Developing a Contextual Model towards Understanding Low Back Pain

Recent advances in mobile computing and sensor technology have provided new opportunities in data collection and analysis, especially in the medical fields of research. Low back pain is a key area within chronic pain management. It is a widespread problem and a major contributor towards disability worldwide. Researchers have concluded that pain can be an individualistic experience. Evidence from other fields of research show that studying the context of the phenomena can allow for a better understanding of its nature. Existing studies may not consider the full context of the patients’ pain, and collect data infrequently (e.g. monthly or yearly). An explanation for this could be due to the cost and difficulty of collecting such data in the past. In this research, we propose a descriptive contextual model that extends a current low back pain model, with contextual attributes and factors. The goal of this research is to provide researchers with a descriptive contextual classification of variables into their respective factors, and to guide future studies in collecting such data, by utilizing advances in mobile and sensor technology

Towards a science and practice of resilience in the face of pain

The primary objective of this paper is to discuss how a resilience approach to (chronic) pain may advance our current understanding of (mal)adaptation to pain. Different resilience perspectives are described, and future challenges for research, prevention and treatment of (chronic) pain are discussed. Literature searches were performed in Web of Science and PubMed to identify relevant literature on risk and resilience in the context of pain. Resilience can be best defined as the ability to restore and sustain living a fulfilling life in the presence of pain. The Psychological Flexibility Model, the Broaden-and-Build Theory, and Self-Determination Theory are described as theories that may provide insight into resilience within the context of (chronic) pain. We describe how a resilience paradigm shifts the outcomes to pursue in pain research and intervention and argue the need for including positive outcomes in addition to negative outcomes. Psychological flexibility, positive affect and basic psychological needs satisfaction are described as potentially important resilience mechanisms with the potential to target both sustainability and recovery from pain. A resilience approach to chronic pain may have important implications for the prevention and treatment of chronic pain problems, as it may give specific indications on how to empower patients to continue living a fulfilling life (in the presence of pain)

Using interpretative phenomenological analysis to inform physiotherapy practice: An introduction with reference to the lived experience of cerebellar ataxia

The attached file is a pre-published version of the full and final paper which can be found at the link below.This article has been made available through the Brunel Open Access Publishing Fund.Qualitative research methods that focus on the lived experience of people with health conditions are relatively underutilised in physiotherapy research. This article aims to introduce interpretative phenomenological analysis (IPA), a research methodology oriented toward exploring and understanding the experience of a particular phenomenon (e.g., living with spinal cord injury or chronic pain, or being the carer of someone with a particular health condition). Researchers using IPA try to find out how people make sense of their experiences and the meanings they attach to them. The findings from IPA research are highly nuanced and offer a fine grained understanding that can be used to contextualise existing quantitative research, to inform understanding of novel or underresearched topics or, in their own right, to provoke a reappraisal of what is considered known about a specified phenomenon. We advocate IPA as a useful and accessible approach to qualitative research that can be used in the clinical setting to inform physiotherapy practice and the development of services from the perspective of individuals with particular health conditions.This article is available through the Brunel Open Access Publishing Fund

Context matters: combined influence of participation and intellectual stimulation on the promotion-focus/employee creativity relationship

In this paper, we examined the interactive effects of two contexts — participation and intellectual stimulation, and promotion focus on creativity. On the basis of a multi-organization sample of 213 employees, we tested and found that although promotion focus was positively related to creativity, the relationship between promotion focus and creativity was most positive when both participation and leader intellectual stimulation were high. We discuss the way contexts in combination influence employee creativity for promotion-oriented individuals, through increasing decision latitude as well as stimulating and promoting creativity

European local authorities’ financial resilience in the face of austerity: a comparison across Austria, Italy and England

European local authorities have been particularly stricken by the current context of decline and cutback management, and represent an ideal place where to study how governments respond to shocks affecting their financial conditions and management. Along these lines, this paper adopt the perspective of financial resilience for looking at the current context of austerity, and related responses, by shedding new lights on the role of internal capacities and conditions in influencing such responses and, ultimately, performance. Through a multiple case study analysis based on 12 European local authorities in Austria, Italy and England, the paper identifies the main shocks perceived by local management, the related short-term and long-term responses, highlighting the dynamics of financial vulnerabilty, awareness, anticipatory capacity, flexibility and recovery ability (ie, financial resilience) in its interaction with the external context and shocks. From the analysis, four patterns of resilience emerge: pro-active resilience, adaptive resilience, passive/fatalist resilience, complacent resilience

From the clinic to the lab (and back) : a call for laboratory research to optimize cognitive-behaviour treatment of pain

Cognitive behavioural therapy (CBT) is the dominant psychological treatment for chronic pain. CBT covers a mixture of aims and a broad range of techniques, including attentional control, modification of maladaptive beliefs and coping strategies and flexible goal setting and acceptance. Patients are exposed to varying selections of these strategies, and a major challenge for clinical practice is to determine what works for whom in which context. We propose that incorporating laboratory research into translational behaviour medicine is a critical developmental step that will help optimizing CBT and provide examples of representative experimental research programs

Exploring the beliefs of young people with cerebral palsy and their families about sport and physical activity in relation to paediatric physiotherapy exercise

Background and Purpose Physiotherapy programmes are an important part of therapeutic input for young people with cerebral palsy (YPwCP), but adherence can be problematic. The involvement of physical activities (PA) could be a possible solution, but YPwCP have lower levels of physical leisure participation than their typically developing peers. Method This qualitative study aimed to explore the beliefs of young people with disabilities and their families about PA in relation to physiotherapy programmes. PA was broadly defined to include not only disability sports, but any aerobic exercise and ‘beliefs’ as perceptions, knowledge and attitudes. A purposive sample of participants from the researcher’s physiotherapy service was invited to undertake semi-structured interviews. Inclusion criteria were 8-19 years of age, having a disability, cognitively able and able to understand and express themselves in English. Parents/care givers were included to capture their discrete perspectives and enable reflective discussion about any synergies or differences between their beliefs and those of their children. Data was analysed using Interpretative Phenomenological Analysis (IPA). Results Two YPwCP and their mothers participated. Three main themes arose: • The feelings evoked by PA, in particular feelings of otherness were underpinned by the desire for ‘normal’ participatory experiences alongside typically developing peers. • External factors and others attitudes affect participation in PA, in particular unfavourable judgements and tokenism within mainstream environments contrasted with a normalising acceptance in disability sports settings. • Physiotherapy and PA are different, participants believed that physiotherapy, physiotherapists and medical venues possessed superior quality, legitimacy and potency. Conclusion The study revealed YPwCP and families’ unique beliefs and preferences concerning PA and the status of physiotherapy and physiotherapists within daily life. Physiotherapists should consider the influence of these beliefs when seeking to signpost to PA or enhance longer-term adherence to programmes within a context of reduced clinical contact

A critical perspective on stigma in physiotherapy: the example of weight stigma

"Manipulating practices is the first ever collection of critical physiotherapy studies and comes at a time of unprecedented change in the profession. Written as a collaboration between 20 authors, many members of the Critical Physiotherapy Network (CPN), the book uncovers the growing body of critical thinking now emerging in physiotherapy. From topics as diverse as 21st century education, ethics, evidence-based practice, touch, and equine therapy; and approaches as varied as disability and performance studies, feminism, logic, narrative theory, new materialism, and phenomenology, the book explores ways of thinking ‘otherwise’ about physiotherapy. Over 16 chapters written by authors from six different countries, Manipulating practices offers insights from some of physiotherapy’s most radical thinkers. The book is also an innovative venture into open source publishing, making it entirely free to download and read. In keeping with the objectives of the CPN, the chapters expose a range of concepts, ideas and practices to critical scrutiny, and reflect the profession’s growing interest in critiquing taken-for-granted ways of practicing and thinking. Manipulating practices will be of interest to clinicians, lecturers, policy-makers, researchers and students, and will provide new impetus to help physiotherapists imagine how the profession might grow and develop into the future.""«Manipulating practices» er den første vitenskapelige antologien som samler kritiske studier innen fysioterapi, og lanseres i en tid der profesjonen er preget av store forandringer. Antologien representerer et samarbeidsprosjekt mellom 20 forskere, hvor majoriteten er medlemmer av Critical Physiotherapy Network (CNP) – et internasjonalt nettverk av forskere og klinikere fra hele verden. Antologien synliggjør den økende tendensen til kritisk tenkning som er i ferd med å vokse frem innenfor fysioterapi. Gjennom å fokusere på varierte tema som utdanning, etikk, evidensbasert praksis, berøring og terapiridning, samt en bred tilnærming som inkluderer funksjonshemming, performance-studier, feminisme, logikk, narrativ teori, ny materialisme og fenomenologi, utforsker antologien nye og annerledes tanker om fysioterapi som fag og profesjon. Antologiens 16 kapitler er skrevet av forskere fra seks ulike land og gir innsikt i forskningen til noen av de mest radikale forskerne i det internasjonale fysioterapimiljøet. Boken er også innovativ gjennom at den publiseres som open access, hvilket betyr at den kan lastes ned og leses gratis og dermed gjøres allment tilgjengelig. I tråd med ambisjonen for CPN, utforskes en rekke ulike begreper, ideer og praktiske tilnærminger relatert til kritisk tenkning innenfor fysioterapi. Slik gjenspeiles også profesjonens økende interesse for å kritisere etablerte måter å praktisere og tenke på, som tidligere har vært tatt for gitt. «Manipulating practices» vil være av interesse for forskere, klinikere, forelesere, politikere og studenter. Antologien vil forhåpentligvis bidra med nye impulser med henblikk på hvordan fysioterapiprofesjonen vil vokse og utvikle seg fremover.

Making mathematics phenomenal : Based on an Inaugural Professorial Lecture delivered at the Institute of Education, University of London, on 14 March 2012

Mathematics is often portrayed as an 'abstract' cerebral subject, beyond the reach of many. In response, research with digital technology has led to innovative design in which mathematics can be experienced to some extent like everyday phenomena. I examine how careful design can 'phenomenalise' mathematics - that is to say create mathematical artefacts that can be directly experienced to support not only engagement but also focus on key ideas. I argue that mathematical knowledge gained through interaction with suitably designed tools can prioritise powerful reasons for doing mathematics, imbuing it with a sort of utility and offering learners hooks on which they can gradually develop fluency and connected understanding. Illustrative examples are taken from conventional topics such as number, algebra, geometry and statistics but also from novel situations where mathematical methods are juxtaposed with social values. The suggestion that prioritising utility supports a more natural way of learning mathematics emerges directly from constructionist pedagogy and inferentialist philosophy