Evangelical young women, contemporary Christianity, and an empowering self- understanding: a study into how contemporary women of faith understand themselves and God in relation to Dei, Holy Scripture and Christian mission

This thesis combines historical reflection with qualitative research to examine how Christian young women from Evangelical traditions are developing religious self- understanding in empowering ways. It seeks to establish connections between the ways in which historians and feminist theologians have responded to forces of restriction and limitation in Christian women’s past, and the strategies of self-empowerment adopted by Evangelical young women today. This study approaches Christian history and the present condition of female self-understanding through three central questions: How do young women understand themselves in relation to the imago Dei? How do young women understand themselves in relation to the Bible? How do young women understand themselves in relation to Christian mission? The first chapter addresses the ways in which young women are responding to historic denials of woman as the imago Dei and concepts of female inferiority or especial guilt by reclaiming possession of the divine image. The next section discusses how young women are relating to the Bible in empowering ways, both by adopting similar strategies to those utilised throughout Christianity’s past, and through the development of their own patterns of interpretation. Finally, this thesis draws attention to Christian mission as a space of empowerment, examining how young women develop life-enriching knowledge of God and self through involvement with mission. This thesis proposes that as young women continue to develop strategies that enable them to understand themselves and their faith in empowering ways, knowledge of their innate dignity and potential will inspire them — and those who come after them — to witness to God freely and fully in all contexts.

Supporting self-management: development and evaluation of a digital resource for adults with asthma

The problem: Around 300 million people worldwide have asthma and prevalence is increasing. Support for optimal self-management can be effective in improving a range of outcomes and is cost effective, but is underutilised as a treatment strategy. Supporting optimum self-management using digital technology shows promise, but how best to do this is not clear. Aim: The purpose of this project was to explore the potential role of a digital intervention in promoting optimum self-management in adults with asthma. Methods: Following the MRC Guidance on the Development and Evaluation of Complex Interventions which advocates using theory, evidence, user testing and appropriate modelling and piloting, this project had 3 phases. Phase 1: Examination of the literature to inform phases 2 and 3, using systematic review methods and focussed literature searching. Phase 2: Developing the Living Well with Asthma website. A prototype (paper-based) version of the website was developed iteratively with input from a multidisciplinary expert panel, empirical evidence from the literature (from phase 1), and potential end users via focus groups (adults with asthma and practice nurses). Implementation and behaviour change theories informed this process. The paper-based designs were converted to the website through an iterative user centred process (think aloud studies with adults with asthma). Participants considered contents, layout, and navigation. Development was agile using feedback from the think aloud sessions immediately to inform design and subsequent think aloud sessions. Phase 3: A pilot randomised controlled trial over 12 weeks to evaluate the feasibility of a Phase 3 trial of Living Well with Asthma to support self-management. Primary outcomes were 1) recruitment & retention; 2) website use; 3) Asthma Control Questionnaire (ACQ) score change from baseline; 4) Mini Asthma Quality of Life (AQLQ) score change from baseline. Secondary outcomes were patient activation, adherence, lung function, fractional exhaled nitric oxide (FeNO), generic quality of life measure (EQ-5D), medication use, prescribing and health services contacts. Results: Phase1: Demonstrated that while digital interventions show promise, with some evidence of effectiveness in certain outcomes, participants were poorly characterised, telling us little about the reach of these interventions. The interventions themselves were poorly described making drawing definitive conclusions about what worked and what did not impossible. Phase 2: The literature indicated that important aspects to cover in any self-management intervention (digital or not) included: asthma action plans, regular health professional review, trigger avoidance, psychological functioning, self-monitoring, inhaler technique, and goal setting. The website asked users to aim to be symptom free. Key behaviours targeted to achieve this include: optimising medication use (including inhaler technique); attending primary care asthma reviews; using asthma action plans; increasing physical activity levels; and stopping smoking. The website had 11 sections, plus email reminders, which promoted these behaviours. Feedback during think aloud studies was mainly positive with most changes focussing on clarification of language, order of pages and usability issues mainly relating to navigation difficulties. Phase 3: To achieve our recruitment target 5383 potential participants were invited, leading to 51 participants randomised (25 to intervention group). Age range 16-78 years; 75% female; 28% from most deprived quintile. Nineteen (76%) of the intervention group used the website for an average of 23 minutes. Non-significant improvements in favour of the intervention group observed in the ACQ score (-0.36; 95% confidence interval: -0.96, 0.23; p=0.225), and mini-AQLQ scores (0.38; -0.13, 0.89; p=0.136). A significant improvement was observed in the activity limitation domain of the mini-AQLQ (0.60; 0.05 to 1.15; p = 0.034). Secondary outcomes showed increased patient activation and reduced reliance on reliever medication. There was no significant difference in the remaining secondary outcomes. There were no adverse events. Conclusion: Living Well with Asthma has been shown to be acceptable to potential end users, and has potential for effectiveness. This intervention merits further development, and subsequent evaluation in a Phase III full scale RCT.

Devotional reading and dissolving the self: a critical reading of the late medieval Scottish Legendary using Kristevan theory

The Scottish Legendary is a fourteenth century collection of saints’ lives in Older Scots. The prologue describes the lives as ‘merroure’ (mirror) to readers from which ‘men ma ensample ta’ (people may take example). Thus, the Legendary sets out to reveal how the reader is (mirror) thereby moving her to wish to become how she should be (exemplarity). This dissertation argues that, rather than encouraging devotion to saints along purely dogmatic lines, the Legendary transforms the reader’s selfhood by engaging her affectively, i.e. on an emotional and somatic level. By provoking the reader affectively, the text puts the reader into what Julia Kristeva has described as a ‘semiotic state’ which harks back to the reader’s or listener’s pre-cultural, pre-subjective self (Kristeva, 1984). Thus, the text disrupts the reader’s conception of herself as a complete, hermetic subjectivity, thereby dissolving the boundaries of the reader’s self. The Legendary most powerfully infiltrates the reader’s sense of self along these lines in the moments in which female saints’ bodies are tortured and dismembered. These scenes foreground the permeability of human flesh as well as its powerful influence over selfhood. Such images of abjection are, in Kristeva’s words, ‘opposed to I’; by confronting the reader with the disintegration of subjectivity in abjection, the text incites the reader to likewise experience herself as abject, i.e. disintegrable and permeable (Kristeva 1982). As I shall demonstrate, Kristeva’s psychoanalytic theory of the formation of the self offers a fruitful framework for understanding the processes of self-knowledge through reading that these saints’ lives inspire.