Counter-Mappings: Cartography and Difference

Introduction to the co-edited book 'Cartographies of Differences: Interdisciplinary Perspectives

What do people think about running barefoot/with minimalist footwear? A thematic analysis

Objectives

Barefoot running describes when individuals run without footwear. Minimalist running utilizes shoes aimed to mimic being barefoot. Although these forms of running have become increasingly popular, we still know little about how recreational runners perceive them.
Design

In-depth interviews with eight recreational runners were used to gather information about their running experiences with a focus on barefoot and minimalist running.
Methods

Interviews were analysed using a latent level thematic analysis to identify and interpret themes within the data.
Results

Although participants considered barefoot running to be ‘natural’, they also considered it to be extreme. Minimalist running did not produce such aversive reactions. ‘Support’ reassured against concerns and was seen as central in protecting vulnerable body parts and reducing impact forces, but lacked a common or clear definition. A preference for practical over academic knowledge was found. Anecdotal information was generally trusted, as were running stores with gait assessment, but not health professionals.
Conclusion

People often have inconsistent ideas about barefoot and minimalist running, which are often formed by potentially biased sources, which may lead people to make poor decisions about barefoot and minimalist running. It is important to provide high-quality information to enable better decisions to be made about barefoot and minimalist running.

Statement of contribution

What is already known on this subject?
There is no known work on the psychology behind barefoot and minimalist running. We believe our study is the first qualitative study to have investigated views of this increasingly popular form of running.
What does this study add?
The results suggest that although barefoot running is considered ‘natural’, it is also considered ‘extreme’. Minimalist running, however, did not receive such aversive reactions.
‘Support’ was a common concern among runners. Although ‘support’ reassured against concerns and was seen as central in protecting vulnerable body parts and reducing impact forces, it lacked a common or clear definition.
A preference for practical over academic knowledge was found. Anecdotal information was generally trusted, as were running stores with gait assessment, but not health professionals.

The contribution of qualitative research in designing a complex intervention for secondary prevention of coronary heart disease in two different healthcare systems

Background: Developing complex interventions for testing in randomised controlled trials is of increasing importance in healthcare planning. There is a need for careful design of interventions for secondary prevention of coronary heart disease (CHD). It has been suggested that integrating qualitative research in the development of a complex intervention may contribute to optimising its design but there is limited evidence of this in practice. This study aims to examine the contribution of qualitative research in developing a complex intervention to improve the provision and uptake of secondary prevention of CHD within primary care in two different healthcare systems.

Methods: In four general practices, one rural and one urban, in Northern Ireland and the Republic of Ireland, patients with CHD were purposively selected. Four focus groups with patients (N = 23) and four with staff (N = 29) informed the development of the intervention by exploring how it could be tailored and integrated with current secondary prevention activities for CHD in the two healthcare settings. Following an exploratory trial the acceptability and feasibility of the intervention were discussed in four focus groups (17 patients) and 10 interviews (staff). The data were analysed using thematic analysis.

Results: Integrating qualitative research into the development of the intervention provided depth of information about the varying impact, between the two healthcare systems, of different funding and administrative arrangements, on their provision of secondary prevention and identified similar barriers of time constraints, training needs and poor patient motivation. The findings also highlighted the importance to patients of stress management, the need for which had been underestimated by the researchers. The qualitative evaluation provided depth of detail not found in evaluation questionnaires. It highlighted how the intervention needed to be more practical by minimising administration, integrating role plays into behaviour change training, providing more practical information about stress management and removing self-monitoring of lifestyle change.

Conclusion: Qualitative research is integral to developing the design detail of a complex intervention and tailoring its components to address individuals' needs in different healthcare systems. The findings highlight how qualitative research may be a valuable component of the preparation for complex interventions and their evaluation.

Implementing a resuscitation policy for patients at the end of life in an acute hospital setting: qualitative study

Objective : To explore attitudes and experiences of doctors and nurses regarding cardiopulmonary resuscitation for patients with end stage illness in an acute hospital. Design : Qualitative study; thematic analysis of two audio-taped focus groups and four semi-structured interviews. Setting : Acute district hospital, Northern Ireland. Participants : Seven nurses and nine doctors; varying nationality, gender and years of professional experience; involved in cardiopulmonary resuscitation decision-making. Results : Participants reported different interpretations of resuscitation policy and of what do not attempt to resuscitate (DNAR) decisions meant in relation to practical care for patients. This confusion in translating policy into practice contributed to communication difficulties in initiating, documenting and implementing cardiopulmonary resuscitation decisions. Participants were aware of how clinical conditions could change and reported uncertainty in determining end stage illness; they expressed fears of potential consequences of DNAR decisions for patients' care. The more disease-centred approach of doctors to patients' management, compared to nurses' more patient-centred approach, contributed to inter-professional conflict within teams. Doctors identified training needs in applying resuscitation policy and ethical principles in `real life' and nurses identified a need for ongoing professional support, which was perceived as being less available to junior doctors. Personal relationships between staff and patients, cultural reluctance to address sensitive issues and local community expectations of relatives being involved in decisions added to policy implementation difficulties. Conclusions : The findings indicate a need for ongoing staff support and training in applying resuscitation policy to decisions for patients with end stage illness in an acute hospital. They support suggestions that reviews of local resuscitation policy and of national guidelines should be undertaken with openness and honesty regarding the goals, opportunities and difficulties involved in trying to deliver good end of life care in local settings. Palliative Medicine 2007; 21 : 305—312 Key Words: do not attempt resuscitation (DNAR) • end stage illness • inter-professional • policy • resuscitation decisions

Mapping the realm: A New Look at the Gough Map of Britain (c.1360)

The mid-fourteenth century map of Britain known as the ‘Gough’ map is the earliest extant depiction of the island in geographically recognizable form. Hitherto, however, interest in the road or route patterns marked on the map has meant that the map's extraordinarily rich settlement geography has not received the attention it merits and that, consequently, the point of the map may have been missed. The availability of a digital scan of the map coupled with the use of Geographical Information System (GIS) software provides the opportunity for a new look at the Gough map and the questions it poses. Attention in this article is directed to the settlement geography it shows, and in particular to the map's 654 cities, towns, villages, castles and monasteries. Their geographical positions as given on the manuscript are compared with their modern equivalents to shed light on some of the basic questions—the map's place of origin, the purpose or purposes for which it was made and the circumstances of its production—that have posed such a challenge for scholars. Our preliminary conclusion is that the key to understanding the original primary role of the Gough map lies in its accurate but selective depiction of the settlement geography of fourteenth-century Britain.

Repositioning documents in social research

In matters of social research sociologists and other social scientists have tended to view documents primarily as sources of evidence and as receptacles of inert content.The key strategies for data exploration have consequently been associated with various styles of content or thematic analysis. Even when discourse analysis has been recommended, there has been a marked tendency to deal with records, files, and the like, primarily as containers - things to be read, understood, and categorized. In this article, however, the author seeks to demonstrate that by focussing on the functioning of documents instead of content, sociology can embrace a much wider range of approaches to both data collection and analysis. Indeed, the adoption of such a programme encourages researchers to see documents as active agents in the world, and to view documentation as a key component of dynamic networks rather than as a set of static and immutable 'things'.

The experience of cancer cachexia: A qualitative study of advanced cancer patients and their family members

Background
Cachexia in advanced malignancy is a debilitating syndrome which contributes to approximately two million deaths worldwide annually. In spite of advances in understanding the biomedical aspects of cancer cachexia, little attention has been paid to exploring its holistic impact on patients and those who care for them.

Objective
The aim of this paper is to describe the lived experience of cachexia from the perspective of patients with cancer and their family members.

Design
An interpretative phenomenological approach was employed.

Setting and participants
A purposive sampling strategy recruited 15 patients and 12 family members from the Regional Cancer Centre in Northern Ireland.

Method
Each participant was interviewed during 2004/2005 using an unstructured interview. All interviews were recorded and transcribed verbatim. Analysis combined a two stage approach using thematic and interpretative phenomenological analysis.

Results
Analysis generated six superordinate themes that reflected the complex dynamics of the cachexia experience. Themes were: physiological changes in appetite; visuality of cachexia; weight loss interpreted as a bad sign; response from health care professionals; conflict over food; and coping responses.

Conclusions
Findings confirmed that cancer cachexia has far reaching implications for patients and their families, extending beyond physical problems into psychological, social and emotional issues. This insight is a critical first step in the development of more responsive care for these clients.

The immediate Life support course: implementation into an undergraduate nursing programme

This paper outlines how the immediate life support (ILS) course was incorporated into an undergraduate-nursing curriculum in a university in Northern Ireland. It also reports on how the students perceived the impact of this course on their clinical practice. The aim was to develop the student’s ability to recognise the acutely ill patient and to determine the relevance of this to clinical practice. Prior to this the ILS course was only available to qualified nurses and this paper reports on the first time students were provided with an ILS course in an undergraduate setting. The ILS course was delivered to 89 third year nursing students (Adult Branch) and comprised one full teaching day per week over two weeks. Recognised Advanced Life Support (ALS) instructors, in keeping with the United Kingdom Resuscitation Council guidelines, taught the students. Participants completed a 17 item questionnaire which comprised an open-ended section for student comment. Questionnaire data was analysed descriptively using SSPSS version 15.0. Open-ended responses from the questionnaire data was analysed by content and thematic analysis. Results Student feedback reported that the ILS course helped them understand what constituted the acutely ill patient and the role of the nurse in managing a deteriorating situation. Students also reported that they valued the experience as highlighting gaps in their knowledge Conclusion. The inclusion of the ILS course provides students with necessary skills to assess and manage the deteriorating patient. In addition the data from this study suggest the ILS course should be delivered in an inter-professional setting – i.e taught jointly with medical students. References: Department of Health & Quality Assurance Agency (2006). Department of Health Phase 2 benchmarking project – final report. Gloucester: Department of Health, London and Quality Assurance Agency for Higher Education

The Fraternity of Metaphors: Jean-Luc Godard's Film Socialisme

Since the 'completion' of Histoire(s) du cinema (1988-1998), Jean-Luc Godard's work has become increasingly mosaic-like in its forms and configurations, and markedly elegiac in its ruminations on history, cinema, art, and thought. While his associative aesthetic and citational method –including his choice of ‘actors’, and the fragmentariness of his ‘soundtracks’ – can combine to create a distinctive cinematic event, the films themselves refuse to cohere around a unifying concern, or yield to a thematic schema. Not surprisingly, Film Socialisme does not offer us the illusion of narrative or structural integrity anymore than it contributes to the quotidian rhetoric of political and moral argument. It is, however, a political film in the sense that it alters something more fundamental than opinions and points of view. It transforms a way of seeing and understanding reality and history, fiction and documentary, images, and images of images. If anything, it belongs to that dissident or ‘dissensual’ category of artwork capable of ‘emancipating the spectator’ by disturbing what Jacques Rancière terms ‘the distribution of the sensible’ in that it generates gaps, openings, and spaces, poses questions, invites associations without positing a fixed position, imposing an interpretation, or allowing itself to invest in the illusion of expressive objectivity and the stability of meaning. The myriad citations and fragments that comprise the film are never intended to culminate into anything cohesive, never mind conclusive. In one sense, they have no source and no context beyond their moment in the film itself, and what we make of that moment. This article studies the degree to which Godard allows these images and sounds to combine and collide, associate and dissolve in this film, arguing that Film Socialisme is both an important intervention in the history of contemporary cinema, and necessary point of reference in any serious discussion of the relations between that cinema and political reality.