"Trapped": Gender, Identities and PE

Physical Education (PE) is one of the most gendered school subjects, and is historically based on a binary which normalises a difference between young men and young women. As young people develop through adolescence, their social lives are characterised by interconnected social fields, including schooling, sport and media. This study sought to explore how young people negotiate their gendered identities within, and across, these interconnected fields using a Bourdieusian analysis. I used a mixed-methods approach of collective case studies to answer three research questions: 1. What role does sport play in the ways young people negotiate their gendered identity? 2. What role do schooling and media messages play in reproducing gender norms for young people? 3. How does social class influence how young people understand sport and their gendered identity? My methods combined a content and narrative analysis of media messages produced by four online sports media outlets during Rio 2016 Olympic Games with case studies in three demographically different schools in North East England. In each school, Year 11 students completed a questionnaire about their participation in sport and physical activity, coupled with their views of masculinity and femininity. Following this, interviews with 70 young people (33 males, 37 females) were conducted which focused on how young people negotiate their gendered identities within different social fields. Using Bourdieusian concepts of habitus, field and capital, this study has shown that these young people are strongly influenced by rigid and stereotypical representations of masculinity and femininity which are often conflated with binary notions of biological sex. The internalisation of these norms within one’s gendered habitus has meant that many young people expressed a sense of being “trapped” by these rigid notions of “acceptable” gendered behaviours, and consequently reproduce an ideology of difference between masculinity and femininity. Sport is internalised as “natural” within young men’s habitus, where participation and excellence in the “right” sport can lead to the accrual of social status and popularity. In contrast, the “sporty” female is othered, and little capital can be accrued for female participation in sport. Instead, young women are pressured to presenting an image of a “healthy” female appearance (one which is often unattainable as both skinny and curvy) through a symbolic attention to the body. Many young women go to the gym, but do not engage in vigorous exercise when they are there. Within this thesis, I refer to young people playing the game of gender, whereby there are “rules”, tactics, referees and winners/losers. The expectations of the game differ depending on whether the individual is male or female, and also on one’s classed position. This metaphor demonstrates an awareness that young people can be simultaneously affected by both structure and agency. By using tactics and strategy to manipulate one’s own gendered identity, young people can show agency. However, the rewarding of stereotypical and binary representations of masculinity and femininity through capital often means that many young people feel pressure to reproduce normative behaviours which do not challenge the status quo of the doxa. This PhD paints a negative image of how schooling and PE reinforce gender norms which prevent many young people experimenting and exploring their own gendered identities. However, through challenging young people’s reflexivity during the interview process, I found that many young people can reflect on their behaviours, bringing the often-non-conscious habitus into consciousness. This suggests that to challenge taken-for-granted norms of the habitus, pedagogy and research must encourage this reflexivity and force young people to think about gender in ways they have not done before

Sequent and hypersequent calculi for abelian and łukasiewicz logics

We present two embeddings of Łukasiewicz logicŁinto Meyer and Slaney's Abelian logicA, the logic of lattice-ordered Abelian groups. We give new analytic proof systems forAand use the embeddings to derive corresponding systems forŁ. These include hypersequent calculi, terminating hypersequent calculi, co-NP labeled sequent calculi, and unlabeled sequent calculi

Semantic categorisation of a word supports its phonological integrity in verbal short-term memory

In three immediate serial recall (ISR) experiments we tested the hypothesis that interactive processing between semantics and phonology supports phonological coherence in verbal short-term memory (STM). Participants categorised spoken words in six-item lists as they were presented, according to their semantic or phonological properties, then repeated the items in presentation order (Experiment 1). Despite matched categorisation performance between conditions, semantically-categorised words were correctly recalled more often than phonologically-categorised words. This accuracy advantage in the semantic condition was accompanied by fewer phoneme recombination errors. Comparisons with a no- categorisation ISR baseline (Experiment 2) indicated that, although categorisations were disruptive overall, recombination errors were specifically rarer following semantic cate- gorisation. Experiment 3 replicated the key findings from Experiment 1 and also revealed fewer phonologically-related errors following semantic categorisation compared to a per- ceptual categorisation of high or low pitch. Therefore, augmented activation of semantic representations stabilises the phonological traces of words within verbal short-term memory, in line with the ‘‘semantic binding” hypothesis

Managed Activity Graded Exercise iN Teenagers and pre-Adolescents (MAGENTA) feasibility randomised controlled trial:study protocol

INTRODUCTION: Paediatric chronic fatigue syndrome or myalgic encephalomyelitis (CFS/ME) is a relatively common and disabling condition, yet there is a limited evidence base for treatment. There is good evidence that graded exercise therapy is moderately effective in adults with CFS/ME, but there is little evidence for the effectiveness, cost-effectiveness, acceptability or best method of delivery for paediatric CFS/ME. This study aims to investigate the acceptability and feasibility of carrying out a multicentre randomised controlled trial investigating the effectiveness of graded exercise therapy compared with activity management for children/teenagers who are mildly or moderately affected with CFS/ME. METHODS AND ANALYSIS: 100 paediatric patients (8–17 years) with CFS/ME will be recruited from 3 specialist UK National Health Service (NHS) CFS/ME services (Bath, Cambridge and Newcastle). Patients will be randomised (1:1) to receive either graded exercise therapy or activity management. Feasibility analysis will include the number of young people eligible, approached and consented to the trial; attrition rate and treatment adherence; questionnaire and accelerometer completion rates. Integrated qualitative methods will ascertain perceptions of feasibility and acceptability of recruitment, randomisation and the interventions. All adverse events will be monitored to assess the safety of the trial. ETHICS AND DISSEMINATION: The trial has received ethical approval from the National Research Ethics Service (South West—Frenchay 15/SW/0124). TRIAL REGISTRATION NUMBER: ISRCTN23962803; Pre-results

Clinical effectiveness and cost-effectiveness of cognitive behavioural therapy as an adjunct to pharmacotherapy for treatment-resistant depression in primary care: the CoBalT randomised controlled trial

Background: Only one-third of patients with depression respond fully to treatment with antidepressant medication. However, there is little robust evidence to guide the management of those whose symptoms are 'treatment resistant'.<p></p> Objective: The CoBalT trial examined the clinical effectiveness and cost-effectiveness of cognitive behavioural therapy (CBT) as an adjunct to usual care (including pharmacotherapy) for primary care patients with treatment-resistant depression (TRD) compared with usual care alone.<p></p> Design: Pragmatic, multicentre individually randomised controlled trial with follow-up at 3, 6, 9 and 12 months. A subset took part in a qualitative study investigating views and experiences of CBT, reasons for completing/not completing therapy, and usual care for TRD.<p></p> Setting: General practices in Bristol, Exeter and Glasgow, and surrounding areas.<p></p> Participants: Patients aged 18-75 years who had TRD [on antidepressants for 6 weeks, had adhered to medication, Beck Depression Inventory, 2nd version (BDI-II) score of 14 and fulfilled the International Classification of Diseases and Related Health Problems, Tenth edition criteria for depression]. Individuals were excluded who (1) had bipolar disorder/psychosis or major alcohol/substance abuse problems; (2) were unable to complete the questionnaires; or (3) were pregnant, as were those currently receiving CBT/other psychotherapy/secondary care for depression, or who had received CBT in the past 3 years.<p></p> Interventions: Participants were randomised, using a computer-generated code, to usual care or CBT (12-18 sessions) in addition to usual care.<p></p> Main outcome measures: The primary outcome was 'response', defined as 50% reduction in depressive symptoms (BDI-II score) at 6 months compared with baseline. Secondary outcomes included BDI-II score as a continuous variable, remission of symptoms (BDI-II score of < 10), quality of life, anxiety and antidepressant use at 6 and 12 months. Data on health and social care use, personal costs, and time off work were collected at 6 and 12 months. Costs from these three perspectives were reported using a cost-consequence analysis. A cost-utility analysis compared health and social care costs with quality adjusted life-years.<p></p> Results: A total of 469 patients were randomised (intervention: n = 234; usual care: n = 235), with 422 participants (90%) and 396 (84%) followed up at 6 and 12 months. Ninety-five participants (46.1%) in the intervention group met criteria for 'response' at 6 months compared with 46 (21.6%) in the usual-care group {odds ratio [OR] 3.26 [95% confidence interval (CI) 2.10 to 5.06], p < 0.001}. In repeated measures analyses using data from 6 and 12 months, the OR for 'response' was 2.89 (95% CI 2.03 to 4.10, p < 0.001) and for a secondary 'remission' outcome (BDI-II score of < 10) 2.74 (95% CI 1.82 to 4.13, p < 0.001). The mean cost of CBT per participant was £910, the incremental health and social care cost £850, the incremental QALY gain 0.057 and incremental cost-effectiveness ratio £14,911. Forty participants were interviewed. Patients described CBT as challenging but helping them to manage their depression; listed social, emotional and practical reasons for not completing treatment; and described usual care as mainly taking medication.<p></p> Conclusions: Among patients who have not responded to antidepressants, augmenting usual care with CBT is effective in reducing depressive symptoms, and these effects, including outcomes reflecting remission, are maintained over 12 months. The intervention was cost-effective based on the National Institute for Health and Care Excellence threshold. Patients may experience CBT as difficult but effective. Further research should evaluate long-term effectiveness, as this would have major implications for the recommended treatment of depression.<p></p&gt

Towards a Proof Theory of G\"odel Modal Logics

Analytic proof calculi are introduced for box and diamond fragments of basic modal fuzzy logics that combine the Kripke semantics of modal logic K with the many-valued semantics of G\"odel logic. The calculi are used to establish completeness and complexity results for these fragments

Choice of Moisturiser for Eczema Treatment (COMET):feasibility study of a randomised controlled parallel group trial in children recruited from primary care

OBJECTIVES: To determine the feasibility of a randomised controlled trial of ‘leave on’ emollients for children with eczema. DESIGN: Single-centre, pragmatic, 4-arm, observer-blinded, parallel, randomised feasibility trial. SETTING: General practices in the UK. PARTICIPANTS: Children with eczema aged 1 month to <5 years. OUTCOME MEASURES: Primary outcome—proportion of parents who reported use of the allocated study emollient every day for the duration of follow-up (12 weeks). Other feasibility outcomes—participant recruitment and retention, data collection and completeness and blinding of observers to allocation. INTERVENTIONS: Aveeno lotion, Diprobase cream, Doublebase gel, Hydromol ointment. RESULTS: 197 children were recruited—107 by self-referral (mainly via practice mail-outs) and 90 by inconsultation (clinician consenting and randomising) pathways. Participants recruited inconsultation were younger, had more severe Patient-Oriented Eczema Measure scores and were more likely to withdraw than self-referrals. Parents of 20 (10%) of all the randomised participants reported using the allocated emollient daily for 84 days. The use of other non-study emollients was common. Completeness of data collected by parent-held daily diaries and at monthly study visits was good. Daily diaries were liked (81%) but mainly completed on paper rather than via electronic (‘app’) form. Major costs drivers were general practitioner consultations and eczema-related prescriptions. Observer unblinding was infrequent, and occurred at the baseline or first follow-up visit through accidental disclosure. CONCLUSIONS: It is feasible in a primary care setting to recruit and randomise young children with eczema to emollients, follow them up and collect relevant trial data, while keeping observers blinded to their allocation. However, reported use of emollients (study and others) has design implications for future trials. TRIAL REGISTRATION NUMBER: ISRCTN21828118/EudraCT2013-003001-26