This thesis presents an analysis of the beliefs and practices surrounding balneotherapy, a technique that uses waters of natural mineral springs for healing. Balneotherapy as employed in the treatment of mainly chronic, incurable and painful disorders will be used as a tool for revealing the pluralistic medical belief systems in the two cultures chosen for this study, the cultures of Japan and the Czech Republic. This is an ethnographic study based on fieldwork which was carried out in two locations - Misasa Onsen in Japan and Jáchymov in the Czech Republic. Linked by the presence of natural mineral springs with similar properties, by historical connections and by the existence of medical establishments practicing balneotherapy these spas made suitable locations for the study of medical practices and beliefs in different cultural systems of medicine. The two countries support a pluralistic cultural system of medical care into which both cosmopolitan and ethnomedical sets of values are incorporated. While the involvement of cosmopolitan medicine showed great similarities between the two cultures the patients’ constructed experience of illness showed many differences. This thesis argues that these differences are due to cultural factors belonging to the domain of active response to illness acquired during acculturation and deeply embedded sets of cultural notions of illness, health and healthcare. The thesis investigates these cultural factors and sets them in the frameworks of several cultural constructs some of which are common to both cultures but most of which are unique. The practice of balneotherapy in the two countries has developed and changed since the adoption of its theory in the nineteenth century. What has emerged in both cases is a complex method of holistic healing comprising both physiological and psychological elements. It is hoped that this study added to the knowledge of the meanings contained within the medical cultural systems of Japan and Czech Republic.

This narrative study sought to explore Physiotherapy students’ stories of their undergraduate experiences to gain an insight into the process of becoming and being a student. It presents findings gathered from a three-year longitudinal study in which the central aim was to listen to students’ stories told in their own words over a series of narrative interviews throughout their degree programme. As such I have presented some of the personal and social circumstances that can influence students’ experiences during the process of becoming and being a Physiotherapy student. The seven students who volunteered to be included in the study were interviewed on at least five occasions and at each interview they were encouraged with a narrative prompt to tell the stories of their experiences as a series of ‘episodes’ beginning and finishing wherever and however they felt was most appropriate. Analysis of the stories revealed that whilst each individual’s experience of university life was multi-layered, for each student a specific orientation dominated their re-telling of 'being a student' across their interviews. Thus the stories are presented in relation to these orientations: peer support (two students); financial difficulties (two students); learner self-direction (two students); or personal difficulties (one student). In addition, I have considered the narratives in terms of Heidegger’s (1926/62) concepts of ‘being’ and ‘time’ to inform the analysis and interpretation of the data: to present a more insightful exploration of the students’ experiences. These temporal narratives offer an insight into what university life was like for those undergoing it, providing a greater understanding of what ‘being a student’ meant for these particular students. The study demonstrates that ‘becoming’ and ‘being’ a student are about students developing a sense of themselves and of belonging to an institution. Ultimately a higher education is necessarily a process of becoming and as such can be considered as a transformation of ‘being’ as students develop over time.

This research investigates the experiences of 18 mature career-changing physiotherapists over the first three years of belonging to their new profession, employing and critiquing Lave and Wenger’s (1991) theory of community of practice in so doing. Such newcomers to a profession bring with them social and cultural capital which can impact upon the new workplace and their progress within it, as might their biographies, atypical for their chosen profession. Very little has been written about the effect of importing people experienced in another occupation into a profession. This leaves an empirical and theoretical gap to be explored regarding both the effect on the individuals and on the practice of the communities they join. No-one has considered what might be involved in what amounts to identity re-construction in the new career, and what impact the employment context (possibly unstable or fluctuating) might have on the process. Annual semi-structured interviews were chosen as the appropriate mode of generating data from the main respondents, augmented by single interviews with six physiotherapy managers and four established clinicians to provide additional necessary context. The recorded transcripts were analysed using brief interviewee narratives, pro formas and reflective questions. It was found that previous experience, including upbringing and habitus, were particularly influential in these newcomers’ progress, and individuals may be beginning to self-manage their careers, a practice which questions and adds to Lave and Wenger’s (1991) theory of legitimate peripheral participation. Other elements that contradicted community of practice theory included the fact that it was with patients and their carers that social interaction leading to learning occurred most, and it was often to this client group that practitioners felt loyalty and a sense of belonging, rather than to any community of fellow practitioners. Also solo workers are often isolated from the newcomer and cannot pass on their learning as Lave and Wenger (1991) suggest. Full participation was found to be difficult to define, equating with proficiency rather than expertise. The thesis as a whole gives some indication of the way in which a profession’s traditions may be changing with respect to widening participation and the problems of a context of fractured and uncertain employment.

No description available.

Circle dance, which derives from the tradition of folk dances, is a popular form of dance and is practiced worldwide. As a form of meaningful physical and leisure activity, circle dance can be explored in the context of occupational therapy principles and practices to promote health and well-being. However, to date, the synergy between circle dance, occupational therapy and well-being has yet to be explored. This research develops an understanding of the complexity and meanings attributed to circle dance and its impact on occupational well-being and considers how pedagogic practice might facilitate a sense of well-being in participants. Using a constructivist approach to grounded theory (Charmaz, 2006), thirty nine in-depth interviews with participants, teachers and coordinators of teacher training programmes from the circle dance network in the United Kingdom (U.K.) were undertaken. The process of simultaneous data collection and analysis culminated in the development of three major categories, representing the meanings and experiences of circle dance participants, teachers and training coordinators. From the intersection of the three major categories, a core category was generated and named by an in-vivo code “There is a place for everybody”. The findings of this study suggest that engagement in circle dance creates meaning and can influence people’s health and well-being; they also highlight the important role that pedagogical practice plays in enriching the experience of the participants and in sustaining occupational engagement and continued involvement. This investigation provides a detailed knowledge of the process of being engaged in circle dance, whilst informing occupational therapy practice and advancing occupation-based knowledge in the field of leisure, physical activity and wellbeing. It also makes a unique contribution in relation to the pedagogy of circle dance and informs teachers from within the U.K. network offering a comprehensive understanding of the benefits of circle dance.

The relationships between humans and animals have been associated with various therapeutic implications. While there is no agreed upon name, the term "pet facilitated therapy" has become widely accepted. Pet facilitated therapy has been particularly adopted to describe the relationship between humans and domestic animals. In contrast to public attitudes o f twenty years ago, the field of animal-human relationships is now respected as a legitimate area of research investigation (Levinson, 1982.) Numerous studies have been conducted on the benefits of the relationships between domestic animals and humans; however, there continues to be little empirical evidence that specifically addresses the relationship between humans and horses. Therapeutic horseback riding, a term which takes into account the relationship formed with the horse both while riding and on the ground, has been widely accepted among the professionals in the field. Despite this agreement, applied research in the field is needed to validate its apparent benefits. The present study was developed to determine how a therapeutic horseback riding program can predict outcome on self-esteem, frustration, tolerance, depression and anxiety. Participants were 81 emotionally disturbed males between the ages of 6-16 who were students in a residential treatment center. Results were analyzed using zero-order correlations and a series of setwise multiple regression equations. The results indicated that children who experienced a meaningful bond to a horse were more anxious and depressed. However, the bond with a horse did not significantly influence a child's self- esteem or frustration tolerance. Children who were more involved in the horsemanship program tended to be less depressed and anxious. A child's self-esteem and frustration tolerance were not affected by their involvement in the horsemanship program. Children's conduct in the horsemanship program did not significantly influence their self-esteem, frustration tolerance, depression or anxiety. Implications of these results are for the therapeutic use of horseback riding as an adjunct or alternative therapy for emotionally handicapped individuals.

No description available.

Resistance to radiotherapy is a significant cause of treatment failure and tumour relapse. Strategies to improve the efficacy of radiotherapy are sought to improve therapeutic responses. c-FLIP is a critical regulator of the extrinsic apoptotic pathway and is frequently overexpressed in many cancers, including non-small cell lung carcinoma (NSCLC). c-FLIP overexpression contributes to resistance to death receptor- and chemotherapy-induced cell death through inhibition of caspase-8 activation. This Thesis demonstrates for the first time that c-FLIP is a critical regulator of ionizing radiation (IR)-induced cell death in in vitro models of NSCLC. Importantly, down-regulation of c-FLIP using siRNA sensitizes cells to IR, conversely, overexpression of c-FLIP confers increased radioresistance to cells. Overexpression of a c-FLIP-mutant which cannot interact with FADD and thereby cannot prevent caspase-8 activation does not protect cells from IR-induced cell death. Furthermore, silencing of caspase-8 or death receptors, particularly DR5 and TNFR1, attenuates IR-induced cell death indicating the importance of the extrinsic apoptotic pathway in mediating cellular responses to IR. c-FLIP depletion was also shown to increase levels of DNA damage, and further enhance IR-induced DNA damage. Given the increased radioresistance of c-FLIP overexpressing cells, c-FLIP expression should be investigated in clinical samples as a candidate predictive biomarker of response to radiotherapy. A FDA-approved HDAC inhibitor was used to downregulate c-FLIP protein levels and radiosensitize NSCLC cells. The radiosensitization was shown to be highly dependent on c-FLIP downregulation. Therefore, this study provides pre-clinical evidence that pharmacological inhibition of c-FLIP may improve the response of NSCLC to radiotherapy and enable improved control of radiation-resistant subpopulations of tumour cells that express high levels of c-FLIP.

Photobiomodulation refers to low-intensity light therapy (LILT) in the far-red to near-infrared (IR) region of the spectrum (630-1000nm). A peak wavelength, 1072nm (IR1072), in the IR transmission spectrum has been previously shown to have protective effects against UVA toxicity in human lymphocytes and beneficial effects on working memory in IR-treated 12 month old CD-1 mice. The aim of this investigation was to establish the beneficial effects of IR1072 in the murine mammalian CNS utilising a range of in vivo and in vitro model systems. Acute treatment of primary rat neuronal cultures with IR1072 endowed an insult severity-dependent protective effect; the less severe the insult the more profound the protection. An age-dependent (3 month to 12 month) reduction in brain derived neurotrophic factor (BDNF) and heat shock protein HSP27, and HSP40 and HSP90 was observed in both CD-1 and TASTPM Alzheimer disease mice, which may underlie the severe learning deficits seen in these mice. Acute whole body treatments of CD-1 mice in vivo comprising ten consecutive daily 6 minute sessions of IR1072 elicited increased mitochondrial complex II enzyme activity. Long-term chronic in vivo IR1072 treatments in CD-1 mice, consisting of biweekly 6 minutes sessions spanning a 5 month period, increased expression of selective HSPs, notably HSP27 in cortical and hippocampal regions. Following chronic IR1072 treatment, a profound reduction of AMPA receptor binding sites in CD-1 mice, and reduced total A?1-42 expression and small amyloid plaque counts (in cortex and dentate gyrus) in TASTPM mice, was observed. Overall, this thesis reveals new mechanisms of photobiomodulation with IR1072 which involves restoring cellular homeostasis for optimal functional operation of a neuron.

Both the quantity and distribution of body fat are associated with the expression of inflammatory markers. This thesis aims to examine (1) associations between measures of body composition (anthropometric and dual-energy X-ray absorptiometry (DXA)) with markers of endothelial dysfunction and inflammation, (2) the efficacy of body composition indices as predictors of inflammation in young adults and postmenopausal women, (3) the effects of modest weight change on markers of inflammation over 24 months in postmenopausal women and (4) the effects of a calcium rich marine-derived multi-mineral supplement administered alone or with short-chain fructo-oligosaccharides (scFOS) on cardiovascular disease (CVD) risk factors in postmenopausal women over 24 months. Results demonstrate that anthropometric measures of body composition are similarly associated with markers of inflammation in comparison to DXA and therefore may be reliable and clinically useful in the prediction of disease risk in young adults and postmenopausal women. Although sex differences were apparent, similar strong associations between leptin and body composition measures were evident among both men and women, highlighting a potential role for this marker in the assessment of inflammatory disease risk. Additionally, modest weight change in postmenopausal women has significant effects on pro-inflammatory marker concentrations over 24 months which may positively or negatively impact inflammatory status. With age, women experience changes in body composition, inflammation and bone health. Calcium supplements are routinely taken, particularly by postmenopausal women to meet the daily required intake and prevent osteoporosis. However, high calcium intakes via calcium containing supplements have been implicated as a risk factor for CVD. This thesis demonstrates that supplementation with a calcium rich marine-derived multi-mineral supplement alone or with scFOS, a prebiotic that enhances intestinal absorption, lowered low-density lipoprotein (LDL) and total cholesterol concentrations in postmenopausal women over 24 months and had no effect on body composition, blood pressure or systemic inflammation. Overall, this thesis demonstrates the interplay between body composition, nutrition and inflammation in young adults and postmenopausal women.