In recent years, the Internet has exploded with different kinds of social media, where a significant function is to share your life in text and images. This changes how we form our identity, our religious identity included. The aim of this paper was to study how Instagram forms a space for the creation and development of religious and spiritual beliefs. For this purpose, Instagram updates from five women with yoga oriented Instagram accounts have been analyzed in relation to two theories: Paul Heelas’ och Linda Woodhead’s theory of a spiritual revolution and Heidi Campbell’s theory of networked religion. The aim of the study was to explore how these women presented themselves in their Instagram flow and what part religion and spirituality had in their presentations. The method used was thematic content analyses. Four themes were identified: (1) immanent and transcendent religion, (2) the unique self, (3) the holistic idea and (4) thoughts about the universe and the earth. The conclusion when analyzing the data in relation to the selected theories was that religion and spirituality have a central part in the texts that was published with the pictures and that the women expressed and described religion and spirituality in a way that can be understood in accordance with both the theory of a spiritual revolution and the theory of networked religion, especially with references to storied identity, shifting authority and convergent practice.  Nevertheless, some parts of the result couldn’t fully be explained through these theories and there were some parts of the result that showed that the theories might need some development or adjustment, for example regarding gender roles and female religiosity in the contemporary society.

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Low back pain (LBP) is a common complaint and health problem in Hong Kong, particularly among middle-aged individuals. LBP is the main cause of chronic disability which significantly affects the daily life activities of patients. Pain might result in repeated hospital admissions and subsequently increase the burden on health care providers in Hong Kong. LBP has an enormous effect on quality of life and therefore deserves research attention. Growing evidence shows that yoga may help reduce the level of chronic LBP in adult patients. However, no systematic review has been conducted to support the translation of this theory into practice. Therefore, this thesis aims to evaluate the current evidence on the efficacy of yoga in reducing chronic LBP among adult patients to achieve the following objectives: formulate an evidence-based protocol on yoga practice, assess the implementation potential of the formulated protocol, and develop implementation strategies and evaluation plan for the use of this protocol in a local public hospital in Hong Kong. Five databases were used for the systemic review of relevant studies. These databases were those of Cochrane Library, CINAHL Plus, PudMed, British Nursing Index and Medline (Ovid). A total of eight papers (randomized controlled trials) fulfilled the inclusion criteria of this study. The Scottish Intercollegiate Guidelines Network (SIGN) was used to extract the data and evaluate the paper quality. The findings of the selected papers indicated that yoga practice has a significant effect on reducing pain among adult patients with chronic LBP. The innovation is proposed to be conducted in an adult orthopedic and traumatoloy (O&T) ward. Evidence-based yoga guideline is developed to guide nurses in the effective implementation of the protocol. The SIGN grading system is chosen to grade the recommendations in the guideline. Adult patients with persistent LBP longer than three months are the target population. All study participants practice specific yoga postures under the supervision of yoga instructors and trained nurses in the outpatient clinic. These patients continue home practice for 30 minutes daily or at least twice a week. Based on the findings of the reviewed literatures and the adaptation of these findings into the proposed innovation, the feasibility of implementing evidence-based yoga guideline in the local clinical setting in Hong Kong is demonstrated. An effective communication plan is developed to gain support from stakeholders and efficiently implement the innovation. A two-month pilot study is designed to test the feasibility of the guideline. Pain level, which is the primary outcome of the study, is measured by using Pain Numerical Pain Scale (NRS). Evaluation will be completed after the pilot test and at the end of the whole programme and refinement of the protocol will be accomplished according if necessary. Protocol effectiveness will be determined by a decrease in back pain level after practicing yoga. Other outcomes include the knowledge and satisfactory level of the staff with regards to the protocol, as well as and the costs and benefits of program implementation. / published_or_final_version / Nursing Studies / Master / Master of Nursing

Motivation Impairments of attention and memory are detectable in early psychosis, and often result in severe, longstanding functional impairments. Pharmacological interventions for cognitive impairments have been largely unsuccessful. The current study aims to explore the effects of aerobic exercise and mind-body exercise (yoga) on cognitive functioning and clinical symptoms in female patients with early psychosis. The potential neuromechanism underlying the clinical consequences was also investigated. Methods Female patients (n=120) diagnosed with schizophrenia spectrum disorders, brief psychosis, psychosis NOS, or delusional disorder (according to SCID) were recruited from three hospital/clinic sites. They were randomized into integrated yoga therapy group, aerobic exercise programme group, and waiting list as the control group. Both interventions were held three times weekly. At baseline and at 12 weeks, clinical symptoms, cognitive functions, quality of life and fitness levels were assessed in all participants, and completed structural MRI data were collected in 58 patients. Repeated measures ANOVA and ANCOVA analyses of the clinical, cognitive, quality of life and fitness data were compared between baseline and at 12 weeks among the three groups. Post-hoc Bonferroni test was used for comparing between two groups. Structural MRI data was analyzed by FreeSurfer V5.1 and Qdec V1.4 to calculate the brain volume and cortical thickness. Results Completed clinical and cognitive data were collected in 85 patients, and completed MRI imaging data of good quality were collected in 39 patients. No significant differences in age, education years, and duration of the illness at baseline were observed among the three groups. Both yoga and aerobic exercise groups demonstrated significant improvements in verbal encoding (p<0.01), short-term memory (p<0.05), long-term memory (p<0.01), and working memory (p<0.01) with moderate to large effect sizes compared to control groups. The yoga group showed significantly enhanced attention and concentration (p<0.05). Both yoga and aerobic exercise significantly improved overall clinical symptoms (p<0.05) and depressive symptoms (p<0.05) after 12 weeks. Significant increases were observed in the thickness of the left superior frontal gyrus and the right inferior frontal gyrus (pars triangularis) in the aerobic exercise group. Significant increases were observed in the volume of the postcentral gyrus and the posterior corpus callosum in the yoga group. There was a statistically significant correlation between improvements in working memory and changes in the postcentral gyrus (r=0.54, p<0.01) after controlling for the multiple comparisons with a Bonferroni adjusted alpha level. Discussion Both types of exercise improved memory in early psychosis patients, with yoga having a superior effect on attention than aerobic exercise. Observed increments in the cortical thicknesses and volume may indicate improved neurogenesis. Significance There have been few systematic clinical trial studying exercise and psychosis, and none of them has explored the effects of exercise in female patients with early stage psychosis. The present study indicates possible interventions for cognitive impairments in the patients with early psychosis, which are non-invasive and mostly safe. The application of yoga and aerobic exercise as adjunct treatments to treat psychosis in the clinical setting should be advocated. / published_or_final_version / Psychiatry / Doctoral / Doctor of Philosophy

This dissertation explores the ways in which various Western yoga teachers have interpreted and presented yoga to an American audience, and how media outlets have represented those yoga practices to a broader American audience between the 1890s and the 2010s. In particular, the case studies illuminate the ways in which contemporary concerns have influenced how yoga teachers and media reports have framed and responded to yoga practices. In this dissertation, I present a series of Western yoga practitioners that embody the most interesting and distinctive representations of popular understanding of yoga for their individual historical moments. Though the chapters do not reflect a linear development, recurrent discourses concerning Orientalism, post- colonialism, race, gender, sexuality, and class in the United States re-emerge in each chapter as different yoga schools respond to local and global concerns. Through these different vignettes, a trajectory of American yoga as taught and practiced by Westerners in the United States historicizes yoga in ways that are often overlooked in favor of the “timelessness” of the practice. / text

Traumas such as experiences of military combat, violent personal assault, natural disasters, severe vehicle accidents, being taken as hostage or prisoner, and diagnosis of life threating disease (American Psychiatric Association, 2000) impact every aspect and facet of the lives of trauma survivors including the physical, social, mental, emotional, psychological, and spiritual aspects of well-being. Trauma results in avoidance and dissociation, hyperarousal, and intrusion and constriction (Herman, 1997). Trauma may also lead individuals to anxiety, depression, somatization and cognitive distortions (Briere, 2004), disconnection from their bodies (Ogden el al. 2006; van der Kolk, 2006), and getting stuck in the past (van der Kolk et al., 1996). In leisure contexts, trauma may lead to experiencing avoidance, re-enactment in leisure, and the tendency to isolate and fear emotional and physical intimacy with others (Arai, Griffin, Miatello, & Greig, 2008). The foundation of trauma healing is establishing safety, mourning and reconnection with ordinary life (Herman, 1997), reconnection with the body, and being present (Levine, 2010). While cognitive therapy plays a role in trauma healing, somatic approaches provide additional support to reconnection of body and mind. Somatically-oriented therapies support trauma survivors to acquire a sense of safety and mastery over their bodies and to heal disconnection that results from trauma exposure (van der Kolk, 2003). The promise of interventions integrating body-mind in healing and support various mental health issues are growing and research is showing positive results. There is growing evidence of the role of physically-active leisure in healing trauma (Arai, Mock & Gallant, 2011). Yoga has been supported by a number of studies as a therapeutic intervention for both psychological and physiological conditions associated with trauma (Emerson & Hopper, 2011; Emerson, Sharma, Chaudhry, & Turner, 2009; The Trauma Centre, 2013; van der Kolk, 2012; Ware, 2007) and posttraumatic stress disorder (Descilo et al., 2007; Emerson et al., 2009; van der Kolk, 2012). Yoga originated over 5000 years ago in India and is a holistic and comprehensive system of practice and wellbeing that creates individuality, space, and opening allowing the self to be in the body without judgment. According to Iyengar (2002), yoga lifts up from clutches of pain and sorrow, and enables to live fully, taking a delight in life. The purpose of this phenomenological study was to explore the meanings and experiences of yoga for trauma survivors. Phenomenology attempts to capture participants’ perception of lived experience, plunging deep into the nature of being to embrace a mindful wondering about a project of life, of living, of what it means to live a life (van Manen, 2001). The study engaged thirteen individuals who experienced trauma and had been practicing yoga for at least five years in phenomenological interviews using open and active interview questions. Research questions guiding my study were: What is the nature of the yoga experience? What meanings do people who have experienced trauma make of this experience? What happens in the yoga experience that is healing? The findings emerged in the form of four essences describing the yoga experiences of participants: moving from the darkness of trauma into the light of yoga and living, entering into safe and sacred spaces, letting go into yoga and returning to embodiment of self, and embracing creativity and connection beyond the mat. Through the light that yoga brought into the darkness of the lives of the participants, they realized they are far more than just the trauma they experienced. This light allowed them know and touch the light within, feel safe again, reclaim their connection with self, befriending their bodies while being present in the moment and know the trauma has already happened and they do not have to stay there.

Fourteen cancer caregivers participated in a six-week Vinyasa Yoga (VY) intervention and completed demographic items, psychological distress, measures of QOL, and open-ended questions. There was a significant difference and large effect (n2 =.47) in the total mood disturbance scores; t(13)= 3.43, p=0.005, 95% CI [8.6, 38.1]. There was no significant difference in the Physical Component Score; t(13)= 1.70, p=0.113, 95% CI [-.8, 6.8], n2 =0.18. There was a significant difference and large effect (n2 =.30) in the Mental Component Score; t(13)= -2.37, p=0.034, 95% CI [-12.9, -.6]. Additional analyses indicated that several subdomains of psychological distress and QOL were significant. Responses to the survey questions revealed participants perceived benefiting physically and mentally from the VY intervention, noting improvements in flexibility, core and upper-body strength, mindfulness, breathing, and energy. Although further and more rigorous exploration is required, this study provides support for the feasibility of VY with cancer caregivers.

Symptoms associated with menopause are known to negatively affect quality of life for many women. Moreover, concern about risks associated with hormone replacement therapy can prompt women to seek non-pharmacological approaches to symptom management. Claims exist that yoga can be useful in the management of menopausal symptoms, possibly through modification of endocrine function. This study used a randomized controlled design to examine the effect of yoga on sedentary menopausal women with regard to menopausal symptoms, circulating hormones, musculoskeletal fitness, heart rate, blood pressure, and body mass index. Women participating in a traditional walking program served as the control group. Results indicate that both types of activity were beneficial for perimenopausal women, although the differences between yoga and walking for improvement in menopause symptoms were not statistically significant. The effects do not appear to be associated with hormonal changes. Musculoskeletal fitness in sedentary women improved with activity despite weight gain. / ix, 105 leaves ; 29 cm

Flow state refers to an optimal psychological experience and is associated with a number of experiential qualities one of which is complete absorption in the task at hand. Self-determination theory provides a framework for examining the relation between different types of motivation and flow because it distinguishes among different forms of motivation based on the degree that they can be considered self-determined. Although flow has been studied among athletes and, to a lesser degree, exercisers, no studies have focused on the flow experiences of yoga practitioners. Yoga, which originated in India, has been gaining popularity in the United States. The purpose of this descriptive study was to examine the flow experiences and motivational perspectives of ashtanga yoga practitioners. Five specific aims were addressed. A sample of 127 ashtanga yoga practitioners were recruited from six yoga studios in various locations across the United States. Participants completed a series of questionnaires related to flow experiences, motivational orientation, yoga practice characteristics, and sociodemographic information. The majority of the participants of the study were women, highly educated, and approximately 40 years old. The participants demonstrated a strong commitment to yoga practicing on average 4 times per week for over 1.5 hours. The majority had more than 2.5 years of ashtanga yoga experience. They reported strong intrinsic and selfdetermined extrinsic motivation to practice ashtanga yoga. They reported experiencing flow during ashtanga yoga practice and at least moderately endorsed all nine dimensions of flow state. Higher scores on the EMS subscales of intrinsic motivation (IM) to accomplish things and IM to experience sensation were predictive of higher flow state for the practitioners. The respondents yoga flow scores were significantly higher than the flow scores associated with a comparison other physical activity participated in currently or in the past. Finally, age (inversely) and years of ashtanga yoga experience were predictive of flow experiences for this group of yoga practitioners. For those interested in the study of motivation, these findings contribute to the understanding of the relation between flow and motivation and how enjoyment may be manifested within the context of physical activity.

Post-traumatic stress is a highly prevalent mental health condition. Mind-body interventions like yoga are increasingly being utilized in the treatment of PTS, but further research is needed to assess its effectiveness. This present randomized control study was designed to supplement the current field of inquiry with a relatively large group of participants and mixed method analysis of the data. The PTS symptoms and overall well-being of 50 participants enrolled in an eight-week trauma-specific Kundalini yoga (KY) program were examined. The findings demonstrate that KY may impact PTS symptomology, sleep, positive affect, perceived stress, and feelings of resilience. Eight month follow-up data are presented. Participant narratives are discussed corroborating quantitative findings and suggest that participants learnt tools to modulate emotions leading to self-mastery. Study limitations are presented with recommendations for future trauma-related research and practice.