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THE INFLUENCE OF PATIENT ACTIVATION ON EXERCISE, MEAL PLANNING KNOWLEDGE, AND POLYPHARMACY IN PATIENTS WITH TYPE 2 DIABETES Type 2 Diabetes is a chronic illness associated with multiple medical complications. Successful self-management of type 2 diabetes requires active participation on the part of the patient that includes therapeutic lifestyle interventions in the form of meal planning and exercise. The purpose of this study was to understand and quantify relationships and differences between a measurement of patient activation, physical activity level, meal planning knowledge, and polypharmacy in patients with type 2 diabetes and a hemoglobin A1C (A1C) > 6.5 %. A total of 19 participants were evaluated for the study. Statistical analysis included one-way ANOVA and Pearsons Product Moment Correlation. No significant differences between the level of participant activation and level of physical activity, meal planning knowledge, or medications was found (p< 0.05). A significant negative correlation between number of medications and meal planning for diabetes knowledge test was found (r < 0.01). Additional research addressing specific characteristics of patient activation in the management of type 2 diabetes prior to participation in a self-management program is warranted.

This dissertation will trace the emerging paradigm of transaction as a model for the dynamics of the reading process. The paradigm of transaction, implicit in John Dewey's writings as early as 1896 in "The Reflex Arc Concept in Psychology," was originally described in terms of "interaction" between organism and environment. Only in 1949, in the twilight of his career, did Dewey definitively distinguish between "transaction" and "interaction," ascribing a mutually transformative character to the former process. In Knowing and the Known, Dewey and co-author Arthur F. Bentley (1949) proposed adoption of a wholly new "transactional vocabulary" as a precision tool for a new mode of scientific inquiry, whereby inquiry itself was recognized as a species of transaction between inquirer and observed phenomena. Even before the publication of Knowing and the Known, literary theorist Louise M. Rosenblatt had applied an implicitly transactional model of the relationship between organism and environment to the relationship between reader and text. She described this dynamic model of the reading process in Literature as Exploration (first published in 1938), a work that has inspired an ongoing revolution in the teaching of reading and literature at all instructional levels. In the first edition of this work, Rosenblatt employed Dewey's original term--"interaction"--to describe the dynamic relationship between reader and text. Following the publication of Knowing and the Known in 1949, Rosenblatt began systematically to appropriate Dewey and Bentley's transactional terminology in her analysis of the reader-text relationship. Educators who share the transactional vision of Dewey and Rosenblatt tend to see the role of the teacher as that of a facilitator of reader-text transaction and of reader-reader transaction as arbitrated by the text, rather than as an imparter of authoritative interpretations of texts. Envisioning potentialities for students' growth through such transactions gives rise neither to sanguine optimism nor to despair, but rather to a hopeful meliorism.