A qualitative study exploring support for self-management of long-term conditions in general practice consultations

This doctoral study sought greater understanding of support for self-management in general practice consultations for people living with long-term conditions, and aimed to understand and help address the gap between policy and practice. Methods: Informed by a review of theoretical and methodological literature, a qualitative mixed methods study was undertaken, involving generation and comparative analysis of empirical data arising from three main sources: 1) observations of general practice consultations (n=86); 2) qualitative interviews with health professionals in general practice (n=17); and 3) qualitative interviews with patients with a long-term condition (n=12). Results: The thesis presents key discourse and discursive practices underpinning long-term condition management in general practice consultations. Coping with the disruption of living with a long-term condition was a key theme and identified to be of importance for both patients and health professionals. However, although a shared value, there was little evidence of this coping with the disruption being discussed during consultations. Patients and professionals had difficulty raising and addressing self-management topics whilst attempting to maintain social relations. Structural factors including the use computer templates as well as the division of labour among primary care professionals reinforced this tension. Discussion: In order for self-management support to become normalised into primary care, policy interventions concerning long-term condition management need to take into account of these tensions underpinning the care of patients with long-term conditions. A framework for embedding and integrating support for self-management of long-term conditions within primary care is proposed.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Data Descriptor: A European Multi Lake Survey dataset of environmental variables, phytoplankton pigments and cyanotoxins

Under ongoing climate change and increasing anthropogenic activity, which continuously challenge ecosystem resilience, an in-depth understanding of ecological processes is urgently needed. Lakes, as providers of numerous ecosystem services, face multiple stressors that threaten their functioning. Harmful cyanobacterial blooms are a persistent problem resulting from nutrient pollution and climate-change induced stressors, like poor transparency, increased water temperature and enhanced stratification. Consistency in data collection and analysis methods is necessary to achieve fully comparable datasets and for statistical validity, avoiding issues linked to disparate data sources. The European Multi Lake Survey (EMLS) in summer 2015 was an initiative among scientists from 27 countries to collect and analyse lake physical, chemical and biological variables in a fully standardized manner. This database includes in-situ lake variables along with nutrient, pigment and cyanotoxin data of 369 lakes in Europe, which were centrally analysed in dedicated laboratories. Publishing the EMLS methods and dataset might inspire similar initiatives to study across large geographic areas that will contribute to better understanding lake responses in a changing environment