"Present Your Bodies":Film Style and Unknowability in Jessica Hausner's <i>Lourdes </i>and Dietrich Bruggemann's <i>Stations of the Cross</i>

Since 2005, a number of European films have emerged examining the legacy of Christianity in Western Europe, and the ways in which men, women and children struggle to negotiate questions of religion and secularity, the personal and the institutional, faith and doubt. This article looks at two of these films—Jessica Hausner’s Lourdes (2009) and Dietrich Brüggemann’s Stations of the Cross (2014)—in relation to questions of religious experience, the female body and film style. In both films the battle between these opposing categories is played out on the bodies of women—a paraplegic MS sufferer in Lourdes, an anorexic teen in Stations of the Cross—and both the films end ambiguously with what may, or may not, be a miracle of sorts: a confirmation of faith or a rebuttal. I wish to connect this ambiguity to the use of a very distinctive mise-en-scene in both films, which relies on a heavily restricted colour palate; highly formalised, painterly-compositions; and crucially what David Bordwell has termed “planimetric photography”: a shooting style that eschews depth or diagonals, refusing the spectator entrance into the image and holding her instead at a deliberate distance. My argument, in short, is that these stylistic choices—while gesturing towards a tradition of Christian art—also refuse the spectator either visual or haptic knowledge of the events that the characters undergo. Rather, they are suggestive of the fundamental unknowability that characterises religious experience, leaving us alone, outside of the action, forced to negotiate ourselves between belief and doubt

Arizona\u27s Torres v. Terrell and Section 318.03: The Wild West of Pre-Embryo Disposition

In this Note, Part I examines the three main approaches used in other state supreme court decisions to decide pre-embryo disposition disputes, as well as three perspectives on the legal status of the pre-embryo, and compares them with Arizona’s emerging law. Part II summarizes Arizona’s Torres trial court order and opinion and section 318.03. Part III then analyzes whether the Torres orders and Arizona’s new statutory “most likely to lead to birth standard”12 present constitutional issues and concludes that the trial court’s order, if reinstated by the Arizona Supreme Court, and section 318.03 can be challenged on substantive due process and equal protection grounds. Finally, this Note concludes that, because the initial Torres ruling and section 318.03 create significant legal and policy concerns, in addition to constitutional concerns, patients considering IVF in Arizona should be very cautious

Explaining Young Adolescents’ Physical Activity Decision-Making Using the Prototype Willingness Model of Health Behaviour

Background: Health guidelines suggest young people spend 60 minutes per day in moderate-to-vigorous physical activity, but the proportion meeting this target falls during early adolescence, a developmental stage characterised by impulsive choices not accounted for by behavioural theories based on rational beliefs and intentions. The Prototype Willingness Model (PWM) is a dual-process account of reasoned and social reaction decision-making in which perceptions of prototypes, or social images, influence impulsive willingness to engage in behaviour. Aim: To investigate whether prototype perceptions and willingness constructs can explain variance in young adolescents’ daily physical activity (PA) over and above reasoned action variables of intention, attitudes and norms. Study 1 used focus groups to explore constructs in the PWM. Thematic analysis revealed preliminary evidence that adolescents make both reasoned and more impulsive decisions about physical activity in the presence of peers. Participants were able to describe active and inactive prototypes. Study 2 investigated how far PWM variables explain variance in objectivelymeasured daily average PA. In this prospective study, prototype perceptions and willingness explained additional variance over and above reasoned action variables. Perceived similarity to active images was a significant predictor. Study 3 used implicit association tests to measure whether unconscious bias towards, and similarity to, active and inactive prototypes explained variance in physical activity. Explicit and implicit measures were only weakly correlated, but implicit bias towards active images was stronger in older participants. Study 4 tested of the extent to which PWM variables explain variance in physical activity in large sample of young adolescents, n= 9,230. Prototype similarity predicted significant variance in activity, and variables from the PMW’s social reaction path explained 4% of variance over and above reasoned action variables. Conclusion: This thesis makes a novel contribution to the explanation of adolescent physical activity with evidence that prototype perceptions explain unique variance in daily MVPA. Interventions that target perceived similarity to active and inactive prototypes have potential to increase activity levels

Physiotherapy intervention in Parkinson's disease: systematic review and meta-analysis

Objective To assess the effectiveness of physiotherapy compared with no intervention in patients with Parkinson’s disease. Design Systematic review and meta-analysis of randomised controlled trials. Data sources Literature databases, trial registries, journals, abstract books, and conference proceedings, and reference lists, searched up to the end of January 2012. Review methods Randomised controlled trials comparing physiotherapy with no intervention in patients with Parkinson’s disease were eligible. Two authors independently abstracted data from each trial. Standard meta-analysis methods were used to assess the effectiveness of physiotherapy compared with no intervention. Tests for heterogeneity were used to assess for differences in treatment effect across different physiotherapy interventions used. Outcome measures were gait, functional mobility and balance, falls, clinician rated impairment and disability measures, patient rated quality of life, adverse events, compliance, and economic analysis outcomes. Results 39 trials of 1827 participants met the inclusion criteria, of which 29 trials provided data for the meta-analyses. Significant benefit from physiotherapy was reported for nine of 18 outcomes assessed. Outcomes which may be clinically significant were speed (0.04 m/s, 95% confidence interval 0.02 to 0.06, P<0.001), Berg balance scale (3.71 points, 2.30 to 5.11, P<0.001), and scores on the unified Parkinson’s disease rating scale (total score −6.15 points, −8.57 to −3.73, P<0.001; activities of daily living subscore −1.36, −2.41 to −0.30, P=0.01; motor subscore −5.01, −6.30 to −3.72, P<0.001). Indirect comparisons of the different physiotherapy interventions found no evidence that the treatment effect differed across the interventions for any outcomes assessed, apart from motor subscores on the unified Parkinson’s disease rating scale (in which one trial was found to be the cause of the heterogeneity). Conclusions Physiotherapy has short term benefits in Parkinson’s disease. A wide range of physiotherapy techniques are currently used to treat Parkinson’s disease, with little difference in treatment effects. Large, well designed, randomised controlled trials with improved methodology and reporting are needed to assess the efficacy and cost effectiveness of physiotherapy for treating Parkinson’s disease in the longer term

Associations between fitness, physical activity and mental health in a community sample of young British adolescents: baseline data from the Fit to Study trial

Objectives. To examine relationships between fitness, physical activity and psychosocial problems among English secondary school pupils and to explore how components of physically active lifestyles are associated with mental health and well-being. Methods. A total of 7385 participants aged 11–13 took a fitness test and completed self-reported measures of physical activity, attitudes to activity, psychosocial problems and self-esteem during the Fit to Study trial. Multilevel regression, which modelled school-level cluster effects, estimated relationships between activity, fitness and psychosocial problems; canonical correlation analysis (CCA) explored modes of covariation between active lifestyle and mental health variables. Models were adjusted for covariates of sex, free school meal status, age, and time and location of assessments. Results. Higher fitness was linked with fewer internalising problems (β=−0.23; 95% CI −0.26 to −0.21; p<0.001). More activity was also related to fewer internalising symptoms (β=−0.24; 95% CI −0.27 to −0.20; p<0.001); the relationship between activity and internalising problems was significantly stronger for boys than for girls. Fitness and activity were also favourably related to externalising symptoms, with smaller effect sizes. One significant CCA mode, with a canonical correlation of 0.52 (p=0.001), was characterised high cross-loadings for positive attitudes to activity (0.46) and habitual activity (0.42) among lifestyle variables; and for physical and global self-esteem (0.47 and 0.42) among mental health variables. Conclusion. Model-based and data-driven analysis methods indicate fitness as well as physical activity are linked to adolescent mental health. If effect direction is established, fitness monitoring could complement physical activity measurement when tracking public health

Fit to Study: Reflections on designing and implementing a large-scale randomized controlled trial in secondary schools

Background. The randomised controlled trial (RCT) design is increasingly common among studies seeking good-quality evidence to advance educational neuroscience, but conducting RCTs in schools is challenging. Fit to Study, one of six such trials funded by the Education Endowment Foundation and Wellcome Trust, tested an intervention to increase vigorous physical activity during PE lessons on maths attainment among pupils aged 12–13. This review of designing and conducting an RCT in 104 schools is intended as a resource on which researchers might draw for future studies. Method. We consider intervention design and delivery; recruitment, retention, trial management, data collection and analysis including ethical considerations and working with evaluators. Results. Teacher training, intervention delivery and data collection during large-scale RCTs require a flexible approach appropriate to educational settings, which in turn entails planning and resources. Conclusion. Simple interventions, with few outcome measures and minimal missing data, are preferable to more complex designs

Lee Silverman voice treatment versus standard NHS speech and language therapy versus control in Parkinson's disease (PD COMM pilot):study protocol for a randomized controlled trial

Background: Parkinson’s disease is a common movement disorder affecting approximately 127,000 people in the UK, with an estimated two thirds having speech-related problems. Currently there is no preferred approach to speech and language therapy within the NHS and there is little evidence for the effectiveness of standard NHS therapy or Lee Silverman voice treatment. This trial aims to investigate the feasibility and acceptability of randomizing people with Parkinson’s disease-related speech or voice problems to Lee Silverman voice treatment or standard speech and language therapy compared to a no-intervention control. Methods/Design: The PD COMM pilot is a three arm, assessor-blinded, randomized controlled trial. Randomization will be computer-generated with participants randomized at a ratio of 1:1:1. Participants randomized to intervention arms will be immediately referred to the appropriate speech and language therapist. The target population are patients with a confirmed diagnosis of idiopathic Parkinson’s disease who have problems with their speech or voice. The Lee Silverman voice treatment intervention group will receive the standard regime of 16 sessions between 50 and 60 minutes in length over four weeks, with extra home practice. The standard speech and language therapy intervention group will receive a dose determined by patients’ individual needs, but not exceeding eight weeks of treatment. The control group will receive standard care with no speech and language therapy input for at least six months post-randomization. Outcomes will be assessed at baseline (pre-randomization) and post- randomization at three, six, and 12 months. The outcome measures include patient-reported voice measures, quality of life, resource use, and assessor-rated speech recordings. The recruitment aim is at least 60 participants over 21 months from 11 sites, equating to at least 20 participants in each arm of the trial. This trial is ongoing and recruitment commenced in May 2012. Discussion: This study will provide information on the feasibility and acceptability of randomizing participants to different speech and language therapies or control/deferred treatment. The findings relating to recruitment, treatment compliance, outcome measures, and effect size will inform a future phase III randomized controlled trial

Unspoken playground rules discourage adolescent physical activity in school : a focus group study of constructs in the Prototype Willingness Model

The health benefits of exercise in school are recognised, yet physical activity continues to decline during early adolescence despite numerous interventions. In this study we investigated whether the Prototype Willingness Model, an account of adolescent decision-making that includes both reasoned behavioural choices and unplanned responses to social environments, might improve understanding of physical activity in school. We conducted focus groups with British pupils aged 12-13 and used deductive thematic analysis to search for themes relating to the model. Participants described reasoned decisions about physical activity outside school and unplanned choices to be inactive during break, in response to social contexts described as more ‘judgmental’ than in primary school. Social contexts appeared characterised by anxiety about competence, negative peer evaluation and inactive playground norms. The Prototype Willingness Model might more fully explain physical activity in school than reasoned behavioural models alone, indicating potential for interventions targeting anxieties about playground social environments

QUALZICE: A QUALitative exploration of the experiences of the participants from the ZICE clinical trial (metastatic breast cancer) receiving intravenous or oral bisphosphonates

BACKGROUND: This qualitative sub-study aimed to explore the experiences of participants on the National Cancer Research Institute ZICE clinical trial, a randomised trial assessing two types of bisphosphonate treatment in breast cancer patients with bone metastases. Participants in the clinical trial were randomly allocated to receive either zoledronate, delivered by an intravenous (IV) infusion at clinic, or oral ibandronate, taken at home.METHODS: Qualitative research interviews were conducted with participant groups organised by treatment and location. Interviews covered experiences and understanding of bisphosphonate treatment, the experience of the delivery mechanisms (IV or oral), side effects and benefits, and quality of life issues. The analytic framework was interpretative phenomenological analysis.RESULTS: This paper reports on one of four superordinate themes: participants' experience of the ZICE trial, which explores the participants' experiences with clinical trial-related processes. Results show that participants were generally satisfied with their randomised treatment, although most participants had an initial preference for oral bisphosphonates. Some difficulties were reported from participants for both interventions: needle phobia, poor veins, difficulty with swallowing and gastric side effects, but pain control was improved with both modes of delivery. However, the infused bisphosphonate was reported to lose effectiveness after three weeks for some participants, whereas the oral bisphosphonate was reported to give consistent pain control. Geographical location and distance to travel made little difference to convenience of access to clinic as the reported lengths of travel time were similar due to traffic congestion in the urban areas. Most participants understood the trial processes, such as randomisation, and information about bisphosphonates but some participants showed little understanding of certain aspects of the trial. Some participants reported difficulties in accessing dental treatment due to their dentist's perceptions of bisphosphonate treatment.CONCLUSIONS: In trials of medicinal products, especially when testing for non-inferiority, participants' preferences and idiosyncrasies in relation to treatments should not be assumed. This study has shown that in a trial context, participants' views can usefully add to the main trial outcomes and they should be taken into account when prescribing in the real world.TRIAL REGISTRATION: ISRCTN13914201. Main ZICE MREC: 05/MRE09/57. CRUK E/04/022.</p

An occupational therapy intervention for residents with stroke related disabilities in UK care homes (OTCH): cluster randomised controlled trial

Objective To evaluate the clinical efficacy of an established programme of occupational therapy in maintaining functional activity and reducing further health risks from inactivity in care home residents living with stroke sequelae. Design Pragmatic, parallel group, cluster randomised controlled trial. Setting 228 care homes (>10 beds each), both with and without the provision of nursing care, local to 11 trial administrative centres across the United Kingdom. Participants 1042 care home residents with a history of stroke or transient ischaemic attack, including those with language and cognitive impairments, not receiving end of life care. 114 homes (n=568 residents, 64% from homes providing nursing care) were allocated to the intervention arm and 114 homes (n=474 residents, 65% from homes providing nursing care) to standard care (control arm). Participating care homes were randomised between May 2010 and March 2012. Intervention Targeted three month programme of occupational therapy, delivered by qualified occupational therapists and assistants, involving patient centred goal setting, education of care home staff, and adaptations to the environment. Main outcome measures Primary outcome at the participant level: scores on the Barthel index of activities of daily living at three months post-randomisation. Secondary outcome measures at the participant level: Barthel index scores at six and 12 months post-randomisation, and scores on the Rivermead mobility index, geriatric depression scale-15, and EuroQol EQ-5D-3L questionnaire, at all time points. Results 64% of the participants were women and 93% were white, with a mean age of 82.9 years. Baseline characteristics were similar between groups for all measures, personal characteristics, and diagnostic tests. Overall, 2538 occupational therapy visits were made to 498 participants in the intervention arm (mean 5.1 visits per participant). No adverse events attributable to the intervention were recorded. 162 (11%) died before the primary outcome time point, and 313 (30%) died over the 12 months of the trial. The primary outcome measure did not differ significantly between the treatment arms. The adjusted mean difference in Barthel index score at three months was 0.19 points higher in the intervention arm (95% confidence interval −0.33 to 0.70, P=0.48). Secondary outcome measures also showed no significant differences at all time points. Conclusions This large phase III study provided no evidence of benefit for the provision of a routine occupational therapy service, including staff training, for care home residents living with stroke related disabilities. The established three month individualised course of occupational therapy targeting stroke related disabilities did not have an impact on measures of functional activity, mobility, mood, or health related quality of life, at all observational time points. Providing and targeting ameliorative care in this clinically complex population requires alternative strategies