Managing Stress and Pain to Prevent Patient Discomfort, Distress and Delayed Wound Healing.

Evidence suggests stress slows the healing of wounds but pain may also play a part. Regular assessment could improve patients' quality of life and recovery time.

Defrauding Daughters Turning Deviant Wives? Reading Female Agency in The Merchant of Venice

Brabantio’s words “Look to her, Moor, if thou hast eyes to see:| She has deceived her father, and may thee” ( Othello , 1.3.292–293) warn Othello about the changing nature of female lo yalty and women’s potential for deviancy. Closely examining d aughters caught in the conflict between anxious fathers and husbands-to- be, this article departs from such paranoid male fa ntasy and instead sets out to explore female deviancy in its legal and dramatic implications with reference to Shakespeare ’s The Merchant of Venice . I will argue that Portia’s and Jessica’s struggle to evade male subsidiarity results in their conscio us positioning themselves on the verge of illegality. Besides occa sioning productive exploration of marriage, law and justice within what Morss (2007:183) terms “the dynamics of human desir e and of social institutions,” I argue that female agency, s een as temporary deviancy and/or self-exclusion, reconfigures the ma le domain by affording the inclusion of previous outsiders (Anto nio, Bassanio and Lorenzo) .

Exercise Prescription for Patients with Non-specific Chronic Low Back Pain: a Qualitative Exploration of Decision Making in Physiotherapy Practice

Background: Providing an effective exercise prescription process for patients with non-specific chronic low back pain (NSCLBP) is a challenging task. Emerging research has indicated that partnership in care and shared decision making are important for people with NSCLBP and calls for further investigation into the approaches used to prescribe exercise. Objective: To explore how shared decision making and patient partnership are addressed by physiotherapists in the process of exercise prescription for patients with NSCLBP. Design: A qualitative study using a philosophical hermeneutic approach. Methods: Eight physiotherapists were each observed on three occasions undertaking their usual clinical activities (total n=24 observations). They conducted brief interviews after each observation and a later in depth semi-structured interview. Iterative hermeneutic strategies were used to interpret the texts and identify the characteristics and processes of exercise prescription for patients with NSCLBP. Findings: The findings revealed how physiotherapy practice often resulted in unequal possibilities for patient participation which were in turn linked to the physiotherapists? assumptions about the patients, clinical orientation, cognitive and decision making processes. Three linked themes emerged: (1) I want them to exercise, (2) Which exercise? - the tension between evidence and everyday practice and (3) Compliance-orientated more than concordance based. Conclusions: This research, by focusing on a patient-centred approach, makes an important contribution to the body of evidence relating to the management of NSCLBP. It challenges physiotherapists to critically appraise their approaches to the prescription of exercise therapy in order to improve outcomes for these patients.