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.

Disappearing acts : making things + making things go away

Thesis (Master's)--University of Washington, 2014

Tourism policy making: the policymakers' perspectives

This research explores tourism policy making, from the perspectives of policy makers using grounded theory. It focuses on Leeds, a city in the North of England, which is characterized by its turbulent environment. The paper identifies themes around policy making, including low status, lack of clarity, uncertainty, lack of consensus and congruence and complexity. Its findings indicate policy making is essentially a social process, involving communication and negotiation between people in the context of wider change. It suggests a social conceptualization, and further research to investigate the communications involved in producing policy rather than the current research focus on the tangible outputs of the process such as a plan or a physical development.

Changing climate, changing decisions : understanding climate adaptation decision-making and the way science supports it

Tese de doutoramento, Ciências do Ambiente, Universidade de Lisboa, Faculdade de Ciências, Universidade Nova de Lisboa, 2015

Making way for change at the Bar: The practical implications of the new Bar Standards Board Handbook

The Legal Services Act 2007 caused a need to change professional conduct rules for lawyers in England and Wales. The Bar Standards Board Handbook brings substantial changes to the way barristers are regulated. Changes include litigation rights, reporting of professional misconduct, an increased focus on chambers, and expansion to include employees of chambers and barristers without practicing certificates (unregistered or non-practicing barristers). The approach to enforcement and supervision moves to include elements of outcome focused, principle based and risk based approaches. These changes have the potential to change the practice of different groups of barristers and the dynamics between them.

(un)childhood: performing the voices and times of childhood through relational video-making

This practice-based PhD is comprised of two interrelated elements: (i) ‘(un)childhood’, a 53’ video-essay shown on two screens; and (ii) a 58286 word written thesis. The project, which is contextualised within the tradition of artists working with their own children on time-based art projects, explores a new approach to timebased artistic work about childhood. While Stan Brakhage (1933-2003), Ernie Gher (1943-), Erik Bullot (1963-) and Mary Kelly (1941-) all documented, photographed and filmed their children over a period of years to produce art projects (experimental films and a time-based installation), these projects were implicitly underpinned by a construction of childhood in which children, shown as they grow, represent the abstract primitive subject. The current project challenges the convention of representing children entirely from the adult’s point of view, as aesthetic objects without a voice, as well as through the artist’s chronological approach to time. Instead, this project focuses on the relational joining of the child’s and adult’s points of view. The artist worked on a video project with her own son over a four-and-a-half year period (between the ages of 5 and 10) through which she developed her ‘relational video-making’ methodology. The video-essay (un)childhood performs the relational voices of childhood as resulting from the verbal interactions of both children and adults. The non-chronological nature of(un)childhood offers an alternative to the linear-temporal approach to the representation of childhood. Through montage and a number of literal allusions to time in its dialogue, (un)childhood performs the relational times of childhood by combining children’s lives in the present with the temporal dimensions that have traditionally constructed childhood: past, future and timeless.

The making of Channel 4

An analysis of the early years of Channel 4 drawing on the recollections of those directly involved.