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Dominic Malcolm

In this article I examine the role and working practice of rugby union club doctors in England. While medicine is widely perceived to be one of the most powerful professions in Western societies, sociologists of sport have argued that sport clinicians often wield relatively limited power over their athlete-patients. In this article I therefore attempt to shed further light on the “peculiar” character of sports medicine. Using data drawn from interviews and questionnaires, I argue that this phenomenon can be understood only by looking at the structure of the sports medicine profession, the specificities of the rugby club as a workplace setting, and the relationships club doctors have with clients (coaches and athletes) and other health care providers (physiotherapists).

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Cecilia Winberg, Gunilla Carlsson, Christina Brogårdh and Jan Lexell

Maintaining regular physical activity (PA) can be challenging for persons with late effects of polio. This qualitative study of ambulatory persons with late effects of polio explored their perceptions of PA, as well as facilitators of and barriers to PA. Semistructured interviews were conducted with 15 persons and analyzed with content analysis using the International Classification of Functioning, Disability and Health (ICF) as a framework. The participants described positive perceptions of PA and its health benefits. PA was used to prevent further decline in functioning, and the type and frequency of activities had changed over time. Past experiences and personal characteristics impacted PA. Support from close relatives, knowledgeable health care professionals, mobility devices, and accessible environments facilitated PA, whereas impairments, inaccessible environments, and cold weather were the main barriers. To perform PA regularly, persons with late effects of polio may benefit from individualized advice based on their disability and personal and environmental factors.

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Ulrika Olsson Möller, Jimmie Kristensson, Patrik Midlöv, Charlotte Ekdahl and Ulf Jakobsson

Objectives:

To investigate the effects of a home-based one-year case management intervention in older people with functional dependency and repeated contact with the health care services on self-reported falls and self-reported injurious falls.

Methods:

The study was a randomized controlled trial with repeated follow-ups. The sample (n = 153) was consecutively and randomly assigned to the intervention group (n = 80, mean age = 81.4 [SD 5.9]) or control group (n = 73, mean age = 81.6 [SD 6.8]). The intervention group received a case management intervention which comprised monthly home visits during 12 months by nurses and physiotherapists employing a multifactorial preventive approach.

Results:

In the intervention group, 96 falls occurred during the intervention period compared with 85 falls in the control group (p = .900). There were 40 and 38 injurious falls (p = .669) in the intervention and control groups, respectively.

Conclusions:

This home-based case management intervention was not able to prevent falls or injurious falls.

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Alan G. Ingham

What follows here is an essay—a rather one-sided viewpoint that is both tentative and, within the limits of a journal article, incomplete. I attempt to understand how our recent preoccupation with our bodies is being mobilized as one solution to the fiscal crisis of the welfare state. The deep-rooted assumptions of voluntarism that characterize liberal ideology, I claim, are surfacing again in the debate over lifestyle. And lifestyle, it appears, has become an ideological construction which diverts attention from the structural impediments to well-being by framing health issues in terms of personal, moral responsibilities—a “pull yourself up by the bootstraps” alternative to state intervention in health care. Some implications of the lifestyle ideology for physical educationists are presented.

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Jacquelyn Allen Collinson

Despite a growing body of research on the sociology of time and, analogously, on the sociology of sport, to date there has been relatively little sports literature that takes time as the focus of the analysis. Given the centrality of time as a feature of most sports, this would seem a curious lacuna. The primary aims of this article are to contribute new perspectives on the subjective experience of sporting injury and to analyze some of the temporal dimensions of sporting “injury time” and subsequent rehabilitation. The article is based on data derived from a 2-year autoethnographic research project on 2 middle/long-distance runners, and concludes with some indicative comments regarding the need for sports physiotherapists and other health-care practitioners to take into account the subjective temporal dimension of injury and rehabilitative processes.

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Catrine Tudor-Locke, Anita M. Myers, C. Shanthi Jacob, Gareth Jones, Darien-Alexis Lazowski and Nancy A. Ecclestone

The Home Support Exercise Program (HSEP) was developed to reach frail community seniors through home support workers (HSWs) rather than more costly health care professionals such as visiting nurses or physical therapists. This article describes the development and formative evaluation of the HSEP prototype, including the training of case managers and HSWs. In the HSEP’s final form, each client is instructed on 10 simple, functional, and progressive exercises and given an illustrated booklet and a short video. Ongoing encouragement is provided by specifically trained HSWs during regular visits (at least once a week). Formative evaluation of the HSEP model was used to examine and resolve implementation and delivery issues. Qualitative data were collected through focus groups or interviews with each stakeholder group—administrators/coordinators, case managers, HSWs, agency supervisors, and clients themselves. Evaluation findings were used to modify training, instructional, and support materials and the exercises.

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Sandra O'Brien Cousins

This study analyzed older women's (age 57–92, N = 32) descriptions of motivating triggers for physical activity. Among active women, activity was triggered by situations such as declining fitness levels, low bone density, more free time, fears about inadequate health care leading to self-care, expectations for reduced aches and pains, awareness of new community programs, and public reports of the health benefits. Semiactive women had doubts about the appropriateness of being active. Inactive people also experienced triggers but seemed firmly committed to a less active lifestyle by reminding themselves that retirement requires no commitments, exercise is not needed if you are healthy, exercise is not appropriate if you are ill, being very busy is a substitute activity, and serving others is less selfish. The findings suggest that active-living interventions might be more effectively aimed at semi active seniors who seem positively disposed to participating but need help to get started or to stay involved.

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Stephan R. Walk

Recent work has suggested that masculinist sport subcultures (e.g., Young & White, 1995) and “conspiratorial” sports organizations (Nixon, 1992a) foster the acceptance of pain and injury by athletes. Using semistructured interviews, this study examined the experiences and beliefs of 22 student athletic trainers at a large university. The study found that student athletic trainers had conflicting alliances to student athletes and to staff trainers, held competing beliefs about athlete pain and injury, and struggled with athletes who did not properly use health care services and advice. It is recommended that future studies focus upon processes of negotiation and conflict, that more attention be directed to medical treatment of injured women athletes, and that recommendations to change medical services for athletes await further research.

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Anna-Karin Welmer, Annika Mörck and Synneve Dahlin-Ivanoff

The aim of this study was to describe experiences of physical activity, perceived meaning, and the importance of and motives and barriers for participation in physical activity in people 80 years of age and older. A qualitative design with focus-group methodology was used. The sample consisted of 20 community-living people age 80–91 yr. Data analyses revealed 4 themes: physical activity as a part of everything else in life, joie de vivre, fear of disease and dependence, and perceptions of frailty. Our results suggest that physical activity was not seen as a separate activity but rather as a part of activities often rated as more important than the physical activity itself. Thus, when designing physical activity interventions for elderly people, health care providers should consider including time for social interaction and possibilities to be outdoors. Moreover, assessment of physical activity levels among elderly people should include the physical activity in everyday activities.

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Michael B. Hudson

It can be challenging deciding how to resolve personal and professional dilemmas, and the dilemmas that athletic trainers and athletic therapists experience are no different, if not more complex, than the dilemmas other health care professionals experience. The moral behaviors individuals demonstrate with these dilemmas come from their experiences; however, moral beliefs may not always coincide with professional obligations and ethics. The purpose of this article is to examine factors that influence decision making for athletic trainers and athletic therapists to identify and describe policies for guiding moral behaviors in the workplace. These key policies include education in ethical decision making, developing a workplace code of conduct, communicating policies regarding professional behaviors, appraising accepted values and behaviors in the workplace, and investigating possible ethical violations and applying appropriate sanctions.