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Exercise perceptions and experiences in adults with Crohn’s disease following a combined impact and resistance training programme: A qualitative study
Get PDFBackground: Exercise is increasingly being recognized to counteract specific complications of Crohn's disease (CD). The aim of this study was to explore exercise experiences and perceptions after engaging in a combined impact and resistance training program, involving both intervention and control group viewpoints.
Methods: Semistructured telephone interviews, involving a convenience sample of participants with CD (n = 41; aged 49.1 ± 12 years) were undertaken up to 6 weeks following completion of the program. Data were analyzed using thematic analysis.
Results: Four overarching themes emerged, along with 11 subthemes: (1) Lack of confidence and knowledge, fears surrounding physical ability and symptoms, coupled with issues not addressed as part of the healthcare pathway played a part in transitioning to inactivity; (2) Improvements in strength, mental well-being, physical fitness, fatigue, abdominal and joint pain, comorbidities, and self-management strategies were among the reported benefits of exercise participation; (3) Seeing progress, goal setting, enjoyment, and a peer-led program receiving support and advice increased motivation. Whereas work-related tiredness, other commitments, and self-directed exercise were reported as exercise barriers; (4) The intervention design was well received and the journey from start to finish was positively discussed, important considerations for future interventions and implementation strategies.
Conclusions: The study yielded novel perceptions on the transition to inactivity following receiving a diagnosis, physical and psychological benefits accruing from the intervention, and views on program design. Information that will provide an essential step in the development of implementing exercise guidelines into the clinical pathway and supporting individuals with self-management options.
Keywords: Crohn’s disease; exercise perceptions; qualitative; resistance training
Contextualizing gender and transformational spaces in mountaineering adventure sports and leisure
No full textThis book is the first edited collection to offer an intersectional account of gender in mountaineering adventure sports and leisure. It provides original theoretical, methodological, and empirical insights into mountain spaces as sites of socio-cultural production and transformation. The popular perception of sporting adventure is saturated with notions of European exploration and colonisation that have been prolifically relayed and romanticised through adventure stories. Adventure is part of who we are and has its origins in exploration, science, and war (Kirk, 2021). Simply put, adventure is different from everyday life and entails a sensory knowledge formed of risk, exclusivity, and elitism (Cater, 2013). Yet, as Cater (2013, p. 9) notes “adventure has an underlying masculinist imperative that is culturally constructed” and thus gendered. Moreover, adventure as an object of knowledge is materialised within adventurous masculinised bodies as semiotic generative nodes that symbolise, and are sedimented in adventure environments. As such, the familiar trope of mountaineering heroism is embodied in the suffering, bravery, strength, speed and risk-taking that are characteristic of this masculinist pursuit. Adventure sports and leisure are inescapably part of a hegemonic global society that works to justify the subordination of those outside dominant norms (Connell, 2005). Accordingly, we treat gender as a broad spectrum where identity is not tied to nature/culture, mind/body and male/female binaries, whilst recognising the importance of embodiment (Eger, Munar, & Hsu, 2021). Indeed, historically assigned gender identity continues to have significant consequences, in the worst case by essentialising bodies as having fixed traits (Eger et al., 2021). For example, bodies can be ‘inscribed’ with gendered meanings in relation to the masculine norm in an adventure that privileges heroic characteristics such as aggression, competition and unwillingness to admit weakness or dependency (after Connell, 2005).
Yet, the codification of mountaineering has changed little since the conjoining of Victorian notions of adventure, modernity and manliness evolved in the 1850s as a leisure and nation-building sport (Logan, 2006). This hypermasculine mountaineering legacy based on male institutions and styles of interaction (white middle-class males from the West) has silenced the achievements of those outside the dominant norm (Frohlick, 2006; Hall & Brown 2022; Ortner, 1999; Rak, 2021). Mountaineering is largely a monoculture that excludes those of ethnicity, dis/ability, gender, sexuality and age leading to significant underrepresentation (Frohlick, 1999/2000; Miller & Mair, 2019). Topographically and geographically, femininity is virtually absent in the classification of mountains as sporting adventure and leisure spaces and places. This is indicative of how far current governance structures must go to mainstream gender and address inequality. Women and those of difference are significantly underrepresented in general participation and leadership roles in mountaineering and face discrimination when they do (Allin & West, 2013; Avner et al., 2021; Hall, 2018; Hall & Brown, 2022; O’Brien & Allin, 2022). Such inequalities are compounded by a lack of role models, access to appropriate outdoor clothing, poor media representation and the challenges of securing leadership and governance roles and employment in the outdoor adventure industry (Frohlick, 2006; Gray & Mitten, 2018; Morton, 2018; Rak, 2021; Rickly, 2016; Sharp, 2001). Despite these challenges, those of difference are using mountaineering to resist, rather than submit to, these constraints by employing a broad range of strategies that enables their participation (Evans & Anderson, 2018). In doing so, they challenge traditionally gendered discourses in mountaineering and promote alternative mountaineering practices and ways of being in the mountains (Dilley & Scraton, 2010)
Thomas Hardy and the Folk Horror Tradition
No full textThomas Hardy and the Folk Horror Tradition takes the uncanny and unsettling fiction of Thomas Hardy as fundamental in examining the lineage of 'Hardyan Folk Horror'. Hardy's novels and his short fiction often delve into a world of folklore and what was, for Hardy the recent past. Hardy's Wessex plays out tensions between the rational and irrational, the pagan and the Christian, the past and the 'enlightened' future. Examining these tensions in Hardy's life and his work provides a foundation for exploring the themes that develop in the latter half of the 20th century and again in the 21st century into a definable genre, folk horror.
This study analyses the subduing function of heritage drama via analysis of adaptations of Hardy's work to this financially lucrative film market. This is a market in which the inclusion of the weird and the eerie does not fit with the construction of a past and their function in creating a nostalgia of a safe and idyllic picture of England's rural past. However, there are some lesser-known adaptations from the 1970s that sit alongside the unholy trinity of folk horror: the adaptation for television of the Wessex Tales. From a consideration of the epistemological fissure that characterize Hardy's world, the book draws parallels between then and now and the manifestation of writing on conceptual borders. Through this comparative analysis, Thomas Hardy and the Folk Horror Tradition posits that we currently exist on a moment of fracture, when tradition sits as a seductive threat
Let me be me : investigating transgender clients' experiences of their therapeutic relationship with their counsellor
Get PDFBackground
Many transgender individuals experience stigmatisation, victimisation and discrimination and, as a result, have become reliant on counselling services. Previous research indicates that transgender clients have experienced a mixture of negative and positive experiences of counselling and their therapeutic relationships. However, there is limited research that specifically explores the components of therapeutic relationships and transgender clients' experiences of them.
Aim
This study aimed to investigate how transgender clients experience their therapeutic relationship with their counsellor.
Method
This study used semistructured interviews and interpretative phenomenological analysis (IPA). Three adult participants who identified as transgender and had at least three counselling sessions in the past were recruited.
Findings
Key findings indicated positive impacts of the counsellors' congruence, the importance of counsellors having basic knowledge and awareness of the challenges that transgender people may face and how the clients' development of self-awareness aided their evaluations and re-evaluations of their experiences of their therapeutic relationships.
Limitations
Due to the small sample size, the findings cannot be generalised to the wider transgender population.
Implications for Policy
Further research is needed to support the development of affirmative counselling for transgender clients.
Implications for Practice
Counsellors are encouraged to work to respond to the needs of their clients at whatever stage in their process, to acquire basic knowledge and awareness of the challenges that some transgender people may face and to engage with their personal development and reflexivity around gender and identity.
Conclusion
Transgender clients reported both positive and negative experiences of their therapeutic relationships with reference to their own and their counsellors' contributions. Positive experiences were largely associated with the counsellors' use of congruence and working affirmatively, and negative experiences were largely associated with counsellors working nonaffirmatively
‘Untangling the entangled knot’: A critical and genealogical examination of multi-academy trusts’ (MATs) ideologies, power and governance in England
Get PDFThe reduction in local control and oversight of schooling represented by the growth of Multi Academy Trusts (MATs) in England raises critical issues for public policy. These include the articulation and exercise of power in the governance of MATs, the future of democratic governance of local services and accountability. Applying Foucault’s genealogical framework, the paper analyses the antecedents of current governance arrangements and highlights and reinvigorates suppressed, delegitimised and belittled knowledges. The authors argue that the threads of representation, community engagement and local control in school governance are important components of democratic renewal. The paper examines the play of historical and contemporary factors which have fostered a discourse that enables the subjugation of agency, self-governance and autonomy of MAT constituent schools and their communities. This discourse has wider significance for the centralisation of decision making and control away from communities, and the erosion of the polity
Virginia Woolf would have loved The Great British Sewing Bee – as three of her novels prove
No full textEffectiveness and cost-effectiveness of offering a chair-based yoga programme in addition to usual care in older adults with multiple long-term conditions: a pragmatic, parallel group, open label, randomised controlled trial
Get PDFBackground
People with multiple long-term conditions are more likely to have poorer health-related quality of life (HRQOL). Yoga has the potential to improve HRQOL. Gentle Years Yoga© (GYY) is a chair-based yoga programme for older adults. We investigated the effectiveness and cost-effectiveness of the GYY programme in older adults with multiple long-term conditions.
Methods
In this pragmatic, multi-site, open, randomised controlled trial, we recruited older adults aged ≥65 years with ≥2 long-term conditions from 15 primary care practices in England and Wales. Participants were randomly assigned to usual care control or a 12-week, group-based, GYY programme delivered face-to-face or online by qualified yoga teachers. The primary outcome was HRQOL (assessed with EQ-5D-5L) over 12 months. Secondary outcomes included anxiety, depression, falls, loneliness, healthcare resource use, and adverse events.
Results
Between October 2019 and October 2021, 454 participants were randomly assigned to the intervention (n=240) and control (n=214) groups. Seven GYY courses were delivered face-to-face and 12 courses were delivered online. The mean number of classes attended among all intervention participants was nine (SD 4, median 10). In our intention-to-treat analysis (n=422), there was no statistically significant difference between trial groups in the primary outcome of HRQOL (adjusted difference in mean EQ-5D-5L = 0.020 [favouring intervention]; 95% CI -0.006 to 0.045, p=0.14). There were also no statistically significant differences in key secondary outcomes. No serious, related adverse events were reported. The incremental cost-effectiveness ratio was £4,546 per quality-adjusted life-year (QALY) and the intervention had a 79% probability of being cost-effective at a willingness-to-pay threshold of £20,000 per QALY.
Conclusions
The offer of a 12-week chair-based yoga programme in addition to usual care did not improve HRQOL in older adults with multiple long-term conditions. However, the intervention was safe, acceptable, and probably cost-effective
Understanding the influence of user-generated content on tourist loyalty behavior in a cultural World Heritage Site
Get PDFThe emergence of social media has revolutionized tourists’ decision-making processes and behaviours. This study focuses on the effect of user-generated content (UGC) on tourist loyalty behaviour by examining structural relationships between destination image, satisfaction, revisit intention, and word-of-mouth (WOM) publicity. Data were collected from domestic tourists to Gulangyu, a World Heritage Site in China. The findings of this study reveal that UGC indirectly affects tourist loyalty behaviour by influencing destination image and satisfaction. Moreover, the results demonstrate that factual UGC and emotional UGC positively affect tourists’ perceived value of the destination, with emotional UGC having a greater influence
A conditional process model of perfectionism, goal-realization, and post-competition mood
Get PDFResearch has recently begun to examine the relationship between multidimensional perfectionism and athletes’ post-competition mood. However, to date, there have been few attempts to examine the interaction between dimensions of perfectionism or model possible explanatory processes. To address these limitations, in the current study we tested a novel conditional process model whereby the relationship between perfectionistic strivings and post-competition affect was mediated by the degree to which goals were considered to have been met (goal-realization) and that this indirect effect was, in turn, moderated by levels of perfectionistic concerns. We tested this model in a sample of 251 athletes who took part in a “Runmageddon” event - a cross-country obstacle race. Athletes completed measures of perfectionism (perfectionistic strivings and perfectionistic concerns) before the race and measures of goal-realization and mood (tense arousal, energetic arousal, and hedonic tone) between 24 to 48 hours after the race. Analyses revealed that perfectionistic strivings were indirectly linked to a more unpleasant post-competition mood (higher tense arousal and lower hedonic tone) via perceptions of lower goal-realization. In addition, these two indirect effects were statistically significant only when perfectionistic concerns were medium and high. The results support the proposed conditional model and suggest the interplay between dimensions of perfectionism is important for athletes’ post-competition mood, and the level of perfectionistic concerns, especially