Journeying Home: Toward a Feminist Perspective on Pilgrimage

The archetypal feminine has earthy, creative, visceral, emotional and spiritual connotations suggestive of women’s quest for home. I wish to explore the meaning of home within the landscapes of the sacred geography of the soul, invoking the sacredness of place, the meaning of place, and the emotion of place. Findings from a seven-year autoethnographical study of women journeying home to islands in the Thousand Islands, a border region located on the St. Lawrence River between Ontario Canada and upstate New York, demonstrate that these themes figure deeply in the life decisions made by the women studied. ‘The River’ is experienced as a sacred place with great meaning and emotion for the women who call it home. The annual journey ‘home’ to the River takes priority and centrality in their lives while they are physically elsewhere, at work, raising families, getting by. The deep calling of the land and the water, the earthy and watery depths of meaning, family, history, creation, and eternity are felt more readily than expressed. For they say that once one has drunk of the River, one will always hold it in one’s heart. While this visceral lifeline is completed by the annual physical journey home, it also suggests that home is carried within: that the sacred geography of the soul is both inner and outer landscape, its quest both inner and outer pilgrimage

"Engaging with birth stories in pregnancy: a hermeneutic phenomenological study of women's experiences across two generations"

BACKGROUND: The birth story has been widely understood as a crucial source of knowledge about childbirth. What has not been reported is the effect that birth stories may have on primigravid women's understandings of birth. Findings are presented from a qualitative study exploring how two generations of women came to understand birth in the milieu of other's stories. The prior assumption was that birth stories must surely have a positive or negative influence on listeners, steering them towards either medical or midwifery-led models of care. METHODS: A Heideggerian hermeneutic phenomenological approach was used. Twenty UK participants were purposively selected and interviewed. Findings from the initial sample of 10 women who were pregnant in 2012 indicated that virtual media was a primary source of birth stories. This led to recruitment of a second sample of 10 women who gave birth in the 1970s-1980s, to determine whether they were more able to translate information into knowledge via stories told through personal contact and not through virtual technologies RESULTS: Findings revealed the experience of 'being-in-the-world' of birth and of stories in that world. From a Heideggerian perspective, the birth story was constructed through 'idle talk' (the taken for granted assumptions of things, which come into being through language). Both oral stories and those told through technology were described as the 'modern birth story'. The first theme 'Stories are difficult like that', examines the birth story as problematic and considers how stories shape meaning. The second 'It's a generational thing', considers how women from two generations came to understand what their experience might be. The third 'Birth in the twilight of certainty,' examines women's experience of Being in a system of birth as constructed, portrayed and sustained in the stories being shared. CONCLUSIONS: The women pregnant in 2012 framed their expectations in the language of choice, whilst the women who birthed in the 1970s-1980s framed their experience in the language of safety. For both, however, the world of birth was the same; saturated with, and only legitimised by the birth of a healthy baby. Rather than creating meaningful understanding, the 'idle talk' of birth made both cohorts fearful of leaving the relative comfort of the 'system', and of claiming an alternative birth

Development of a National Pain Management Competency Profile to Guide Entry-Level Physiotherapy Education in Canada

Background National strategies from North America call for substantive improvements in entry-level pain management education to help reduce the burden of chronic pain. Past work has generated a valuable set of interprofessional pain management competencies to guide the education of future health professionals. However, there has been very limited work that has explored the development of such competencies for individual professions in different regions. Developing profession-specific competencies tailored to the local context is a necessary first step to integrate them within local regulatory systems. Our group is working toward this goal within the context of entry-level physiotherapy (PT) programs across Canada. Aims This study aimed to create a consensus-based competency profile for pain management, specific to the Canadian PT context. Methods A modified Delphi design was used to achieve consensus across Canadian university-based and clinical pain educators. Results Representatives from 14 entry-level PT programs (93% of Canadian programs) and six clinical educators were recruited. After two rounds, a total of 15 competencies reached the predetermined endorsement threshold (75%). Most participants (85%) reported being “very satisfied” with the process. Conclusions This process achieved consensus on a novel pain management competency profile specific to the Canadian PT context. The resulting profile delineates the necessary abilities required by physiotherapists to manage pain upon entry to practice. Participants were very satisfied with the process. This study also contributes to the emerging literature on integrated research in pain management by profiling research methodology that can be used to inform related work in other health professions and regions

Evolving protocols for research in equitation science

Within the emerging discipline of Equitation Science the application of consistent methodology, including robust objective measures, is required for sound scientific evaluation. This report aims to provide an evaluation of current methodology and to propose some initial guidelines for future research. The value of research, especially that involving small sample sizes, can be enhanced by the application of consistent methodology and reporting enabling results to be compared across studies. This paper includes guidelines for experimental design in studies involving the ridden horse. Equine ethograms currently used are reviewed and factors to be considered in the development of a riddenhorse ethogram are evaluated. An assessment of methods used to collect behavioral and physiological data is included and the use of equipment for measurements (e.g., rein-tension and pressure-sensing instruments) is discussed. Equitation science is a new discipline, subject to evolving viewpoints on research foci and design. Technological advances may improve the accuracy and detail of measurements, but must be used within appropriate and valid experimental designs

Development of a national pain management competency profile to guide entry-level physiotherapy education in Canada

Background National strategies from North America call for substantive improvements in entry-level pain management education to help reduce the burden of chronic pain. Past work has generated a valuable set of interprofessional pain management competencies to guide the education of future health professionals. However, there has been very limited work that has explored the development of such competencies for individual professions in different regions. Developing profession-specific competencies tailored to the local context is a necessary first step to integrate them within local regulatory systems. Our group is working toward this goal within the context of entry-level physiotherapy (PT) programs across Canada. Aims This study aimed to create a consensus-based competency profile for pain management, specific to the Canadian PT context. Methods A modified Delphi design was used to achieve consensus across Canadian university-based and clinical pain educators. Results Representatives from 14 entry-level PT programs (93% of Canadian programs) and six clinical educators were recruited. After two rounds, a total of 15 competencies reached the predetermined endorsement threshold (75%). Most participants (85%) reported being “very satisfied” with the process. Conclusions This process achieved consensus on a novel pain management competency profile specific to the Canadian PT context. The resulting profile delineates the necessary abilities required by physiotherapists to manage pain upon entry to practice. Participants were very satisfied with the process. This study also contributes to the emerging literature on integrated research in pain management by profiling research methodology that can be used to inform related work in other health professions and regions. RÉSUMÉ Contexte: Contexte: Les stratégies nationales nord-américaines préconisent des améliorations sensibles à la formation de base en matiére de prise en charge de la douleur afin de contribuer à la réduction du fardeau de la douleur chronique. Des travaux antérieurs ont généré un ensemble de compétences interprofessionnelles utile en matiére de prise en charge de la douleur afin de guider la formation des futurs professionnels de la santé. Cependant, trés peu de travaux ont porté sur l'acquisition de telles compétences pour des professions individuelles dans différentes régions. L’uisition de compétences spécifiques à une profession adaptées au contexte local est une première étape nécessaire pour leur intégration dans les systèmes réglementaires locaux. Notre groupe travaille à cet objectif dans le cadre de programmes de formation de base en physiothèrapie partout au Canada. Objectifs: Cette étude visait à créer un profil de compétences consensuel pour la prise en charge de la douleur, propre au contexte canadien de la physiothérapie. Méthodes: Un devis Delphi modifié a étè utilisé pour parvenir à un consensus parmi des formateurs en milieu universitaire et clinique en matière de douleur en milieu universitaire et clinique. Résultats: Des représentants de 14 programmes de formation de base en physiothérapie (93 % des programmes canadiens) et de six formateurs en milieu clinique ont été recrutés. Après deux tours, 15 compétences ont atteint le seuil d’approbation prédéterminé (75 %). La plupart des participants (85 %) ont déclaré être « très satisfaits »du processus. Conclusions: Ce processus a permis de dégager un consensus sur un nouveau profil de compétences en matiére de prise en charge de la douleur propre au contexte canadien de la physiothérapie. Ce profil délimite les habiletés requises des physiothérapeutes pour prendre en charge la douleur en début de pratique. Les participants ont été très satisfaits du processus. Cette étude contribue également à la littérature émergente sur la recherche intégrée en matière de prise en charge de la douleur en définissant une méthodologie de recherche qui peut être utilisée pour éclairer des travaux similaires dans d’autres professions de la santé et dans d’autres régions

Over-flexing the horse\u27s neck: A modern equestrian obsession?

We used an opportunistic review of photographs of different adult and juvenile horses walking, trotting, and cantering (n = 828) to compare the angle of the nasal plane relative to vertical in feral and domestic horses at liberty (n = 450) with ridden horses advertised in a popular Australian horse magazine (n = 378). We assumed that horses in advertisements were shown at, what was perceived by the vendors to be, their best. Of the ridden horses, 68% had their nasal plane behind the vertical. The mean angle of the unridden horses at walk, trot, and canter (30.7 ± 11.5; 27.3 ± 12.0; 25.5 ± 11.0) was significantly greater than those of the ridden horses (1.4 ± 14.1; −5.1 ± −11.1; 3.1 ± 15.4, P \u3c 0.001). Surprisingly, unridden domestic horses showed greater angles than feral horses or domestic horses at liberty. We compared adult and juvenile horses in all 3 gaits and found no significant difference. Taken together, these findings demonstrate that the longitudinal neck flexion of the degree desirable by popular opinion in ridden horses is not a common feature of unridden horses moving naturally. Moreover, they suggest that advertised horses in our series are generally being ridden at odds with their natural carriage and contrary to the international rules of dressage (as published by the International Equestrian Federation). These findings are discussed against the backdrop of the established doctrine, which states that carrying a rider necessitates changes in longitudinal flexion, and in the context of the current debate around hyperflexion