Managing Patient-centered Communication across the Type 2 Diabetes Illness Trajectory: A Grounded Practical Theory of Interactional Sensitivity

This article uses the theoretical and methodological framework of Grounded Practical Theory (GPT) to provide a lens for analyzing and interpreting discourse as a situated form of social action in routine Type 2 diabetes visits. Drawing on a total data-set of 400 audio-recorded routine visits, we randomly selected 55 visits for qualitative analysis. In this article, we use Conversation Analysis to document communication techniques, which we in turn use as evidence to ground our claims within the GPT framework. We use two single cases of interaction to analyze communication techniques physicians use when recommending a change from oral medication to insulin. We argue treatment intensification is a key moment in health communication to reflect about patient centeredness because physicians can find themselves in an interactional dilemma: while insulin may effectively help control unstable disease, an insulin recommendation may simultaneously counter patient values and treatment preferences. Our analysis suggests that physicians use what we call interactional sensitivity to balance medical need and patient preferences when making medical decisions by tailoring their communication according to the local situation and the patient's larger illness trajectory. We propose that interactional sensitivity is a type of communication work and a quality of patient-centered communication characterized by the theoretical relationship between tailoring communication to the contingencies of the local interaction and the global illness trajectory. Overall, this article contributes to health communication scholarship by proposing a normative model for reflecting on how physicians negotiate challenging interactions with patients during routine chronic illness visits.     

The Donkey of the Prophet in Shī‘ite Tradition

The present study examines the treatment of the Prophet's mount in Shī‘ite tradition. We discuss the different opinions concerning the ass's name, ‘Ufayr or Ya‘fūr and present various traditions concerning utterances spoken by it, including utterances addressed to the Prophet, and other cases of human-like behaviour on its part, such as an ability to distinguish Muslims from Jews. We then go on to compare the Prophet's ass to those of other prophets, and find a number of similarities between them, in particular their ability to speak a human language. We also discuss the ass's death, which according to Shī‘ite tradition was by suicide, occasioned by the ass's fear following his master's death that someone else, not a prophet, would use it as a mount. We compare the Prophet's ass to those of Noah, and Solomon's Hoopoe, and show how Shī‘ite tradition has focused on similarities among them and utilized those to support the idea of the Imāmate as the Prophet's legacy in Shī‘ite doctrine. We further discuss the preference which Shī‘ite Imāms had for asses as against other mounts, a preference based on their wish to follow in the Prophet's footsteps.     

Portugal and the Mediterranean trade: A Prelude to the discovery of the “new world”

Before the century of great discoveries, and during most of the fifteenth century, the Portuguese developed important commercial activity in the Mediterranean. This is the central issue of this article as seen through two themes: the first is an assessment of the Portuguese organization of Mediterranean trade, with special attention given to the foodstuffs which were, and continued to be, a feature of such trade; and second, is to observe how Portuguese faced competition from others nations’ merchants in the region. The study of these two aspects will provide a better understanding of the re-orientation of Portuguese trade towards the Atlantic.     

A queer circle of friends,indeed! The school social as intervention or as movement

The purpose of this paper to present two approaches intended to support the social lives of those typically on the borders of school life. Circles of friends (CoFs) was designed to assist students labelled with disabilities, while Gay-straight alliances (GSAs) addresses needs of supporting students who identify as lesbian, gay, bisexual, transgender, two-spirited (gay/lesbian/bisexual First Nations people), queer and/or those questioning their sexual identity (LGBTTQQ). In laying out these approaches side by side, I argue that CoFs constitute a dis/abling pedagogy breed acquiescence, further pathologise students and create essentialised identification for all students. GSAs, in contrast, are constitutive of a queer pedagogy and promote active, agentive, healthy more complex identities. In short, CoFs are critiqued through GSAs and implications for inclusive schooling are explored.     

International perspectives on student awareness,experiences and perceptions of research: implications for academic developers in implementing research‐based teaching and learning

This paper explores the implications of the effective integration of research, teaching and learning for academic development through the lens of an international multi‐institutional comparison of student perceptions of research and its impact on their learning environment. The study, with a sample of over 500 final‐year undergraduate students across three institutions in the UK and Canada, represents a spectrum of research and teaching intensive universities and is one of the largest exploring undergraduate student perceptions of research in the linking teaching and research literature. The results indicate a complex relationship between student perceptions and experiences of research and the type of institution, as well as the individual, institutional and national context. They also inform the discussion of particular issues that academic developers face and the strategies they use to improve the integration of research and teaching to benefit the undergraduate learning experience in their institution.

Cet article explore les implications, pour le développement pédagogique, de l’intégration effective de la recherche, de l’enseignement et de l’apprentissage à l’aide de la lentille d’une comparaison internationale multi institutionnelle des perceptions étudiantes à l’égard de la recherche et de leur impact sur l’environnement d’apprentissage. L’étude, reposant sur un échantillon de plus de 500 étudiants en dernière année de 1^er cycle, provenant de trois institutions au Royaume‐Uni et au Canada, représente un spectre d’universités centrées sur l’enseignement ou sur la recherche. L’étude constitue une des recherches les plus importantes au sujet des perceptions étudiantes à l’égard de la recherche dans la littérature portant sur le lien entre l’enseignement et la recherche. Les résultats indiquent une relation complexe entre les perceptions et les expériences des étudiants, et le type d’institution, de même qu’avec les contextes individuel, institutionnel et national. Les résultats contribuent aussi à la discussion de questions particulières auxquelles les conseillers pédagogiques font face ainsi que les stratégies que ceux‐ci utilisent en vue d’améliorer l’intégration de la recherche et de l’enseignement de façon à en faire bénéficier l’expérience d’apprentissage au 1^er cycle au sein de leur institution.     

Higher education curriculum orientations and the implications for institutional curriculum change

This research is based on an empirical study exploring how academics make curriculum decisions and their perceptions of the influences that shape their decisions. Interviews were held with 20 academics from diverse disciplines, who were both research active and committed to teaching. The higher education curriculum was conceptualised as a field of decision-making shaped by academics’ beliefs about educational and contextual influences. The study identified five distinctive curriculum orientations representing coherent patterns of curriculum decisions aligned with academics’ beliefs about educational purposes. Case studies are presented to elucidate each of the curriculum orientations. Curriculum orientations were also found to shape academics’ responses to educational change. The following higher education change drivers are explored: graduate employability and the skills agenda, teaching–research relationships, changing understandings about teaching and learning, educational technologies and flexible delivery. The findings suggest implications for institutional curriculum change initiatives and academic development programmes.     

‘Go over there and look at the pictures in the book’: an investigation of educational marginalisation,social interactions and achievement motivation in an alternative middle school setting

The middle years of school represent a time of educational turbulence, serving to marginalise some students from educational opportunities. Much research has focussed on individual cognitive factors influencing educational engagement, with less attention directed towards social interactions. Theoretically positioned within an expectancy–value model of achievement motivation, this study draws on the lived experience of a 12-year-old student within an alternative school in South Australia, Australia, to explore how social encounters may contribute to educational marginalisation. Findings from a narrative case study employing a semi-structured interview suggested that connections exist between social influences, such as interactions with teachers and peers, and subsequent achievement motivation. This study suggests that social interactions are critical determinants to an individual's educational engagement, affecting educational ability, expectancy and value beliefs.     

Urban teachers’ perceptions of inclusion of migrant children in the Chinese educational institution: a comparative study

Recently China has been undergoing an unprecedented urbanisation process which has resulted in millions of rural families living in urban areas. As part of a study of Chinese migrant children's educational experiences, surveys and interviews were conducted with primary school teachers in a metropolitan city in East China. The objectives of this study were to describe teachers’ perceptions of migrant children's education in both migrant schools and in public schools, and to investigate differences in their beliefs between school types. Results found that urban teachers’ perceptions of educational inclusion of migrant students were slightly negative in general. However, teachers in public schools showed significantly more positive attitudes to inclusion of migrant students than migrant school teachers. In the light of these findings, the paper concludes with implications for practice and policy for education of migrant children in China.     

Latin American immigrant women and intergenerational sex education

People of Latin American descent make up the largest and fastest-growing minority group in the USA. Rates of pregnancy, childbirth, and sexually transmitted infections among people of Latin American descent are higher than among other ethnic groups. This paper builds on research that suggests that among families of Latin American descent, mothers have a particularly strong influence on the sexual attitudes and behaviours of their children, yet that parents of Latin American descent communicate less with their children about sex than parents of other ethnic groups. It examines the messages about sex women received as children in their countries of origin, and how these messages and their views of the USA influence the sexual education women provide for their children. On the basis of data from focus groups, we suggest that, in spite of the persistence of sexual silence, some women's self-reflective analyses of their own sexual education as well as their views of the USA as a sexually more open society contribute to their views of silence as dangerous and trigger more open communication with sons and daughters. Mothers hope to break the cycle of unwanted pregnancy by speaking with daughters about the consequences of menstruation and with sons about contraception.