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“I Like the Olympics, but I’m here not just for the Olympics”: Sex tourism, destination image and the dark side of mega-event tourism in Rio De Janeiro
No full textThe Olympic Games are a major tourism attraction and are used by host cities and destinations to try and positively affect destination image and drive tourism attractiveness. Olympic tourists travel to enjoy the sport and carnival of the event, but some also seek to engage in sex tourism. This study draws on interviews with 10 heterosexual male sex tourists during the 2016 Rio Olympics in order to investigate the relationships between the Olympic Games, destination image, and sex tourism. Findings reveal that the limonoid atmosphere of the event provides an appealing atmosphere for sex tourists to engage in sexual encounters with sex workers and local women. The image of Rio as a destination was important in this, as it was seen as a relaxed and fun destination and Brazilian women as beautiful and sexually available. Issues of power between the mainly white sex tourists from the Global North and more economically vulnerable local women in destinations in the Global South were identified and recommendations offered for how Olympic and host destination stakeholders can better protect those most vulnerable to sexual exploitation during mega-event hosting, such as working with other related organisations to educate tourists and protect local women
R.J. Morris: An Appreciation – Introduction to Special Section
Get PDFThe essays that follow aim to capture aspects of the unique style of R.J. Morris, aspects which taken together represent the formidable legacy that he leaves to the global world of urban history
Creating opportunities to communicate and connect in a global pandemic: Exploring the experiences of people with aphasia of an online conversation partner scheme
Get PDFBackground
Conversation partner schemes for people with aphasia (PWA) can promote communication and quality of life as well as support skill development for students. Initial evidence indicates online conversation partner formats are acceptable as an alternative to in‐person delivery.
Aims
To evaluate the experiences of PWA of an online conversation partner scheme during the global pandemic.
Methods & Procedures
This qualitative study captured the experiences of eight PWA through semi‐structured interviews. Reflexive thematic analysis was used to analyse the data and to create themes and subthemes, reflecting the experiences of the participants through the interpretation of the researchers.
Outcomes & Results
Two main themes were generated, each with subthemes. The first theme was Communicating and connecting online: ‘It was brilliant’ with subthemes: ‘It help me and I help them’: Mutual benefits, ‘Straight away I managed to speak’: Supported conversations, ‘We got to know each other’: Connecting, and ‘Nine out of ten, easy’: Convenient and easy. The second theme was Being me online: lacks ‘Je ne sais quoi’ with subthemes: ‘I like to shake hands’: Missing a human connection, ‘Show me, me self, myself, my broad Yorkshire coming out’: Restricted self‐expression, and ‘Wetherspoons, Wetherspoons’: Loss of the physical environment.
Conclusions & Implications
This study supports the existing evidence that online conversation partner schemes for PWA are successful. It contributes original ideas relating to the acceptability of technology, interaction and self‐expression online for PWA, and considers the benefits of combining both online and face‐to‐face communication and connection opportunities.
WHAT THIS PAPER ADDS
What is already known on the subject
University conversation partner schemes have been shown to improve the communication skills and confidence of PWA and students. A small body of research has shown that online conversation partner schemes are feasible and can be a positive experience for some, but not all, PWA.
What this paper adds to the existing knowledge
Participants found that an online conversation partner scheme during the COVID‐19 pandemic gave them the opportunity to communicate and connect with students, and led to mutual benefits including enjoyment, improved communication skills, confidence and a sense of purpose. They were able to connect through supported conversations and found it convenient and easy to meet online. Despite these benefits, the participants felt that there was something missing in terms of the human connection, self‐expression and the physical environment.
What are the potential or actual clinical implications of this work?
This study suggests that online conversation partner schemes provide an opportunity for those who are restricted in their ability to meet face to face or would prefer the ease and comfort of staying in their own home. However, some people may face more barriers in meeting online due to limited experience, skills or support with technology, and may find it more difficult to communicate, build a connection and express themselves. Either using a combined approach of online and face‐to‐face interactions or providing a choice for PWA will ensure that they are still able to access the psychosocial benefits of participating in a conversation partner scheme
QCA: Quantum Computational Approach for Internet of Things with 5G Connectivity
Get PDFIn this paper, the need for a quantum computing approach is analyzed for IoT applications using the 5G resource spectrum. Most of the IoT devices are connected for data transmission to end users with remote monitoring units, but there are no sufficient data storage units, and more data cannot be processed at minimized time periods. Hence, in the proposed method, quantum information processing protocols and quantum algorithms are integrated where data transmissions are maximized. Further, the system model is designed in such a way for checking the external influence factors that prevent the IoT device from transmitting data to end users. Therefore, with corresponding signal and noise power, it is essential to process the transmissions, thereby increasing data proportions at end connectivity. Once quantum computations are performed, then it is crucial to normalize IoT data units, thus establishing control over entire connected nodes that create a gateway for achieving maximum throughput. The combined system model is tested under four cases where the comparative outcomes prove that with reduced queue reductions of 12%, it is possible to achieve a maximum throughput of 99%
Post-concussion symptom burden and dynamics: Insights from a digital health intervention and machine learning
Get PDFIndividuals who sustain a concussion can experience a range of symptoms which can significantly impact their quality of life and functional outcome. This study aims to understand the nature and recovery trajectories of post-concussion symptomatology by applying an unsupervised machine learning approach to data captured from a digital health intervention (HeadOn). As part of the 35-day program, patients complete a daily symptom diary which rates 8 post-concussion symptoms. Symptom data were analysed using K-means clustering to categorize patients based on their symptom profiles. During the study period, a total of 758 symptom diaries were completed by 84 patients, equating to 6064 individual symptom ratings. Fatigue, sleep disturbance and difficulty concentrating were the most prevalent symptoms reported. A decline in symptom burden was observed over the 35-day period, with physical and emotional symptoms showing early rates of recovery. In a correlation matrix, there were strong positive correlations between low mood and irritability (r = 0.84), and poor memory and difficulty concentrating (r = 0.83). K-means cluster analysis identified three distinct patient clusters based on symptom severity. Cluster 0 (n = 24) had a low symptom burden profile across all the post-concussion symptoms. Cluster 1 (n = 35) had moderate symptom burden but with pronounced fatigue. Cluster 2 (n = 25) had a high symptom burden profile across all the post-concussion symptoms. Reflecting the severity of the clusters, there was a significant relationship between the symptom clusters for both the Rivermead (p = 0.05) and PHQ-9 (p = 0.003) questionnaires at 6-weeks follow-up. By leveraging digital ecological momentary assessments, a rich dataset of daily symptom ratings was captured allowing for the identification of symptom severity clusters. These findings underscore the potential of digital technology and machine learning to enhance our understanding of post-concussion symptomatology and offer a scalable solution to support patients with their recovery
Clinimetrics: The vertical single leg hop test
Get PDFDescription: The vertical single leg hop test (VSLHT) is a functional performance outcome measuring maximum single leg jump height (cm).1 The VSLHT is intended to assess sport-related movements and musculoskeletal loading demands.1,2 To perform this test, an individual stands on one leg, executes a rapid countermovement to a self-selected depth, jumps as high as possible, and then lands on the same leg.2, 3, 4 Height can be measured using instrumentation (eg, contact timing mat)2, 3, 4 or the chalk on wall method. The VSLHT can be completed on both legs in 10 to 15 minutes, including a dynamic warm-up and practice trials (three to five). Typically, multiple maximum effort attempts (minimum of three) are performed with 20 to 30 seconds of rest between attempts
Coal to swole: A survey of anabolic steroid use and muscularity concerns in coalfield areas of Wales
Get PDFBACKGROUND: Growing male anabolic steroid use is often framed as symptomatic of a post-industrial masculinity crisis, but little quantitative evidence exists for this account. We examine whether steroid use is associated with geographic exposure to industrial decline, namely historical coal mining, and whether any association is mediated by masculine norms. METHODS: We fielded a quota-sampled survey of 18-49 year-old men in Wales (N = 1425). Data were geo-linked to the extent of historic coal mining locally to respondents. Generalised linear mixed models were fitted to test our hypotheses. RESULTS: Steroid use (odds ratio = 1.99, 1.10-3.60), but not body image (B = 1.06, -2.02-4.13), was positively associated with mining extent. However, this was not mediated by conformity to masculine norms. DISCUSSION: While use of steroids is more common in former mining areas, this is not due to more prevalent body image issues nor mediated by masculine norms. Thus, accounts of a post-industrial 'thwarted masculinity' do not fit the data. Steroid use in post-industrial areas is an issue for public health and these communities may benefit from targeted interventions to reduce risk of harms
Disparity in Anterior Cruciate Ligament injury management: A case series review across six National Health Service Trusts
No full textBackground
Effective management of anterior cruciate ligament (ACL) injuries requires a comprehensive approach, from initial assessment, through treatment, rehabilitation, and discharge, however no gold standard care pathway exists to help guide clinicians. This case series provides an overview of current ACL injury management processes in six National Health Service (NHS) Trusts.
Methods
This study utilised a retrospective case series design within six NHS Trusts in the Yorkshire region of the United Kingdom. Using a standard operating procedure, each Trust selected ten consecutive ACL injured patients (≥ 16 years), managed either surgically or non-surgically. Data relating to the patient injury journey, patient and injury characteristics, key pathway events, rehabilitation management, outcome measures, and discharge, were collected. Data was anonymised and analysed using descriptive statistics.
Results
Reviews covered 55 patients, median age 25.5 years, (41 males, 14 females). Median time to specialist assessment from injury was 12 days (Interquartile Range [IQR] 6 to 20 days), with 43 patients managed operatively, and 12 non operatively. The median number of physiotherapy sessions was 21 (IQR 9 to 29.5), with outcome measures being variably used across Trusts. Trusts using patient reported outcome measures (PROMS) consistently with their patients provided more physiotherapy appointments (34.5 and 27) and achieved higher return to sport (RTS) rates. Time from injury to discharge varied with a median of 421 (IQR 249 to 546) days. Discharge criteria were applied inconsistently across Trusts, with 31% of cases not using specific criteria. However, Trusts using standardised discharge criteria showed better RTS outcomes, with 27 (61%) patients successfully returning to sport.
Conclusions
This case series review highlighted some good practice in initial ACL management across six NHS Trusts in the Yorkshire region. However, from time to MRI diagnosis to discharge, substantial variation in care is observed. Whether treated operatively or non-operatively, for patients aiming to RTS, this was achieved with greater consistency when more physiotherapy appointments were undertaken, outcome measures and PROMs were used, and specific discharge criteria was utilised. Future larger pathway investigation studies incorporating causative and predictive analysis studies on a national scale are required to determine whether similar trends are observed in a wider ACL injured population, which could help to improve national pathways for patients and clinicians working towards ensuring more positive and standardised patient-related ACL injury outcomes
Banned for doping: Using composite vignettes to portray rugby players’ experiences of anti-doping rule violations
No full textObjective: Understanding the lived experiences of athletes who have been sanctioned for violating anti-doping rules presents the opportunity to listen and learn. Yet, the academic field seldom draws on the voices of those affected when considering doping in sport. Our aim was to illuminate important aspects of sanctioned athletes’ experiences and highlight opportunities for prevention and rehabilitation. Design: A semi-structured interview research design was used, and data informed the development of composite vignettes, a form of creative non-fiction. Method: Semi-structured interviews were conducted with two elite rugby players sanctioned for violating the anti-doping rules within rugby league (n=1) and rugby union (n=1). Three composite vignettes were created illuminating player experiences before, during and after the violations. Findings: The vignettes highlight in participants’ own words the multiple impacts of sport demands and drug use: (1) Leading up to the violation: ‘You’re just treading water, you’re surviving’ (2) ‘There’s just this massive amount of social pressure in rugby, not just on the game, but on who you’re supposed to be’ (3) ‘It was like being hit by a train’. The ADRV aftermath. Conclusions: The role of social identity in the transitions experienced by a rugby player following a critical incident (e.g., serious injury) was a key influencing factor for doping. Alongside addressing the demands of the sport, the need for early intervention and evidence-based support for players experiencing critical incidents (e.g., injury) and transitions was evident to prevent doping violations
Cost-effectiveness of swab versus tissue sampling for infected diabetic foot ulcers from the CODIFI2 randomised controlled trial
Get PDFThis multi-centre, Phase III, prospective, unblinded, two-arm parallel group, randomised controlled trial compared clinical (reported elsewhere) and economic outcomes of swab versus tissue sampling over a 52–104 week period.
Resource use was logged using case record forms and patient questionnaire at weeks 4, 12, 26, 39, 52 and 104, costed using laboratory and published sources from the UK NHS perspective, at 2021/2022 price-year. EQ-5D-3L questionnaires issued at these time points were used to derive quality-adjusted life-years (QALYs).
To account for imbalances such as age, a regression-based approach was used to estimate survival, expected costs and QALYs between the sampling arms. Available case analysis (ACA) and multiple imputation methods were applied for self reported missing data, and ACA for researcher-collected data (survival, hospitalisations and antibiotic use). Probabilistic sensitivity analysis was used to assess the uncertainty of economic results.
Results
We recruited 149 participants (75 swab, 74 tissue) from 21 UK sites, between 07 May 2019 and 28 April 2022 (last follow-up 28 April 2023). Planned sample size was 730 participants, for 90% power to detect 12.5% difference in healing at 52 weeks, but the trial stopped early due to low recruitment.
Expected QALYs in the swab-sampling arm were greater than in the tissue-sampling arm at weeks 26, 52 and 104.
The cost of tissue sampling was greater than of swabbing when including antibiotics and hospitalisation. Swab sampling participants had higher QALYs and lower costs across weeks 26–52, reducing slightly by week 104.
Conclusions
Because of higher costs, lower QALYs and lack of evidence of benefit, potentially due to the trial being underpowered, tissue sampling was dominated by wound swabbing in the cost-effectiveness analysis
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