The narratives of Hardship: : The new and the old poor in the aftermath of the 2008 crisis in Europe

This document is the Accepted Manuscript version of the following article: Hulya Dagdeviren, Matthew Donoghue, and Lars Meier, ‘The narratives of hardship: the new and the old poor in the aftermath of the 2008 crisis in Europe’, The Sociological Review, vol. 65 (2): 369-385, May 2017. The final, definitive version of record is available online at doi: https://doi.org/10.1111/1467-954X.12403. Published by SAGE.This paper examines poverty and hardship in Europe after the 2008 crisis, using household interviews in nine European countries. A number of findings deserve highlighting. First, making a distinction between ‘the old poor’ (those who lived in poverty before as well as after the crisis) and ‘the new poor’ (thosewho fell into hardship after the crisis), we show that hardship is experienced quite differently by these groups. Second, the household narratives showed that while material deprivations constitute an important aspect of hardship, the themes of insecurity and dependency also emerged as fundamental dimensions. In contrast to popular political discourse in countries such as the UK, dependency on welfare or family was experienced as a source of distress and manifested as a form of hardship by participants in all countries covered in this study.Peer reviewedFinal Accepted Versio

"How do pilates trained physiotherapists utilize and value pilates exercise for MSK conditions? A qualitative study"

Background Pilates is a popular exercise therapy approach offering numerous benefits, including muscular strength, flexibility, control, and core stability. Pilates has been widely utilized in the prevention and rehabilitation of a variety of musculoskeletal disorders. Objectives The aim of this study was to explore the experiences and opinions of Pilates trained NHS and private practice physiotherapists in the UK, regarding the perceived benefits, risks, delivery and rationale for this exercise method. Methods This qualitative study used a self‐designed electronic survey to retrieve the views of 30 physiotherapists, who had undertaken formal Pilates Instruction training, recruited by a purposive and snowball sampling method. Questions were either multiple choice or open‐ended, examined via thematic analysis. Results Physiotherapists identified the most important benefits of Pilates as reduction in fear‐avoidance, improving bodily awareness and increasing muscular strength. Exercises that promote general movement were highlighted as being particularly useful, with a majority recommending daily practice for optimum benefit. Participants recognized lack of core strength as a key indicator, whereas others criticized excessive focus on this principle. Conclusions Physiotherapists identified a range of inter‐linked benefits and recognized that Pilates is hugely modifiable. Individualizing exercises can further encourage participation and negate the restriction of some health conditions. NHS and Private Practice Therapists utilize Pilates in a similar way, although rationales for its use may differ, as the justification for Pilates exercise may be evolving. Pilates appears a valuable methodology in the NHS, which can help patients engage with activity

Perceived benefits, rationale and preferences of exercises utilized within Pilates group exercise programmes for people with chronic musculoskeletal conditions : a questionnaire of Pilates‐trained physiotherapists

Introduction: An estimated 29% of the population, around 17.8 million people, live with a musculoskeletal condition in the UK. Pilates exercise has positive benefits, including reducing pain and disability for people with musculoskeletal conditions. The aim of the present study was to explore the views of Pilates ‐ trained physiother- apists in relation to the perceived benefits of, and clinical reasoning for, exercise prescription in Pilates classes. Methods: A qualitative approach was taken to both data collection and analysis, using a thematic framework. Data were collected via electronic questionnaires using open ‐ ended questions. Participants included 15 Pilates ‐ trained physiotherapists who regularly ran Pilates exercise classes within seven private physiotherapy clinics for people with a range of chronic musculoskeletal conditions. Results: The results were organized into six main themes: Perceived benefits 1: Improved function and increased levels of activity. Perceived benefits 2: Improved ability to manage their musculoskeletal condition autonomously; Efficacy of group Pilates exercise; Optimum combination of exercises used within a class; Physiothera- pist rationale for the most effective exercises; Precautions with specific exercises. Conclusions: The study was the first to investigate perceived benefits, rationale and preference for choice of exercise among Pilates ‐ trained physiotherapists. Physiotherapists felt that the Pilates classes facilitated an active lifestyle and self ‐ management approach. They used a combination of exercises in each class to address all the main muscle groups, but some had specific exercise preferences related to the patients' needs. Exercises were linked to evidence around neuromuscular control, direction preference and biomechanical principles

The challenges of communicating research evidence in practice: perspectives from UK health visitors and practice nurses

<p>Background: Health practitioners play a pivotal role in providing patients with up-to-date evidence and health information. Evidence-based practice and patient-centred care are transforming the delivery of healthcare in the UK. Health practitioners are increasingly balancing the need to provide evidence-based information against that of facilitating patient choice, which may not always concur with the evidence base. There is limited research exploring how health practitioners working in the UK, and particularly those more autonomous practitioners such as health visitors and practice nurses working in community practice settings, negotiate this challenge. This research provides a descriptive account of how health visitors and practice nurses negotiate the challenges of communicating health information and research evidence in practice.</p> <p>Methods: A total of eighteen in-depth telephone interviews were conducted in the UK between September 2008 and May 2009. The participants comprised nine health visitors and nine practice nurses, recruited via adverts on a nursing website, posters at a practitioner conference and through recommendation. Thematic analysis, with a focus on constant comparative method, was used to analyse the data.</p> <p>Results: The data were grouped into three main themes: communicating evidence to the critically-minded patient; confidence in communicating evidence; and maintaining the integrity of the patient-practitioner relationship. These findings highlight some of the daily challenges that health visitors and practice nurses face with regard to the complex and dynamic nature of evidence and the changing attitudes and expectations of patients. The findings also highlight the tensions that exist between differing philosophies of evidence-based practice and patient-centred care, which can make communicating about evidence a daunting task.</p> <p>Conclusions: If health practitioners are to be effective at communicating research evidence, we suggest that more research and resources need to be focused on contextual factors, such as how research evidence is negotiated, appraised and communicated within the dynamic patient-practitioner relationship.</p&gt

Negotiating stigmatisation of deviant behaviour: an exploration of locals’ perceptions of nude tourists

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Conceptualising slow tourism: a perspective from Latvia

Slow tourism is perceived as a new type of sustainable tourism and a promising alternative to mass tourism with which tourists, destination managers and tourism service providers are willing to engage. However, inconsistent interpretations impede the clarity of communication between tourism suppliers and consumers. This study re-examines the phenomenon of slow tourism to address this gap in the literature. The focus of the study is Latvia where slowness, until recently, was adopted in tourism branding. This qualitative study revealed that slow tourism is an approach to tourism underpinned by a slow mindset which enhances the core experiential aspect of the phenomenon within ethical boundaries. The environmental and economic aspects appear to be marginal and may fluctuate in intensity according to individuals’ perception. This study offers a theoretical perspective alongside some practical implications for slow tourism and enhances industry awareness of the phenomenon, satisfies consumers’ expectations and improves marketing communications

Intersubjective Identity Work and Sensemaking of Adult Learners on a Postgraduate Coaching Course: Finding the Balance in a World of Dynamic Complexity

This article explores how we make sense of identity in situations of dynamic complexity. It contributes to debates on how dynamic complexity, conceived as periods of heightened uncertainty, disrupts the balance between acting and thinking that is constitutive of sensemaking. The article follows narratives of adult learners (including the first author) aspiring to become academically trained coaches within an emerging industry. We examine dynamic complexity in terms of individuals relating to multiple contexts (e.g. biographical, learning and industry) arguing that each of these creates varying degrees of complexity as individuals relate to a multitude of others within them. We show that heightened uncertainty resulting from such complexity makes greater demands on identity work. This involves both failure (more persistent intransigence of identity) and success (transience of identity). We suggest a mediating role for relationality and reflexivity in making sense of identity as they offer a balance between acting and thinking. By exploring professional identity work of the first author in relation to the participants we explicate the intersubjective nature of identity work and sensemaking. The contribution we make is to theorize identity work as intersubjectively conducted

Missing steps in a staircase: a qualitative study of the perspectives of key stakeholders on the use of adaptive designs in confirmatory trials

Background Despite the promising benefits of adaptive designs (ADs), their routine use, especially in confirmatory trials, is lagging behind the prominence given to them in the statistical literature. Much of the previous research to understand barriers and potential facilitators to the use of ADs has been driven from a pharmaceutical drug development perspective, with little focus on trials in the public sector. In this paper, we explore key stakeholders’ experiences, perceptions and views on barriers and facilitators to the use of ADs in publicly funded confirmatory trials. Methods Semi-structured, in-depth interviews of key stakeholders in clinical trials research (CTU directors, funding board and panel members, statisticians, regulators, chief investigators, data monitoring committee members and health economists) were conducted through telephone or face-to-face sessions, predominantly in the UK. We purposively selected participants sequentially to optimise maximum variation in views and experiences. We employed the framework approach to analyse the qualitative data. Results We interviewed 27 participants. We found some of the perceived barriers to be: lack of knowledge and experience coupled with paucity of case studies, lack of applied training, degree of reluctance to use ADs, lack of bridge funding and time to support design work, lack of statistical expertise, some anxiety about the impact of early trial stopping on researchers’ employment contracts, lack of understanding of acceptable scope of ADs and when ADs are appropriate, and statistical and practical complexities. Reluctance to use ADs seemed to be influenced by: therapeutic area, unfamiliarity, concerns about their robustness in decision-making and acceptability of findings to change practice, perceived complexities and proposed type of AD, among others. Conclusions There are still considerable multifaceted, individual and organisational obstacles to be addressed to improve uptake, and successful implementation of ADs when appropriate. Nevertheless, inferred positive change in attitudes and receptiveness towards the appropriate use of ADs by public funders are supportive and are a stepping stone for the future utilisation of ADs by researchers