughness. Airborne Laser Swath Mapping (ALSM) data was also used to map surface roughness, and shows positive trends with the Landsat imagery analyses. Mapping surface roughness over large areas and in remote settings using multi-spectral, satellite imagery has the potential to be a powerful tool for studying the geomorphology of both Earth and Mars

Contesting the Shape of Political Space: An Investigation of the "Threat of Asylum" in Britain

Defined in terms of a national security discourse, Britain’s asylum policy facilitates a disturbing dissociation of the asylum seeker from the identity of the refugee. The roots of this discourse can, this paper argues, be understood if the asylum seeker is seen as the site of a clash between two conceptualizations of political space—one that sees only the international state system, marked by the rights of sovereign states and exclusive political spaces, and one that sees a more complicated global political structure, marked by spaces of danger and of opportunity, in which human beings, as such, have a right to demand hospitality and inclusion from the state. Aiming to understand this clash, and the possibilities for moving beyond it, this paper analyzes British asylum policy through the lens of Michel Foucault’s account of sovereign biopower in Society Must Be Defended, read together with Giorgio Agamben’s work on the homo sacer and spaces of exception. These texts point towards the counter-narrative of the asylum seeker who refuses to disappear into discourses of national secur­ity, and who suggests a “rival structure” of political space. Understanding this clash requires uncovering the violence, discernible in British asylum policy, which sustains the international state system and in doing so, creates and marginalizes the asylum seeker. This paper draws out the deeply challenging and complex nature of the “problem of asylum,” working against the simplification that a national security discourse imposes on the issue.Définie en termes de discours autour de la sécurité nationale, la politique d’asile de la Grande Bretagne facilite la dissociation du demandeur d’asile de l’identité du réfugié. Cet article fait valoir que pour comprendre la racine de ce discours, il faut voir le demandeur d’asile comme le point de conflit entre deux conceptualisations de l’espace politique — l’une qui ne voit que le système international composé d’états caractérisé par les droits des états souverains et des espaces politiques exclusifs; et l’autre qui voit une structure politique globale bien plus compliquée, marquée par des espaces de danger et d’opportunités, et où les êtres humains ont le droit de demander l’ hospitalité et l’inclusion de la part de l’état. Dans le but de comprendre ce conflit, et les possibilités de le dépasser, cet article analyse la politique du droit d’asile de la Grande Bretagne à travers les lentilles du compte-rendu du bio-pouvoir souverain par Michel Foucault dans Society Must Be Defended, lu de concert avec l’œuvre de Giorgio Agamden sur le homo sacer et les espaces d’exception. Ces textes pointent vers la contre-narration du demandeur d’asile qui refuse de disparaître dans les discours sur la sécurité nationale, et qui au contraire propose une “structure rivale” d’espaces politiques. Pour comprendre ce conflit, il faut enlever la couverture cachant la violence qui peut être discernée dans la politique d’asile britannique, qui soutient le système international d’états et, ce faisant, crée et marginalise le demandeur d’asile. Cet article met à jour la nature profondément difficile et complexe du « problème de l’asile », et s’insurge contre la simplification qu’un discours de sécurité national impose sur le problème

Differential parent and teacher reports of school readiness in a disadvantaged community

Differential ratings by multiple informants are an important issue in survey design. Although much research has focused on differential reports of child behaviour, discrepancies between parent and teacher reports of children’s school readiness are less explored.

Report on Children's Profile at School Entry 2008-2009: Evaluation of the 'Preparing For Life' Early Childhood Intervention Programme

The Children's Profile at School Entry (CPSE) was conducted by the UCD Geary Institute who have been commissioned by the Northside Partnership to assess the levels of school readiness in a designated disadvantaged community of Ireland, as part of an overall evaluation of the Preparing for Life (PFL) early childhood intervention programme.

Health information systems: international lessons

At present Ireland lacks really effective and usable health information systems. The priorities listed in the draft ‘Information for Action’ report cannot be realised within the constraints of the existing systems. Our health information systems are not people centred; they do not facilitate assessment of quality; they make measurement of equity very hard; they do not support an adequate level of democratic or political accountability. The current systems lack credibility with health service staff, at least partly because they seldom see any results from them. There is no adequate system for analysis of and reporting on most of the current Irish health information systems. Despite these problems, components of our systems work well, and produce data of high quality. The Irish Cancer registry provides accurate, timely reports on cancer incidence in Ireland. The National Disease surveillance Centre does excellent work on the collection analysis and dissemination of infectious disease data. The quality of the data collected in the HIPE system by ESRI, and in the Vital Statistics system by the CSO are good. The national disability register works well. It is imperative that the existing systems are not broken in the attempt to bring in new systems. There are many different models in Europe and elsewhere of working health information systems. We would particularly suggest that elements of the systems used in New Zealand, Finland, Scotland and Canada could provide models for further development in Ireland. Specifically, New Zealand has a working model of an e-health Internet; Finland has a good model of a registry based system; Canada has a working model of systems using and analysing health data. Scotland has a very interesting system, with very close integration with primary care. This is a weakness of the Canadian, and especially the Finnish systems. Devising a system based on the best elements of these systems would produce a very powerful tool indeed. It is also worth noting that such a system might lead to substantial opportunities for Irish IT companies here and abroad