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The production and perception of emotional speech is of growing importance to forensic speech scientists. They are often asked by instructing parties to provide an opinion as to whether recordings representing a violent attack are genuine, and whether speech material reflects real distress. However, they are prohibited from making statements regarding the psychological states of speakers by the International Association of Forensic Phonetics and Acoustics Code of Practice (IAFPA 2004). This study investigates two principal questions. First, it investigates how distress speech can be manifested acoustically. In so doing it proposes a taxonomy for comparing distress speech across speakers, assists in delimiting the boundaries of the vocal repertoire, and considers the extent to which acoustic measures of distress speech can distinguish between the vocalisations of real victims and actors. Second, it investigates whether listeners can discriminate between genuine and acted distress portrayals, and to what extent familiarity with forensic material increases listeners’ ability. Recordings from authentic criminal cases involving violent attack are compared with re-enactments by trained actors. Acoustic analyses examine F0, intensity, vowel formant frequencies and articulation rate. The recordings are also used as stimuli in a perceptual listening test, comparing the performance of lay listeners, police call takers and forensic practitioners. The findings lend support to the view that assessments of distress should be exercised with extreme caution. On the one hand, acoustic parameters can distinguish between non-distress and distress conditions, but cannot discriminate between acted and authentic distress, and so IAFPA’s refrain from such an assessment is justified. On the other, listeners who are familiar with authentic distress data, such as police call takers and forensic practitioners, are better able to differentiate between acted and authentic distress than lay listeners. Thus, if an assessment were to be made, the forensic practitioners may be the best group to do so.

Acute low back pain is a commonly occurring symptom that can impact considerably upon a person's life. It is poorly defined, difficult to classify and challenging to measure. However, due to the high prevalence rates of the symptom, cited in the epidemiological literature, and the costs incurred by individuals, health services and society in general, it is vital that clients are encouraged to take more responsibility for their health. This thesis is concerned with perceptions of control in people with acute low back pain. It is about how they respond to this symptom and the way it impacts upon their lives. The underpinning literature is drawn from both medical and social science research, as the work crosses faculty boundaries. Problems are addressed from a physiotherapeutic and social science perspective, as links are formed between the different disciplines. From this literature, a significant theoretical development was the creation of a framework, which enabled the systematic review of existing outcome measures. A number of instruments, relevant to clients with acute low back pain, were reviewed using this framework, for the dimensions of control, function, pain and anxiety. The findings were used to inform the selection of outcome measures in this research. Four studies were then undertaken, all linked to studying clients with acute low back pain. The first study was a survey of general practitioners in Southampton and the New Forest, which identified their strategies for managing clients with acute low back pain. The second study focused on clients' experiences and was a randomized controlled trial, which tested the effectiveness of an information leaflet, designed to encourage clients to take more responsibility for their own health. The third study primarily focused on clients' perceptions of control over time, addressing the question of how these perceptions change during a one-year period. Finally, since recruitment of clients by their doctors was problematic throughout this research, a follow-up survey was undertaken with these health professionals to establish the reasons for this. The results of these studies are used to discuss the importance of clients' perceptions of control and the implications for clinical practice.

Children’s poor social-emotional functioning has been an increasing concern prior to and amidst the COVID-19 pandemic. Childhood and adolescence are critical stages of life where they acquire key cognitive and social-emotional skills that shape their future mental health. When a student’s social-emotional health suffers, so do their relationships, academics, and physical health. The theory of improvement hypothesized that students’ social-emotional health can be improved via fostering trusting relationships, boosting self-esteem, and promoting healthy role models and positive adult-child relationships. To address the problem of practice, the primary investigator implemented a social-emotional learning (SEL)-infused, 8-week physical activity after-school program with a strong mentor/role model component. The following inquiry questions guided this dissertation in practice project: 1) How does students’ social-emotional health change after participating the after-school social-emotional learning-infused physical activity program? And 2) What are faculty, staff, and parent perceptions of the impact of a social-emotional learninginfused physical activity program on third grade students? Measures included time sample observations during the program of n=7 at-risk students with behavioral or emotional challenges, field notes compiled by the primary investigator throughout the program, and focus groups with key stakeholders (i.e., n=8 teachers, n=8 parents, and n=12 mentors) conducted post-program. The patterns in changes of student behavior over time were reported as case-study narratives for each observed student. Focus group transcripts and field notes were coded using content analysis v method and analyzed for key categories and themes. Overall, students’ time sample data showed positive improvements in social-emotional health as well as on-task behavior. Three themes were identified in the qualitative data, including: 1) Growing and thriving together: benefits of the afterschool program 2) Trial and error: reflecting on what went well and didn’t go well in the program and 3) Onward and upward: Fine tuning the program for the future. This program demonstrated initial success for improvements in 3 rd grade children’s social-emotional health. Implications for practice include improved training for all stakeholders in social-emotional learning, inclusion of mentorship, and additional administrative buy-in, including logistical support and funding. Future research can investigate the effect on mentor and student overall mental health and academic achievement.

Outcomes that are measured within children's services should reflect the priorities of young people and their parents. Despite global and national policies that state all young people should be given the opportunity to be heard and their views considered, it is currently unknown which outcomes have meaning and importance to young people experiencing persistent pain. The present study sought the opinion of twenty-one parents and twenty-one young people aged 11-18-years-old who were having treatment for persistent pain in two different hospitals. Using novel methods informed by Q-methodology, interviews were completed in person or if preferred, with online methods, and incorporated drawing a timeline that symbolised the treatment journey from beginning to end. Important positive and negative changes (outcomes) were highlighted, and top priorities described. Thematic analysis identified six themes. The themes "perfect storm" and "free" emerged at the start and end of treatment in both the narratives of young people and parents. It was during treatment that change occurred, and the highest number of outcomes were identified. Themes during treatment reflected key shifts in beliefs, control and mind-set: for young people these were "turning points" that could connect or "disconnect" them from their ideal end-point. These shifts were influenced by relationships, the environment and pivotal moments and appeared central to the young person's recovery. For parents, these shifts could move from a position where parents were "fighting in the dark" to "drawing a line under it". Parents consistently prioritised outcomes relating to the treatment experience (getting a diagnosis or access to services or treatments) whereas young people prioritised outcomes relating to their role functioning (hobbies, sports and going out with friends). Ultimately the decision to change came from the young person. The perceived stage of journey mattered and influenced the outcomes that were prioritised.

Clinical guidelines identify a clear role for managing back pain with structured exercise. Pilates is a commonly recommended modality; however, Pilates-specific research is limited. Research suggests the patient-practitioner relationship may be important in managing persistent low back pain, although further research is needed to evaluate its impact on outcomes. The purpose of this study was to identify the components of the relationship between Pilates teachers and clients with persistent low back pain, explore key influences on the relationship, and to examine whether the interaction represents a therapeutic relationship. This qualitative study used a multi-site, ethnographically-informed methodology. Data collection included observation of 24 Pilates sessions at eight sites in the South of England, and 19 semi- structured interviews with Pilates teachers and clients with persistent low back pain. Data were audio-recorded, transcribed verbatim and analysed thematically. From the interviews and observations, ten themes emerged, of which six related to components of the relationship: (1) eing Known'; (2) 'Encouragement'; (3) 'Teacher Expertise'; (4) 'Mastery' of exercises, facilitated y the teacher; (5) 'Trust'; and (6) 'Professional Identity' of the teacher. Key influences on the relationship were identified in three themes: (7) 'Health Perceptions'; (8) 'Social Influences', such s group dynamic; and (9) 'Service Perceptions'. An additional theme described the perceived impact of the relationship: (10) 'Feeling Good'. Further contextualisation of the findings using a social constructionist lens provided a tentative proposal that the relationship between Pilates teachers and clients with persistent low back pain may be considered a therapeutic relationship. The teacher-as-expert guided the client through culturally-based ritual-like practices associated with control of postural alignment and movement, facilitating a reduction in clients' anxieties by providing meaning for their back pain. This conceptualisation demonstrates a complex, multi-faceted interaction, where the teachers' authority is valued. This novel perspective offers a potential avenue for further research.

Numerous researchers have examined school and student variables that can prevent school failure, dropping out, and the development of delinquent behaviors. Such research suggests that students who establish a strong connection to school early in their academic career have higher academic achievement, better attendance, and more school participation (J. D. Finn, 1989, 1993; Finn & Rock, 1997; Sirin & Rogers-Sirin, 2005). However, there is little research that evaluates mechanisms that could be used to intervene when older students are on course for failure or delinquency. The current study, therefore, attempts to expand on the understanding of precipitating factors for school connection by investigating a possible link between school connection, extracurricular activity participation (EAP), and the relationships with teachers, parents, and peers promoted through activity participation. Latent variable structural equation modeling was used to investigate whether relationships with teachers, parents, and peers mediate the effects of EAP on school connection across time. Data from the base year (8th grade), first follow-up (10th grade), and second follow-up (12th grade) waves of the National Educational Longitudinal Study: 1988-2000 (NELS:88) were used. Three latent variable panel models were created and analyzed; one each for Relationships with Teachers, Relationships with Parents, and Relationships with Peers as the mediating variables. Results supported previous literature in that models reflecting a reciprocal relationship between EAP and school connection were found to have the best fit. Additionally, latent variable structural equation models were constructed to simultaneously compare the influence of EAP on the three types of relationships (i.e., with teachers, parents, and peers) and their subsequent influence on school connection. Finally, a latent variable structural equation model was constructed to explore possible differences in the type of activity in which a student participates on their relationships with others and school connection.

The need to engage the public with accurate information about climate change is urgent. Antarctica has become the focus of research for scientists and artists who seek to understand the complex forces at work. Different perceptions of Antarctica are surveyed. These perceptions are expressed through data sets, art works, dances, words, tones of voice and gestures. An iconography of primal gestural forms is identified that has been used since pre-history to make visible expressions of connection to the natural world. The primary research methodology is practice-based. Interviews with expeditioners, online responses and improvised movement workshops are used as sources for animations and art works. Animated forms arise from circling, spiraling, and crossing gestures. These ancient choreographies describe the dynamic structures that shape the Antarctic ecosystem and reflect structures within the body through which they are generated. Animations are presented at international conferences and exhibitions of Antarctic arts and sciences. An online log is used to display the animations and invite responses. The responses are evaluated. Archetypal gestural forms are found to expand the meaning of climate change data. Recognition of these primal forms (as body knowledge) is found to add a dimension of meaning to scientific information that is an essential component of accurate communication.

Rural areas in the United States have experienced significant changes in recent decades. The focus of this study is the changing geographical character of a three- county area in the Appalachian Ridge and Valley of western Virginia that has experienced population redistribution and settlement changes. Of particular interest is role that local (life-long) residents play in the redistribution of population and changing settlement patterns for rural areas. The principal changes for the study area took place after 1950 as the economy shifted from small-scale general farming to employment opportunities in manufacturing and the service sector. Until the 1950s, the structure of rural settlement for the study area remained essentially un- changed. By the 1950s, rural-to-urban population movements within the study area counties depopulated rural areas and brought about general rural decline. Between 1960-1980, the trend reversed itself whereby small towns and the rural countryside were the principal beneficiaries of renewed population (and household) growth. These gains were manifested in significant additions to the housing inventory and concomitant settlement reorganization. The trend was one whereby the new settlement was concentrated near small towns, the interstate transportation corridor, and at higher densities in the countryside in the form of subdivisions, and road frontage lot arrangements.A survey among a sample population that built conventional houses or placed mobile homes during the 1970s and 1980s was used to assess attitudes and perceptions concerning the residential location decision. The principal findings of the survey were that land availability, living in the country, a sense of belonging to a community, and a high-value placed on living near relatives were the most important considerations when deciding where to build a house or place a mobile home.This study concludes that in a relatively short period of time the geographical character of the study area was changed by local residents through settlement reorgan- ization, and that, in all likelihood, this episode represents a once in a lifetime change for the area.

The study attempted to reduce endometriotic dysmenorrhea through the adaptation of Longo, Clum, and Yaeger's psychosocial treatment regimen for genital herpes symptoms. Thirteen women were assigned to the psychosocial treatment group or a social support control group and followed through 6 weeks each of baseline, intervention, and follow-up. Treatment consisted of training in respiratory relief therapy and suggestive imagery, provision of information about endometriosis, and group discussions of maladaptive and adaptive adjustments, emotional aspects, and sexual intercourse. The social support control group received the same with the exception of respiratory relief therapy and suggestive imagery. A MANOVA of the pre-post-follow-up data for aggregate pain, aggregate distress, aggregate negative affect and hassles measures yielded equivocal results. Data from participants with reported pain above the mean were analyzed separately. Results partially replicated Longo, Clum, and Yaeger's findings, with an important reduction from pre to post and follow-up scores in aggregate pain for the psychosocial but not the social support group. (Abstract shortened with permission of author.)

This thesis examines the developing paradigm of General Semantics, specifically as affected by the theory of E-Prime. Since 1965, D. David Bourland's theory of E-Prime has aroused the interest of many people across the United States. It has also instigated much controversy. Within the General Semantics community, some members condemn E-Prime because of its purported blaspheming of the discipline's fundamental beliefs, as developed by Count Alfred Korzybski. Outside of General Semantics, skeptics working within diverse disciplines variously ground their opposition to E-Prime in areas such as linguistics and sociology, failing to carefully examine E-Prime's relationship to and real implications for General Semantics. In The Structure of Scientific Revolutions, Thomas Kuhn explores the importance of paradigms in scientific process. He sees the various phenomena associated with communities of researchers as pivotal in the direction eventually taken by the majority of persons within an area of study. Membership in one social-academic group or another influences and often preempts research procedures as well as interpretations of results. As a science, General Semantics follows the process, as articulated by Kuhn, of looking for model problems and model solutions. In applying Kuhn's theory of scientific revolutions to the development of E-Prime, this thesis not only tracks the development of both General Semantics and E-Prime to this point, but also analyzes the reasons for existing skepticism toward and emphatic rejection of the emerging paradigm.

Skill-mix change and task shifting among the healthcare workforce has become a key mechanism for the continued provision of effective public healthcare within funding constraints. However, decoupling the healthcare professions from their traditional professional work tasks is not straightforward. Previous research has shown that in some contexts jurisdictional boundaries remain resolute. This thesis uses two case studies to explore the mechanism and effect of challenge to the physiotherapy-medical professional boundary, precipitated by policy to modernise the English National Health Service workforce. The first examines the socio-political events which accompanied the publication of a national clinical guideline that proposed a reconfiguration of healthcare professionals managing people with non-specific low back pain. The second investigates the practice of physiotherapist non-medical prescribing in a musculoskeletal outpatient service in a single NHS Trust in England. The methodology adopted is interpretive policy analysis, informed by Foucault's writings about power/knowledge and governmentality. Through the identification and analysis of policy-related symbolic languages, objects and acts holding meaning for the communities studied, and examination of the system of relations between them, the discursive and extra-discursive constituting and shaping the physiotherapy-medical boundary are revealed. A 'grid of intelligibility' is employed as a framework to discern the circuits of power and the technologies governing physiotherapy practice. 'Medical professionalism' - the pre-eminence of specialist physicians in this field of healthcare - emerged as a dominant discursive formation and the case studies show the significant professional and institutional work required to maintain this. The findings of this thesis suggest that despite the strong policy rhetoric of workforce modernisation, medical professionalism at the physiotherapy-medical boundary continues to thwart jurisdictional change. The historically contingent discourses at the heart of this power struggle mean that both meso-level policies and local-level practice change, directed to workforce reconfiguration, have only limited impact.

The studies presented in this thesis describe the identification of novel capsid motifs involved in cell culture adaptation of FMDV A/Iran/87 A-. Field isolates of foot-and-mouth disease virus (FMDV) use integrins as receptors due to the presence of a conserved integrin-binding RGD motif located on the G-H loop of VP1, whereas cell-culture adapted variants can use other receptors such as heparan sulphate (HS). FMDV A/Iran/87 A- was isolated from a vaccine stock and has a major deletion within the VP1 G-H loop. This virus is unable to bind to integrins (as it lacks the RGD), and lacks the known HS contact residues. Sequence comparison identified a limited number of surface exposed residue changes, including a LEK to SAR tri-peptide at VP2 78-80 and a KE to EK di-peptide at VP2 130-131. Reverse genetics was used to investigate a functional role for these motifs in infection where it was found that VP2 80 (R) and 131 (K) were critical for infectivity. Mutagenesis was then used to introduce these motifs in to another type-A virus whilst simultaneously abrogating integrin-binding. Infectious virus could only be recovered when both the SAR and EK motifs were present suggesting that both the SAR and EK motifs are essential for infection, most likely by forming a novel receptor attachment site. Using immunofluorescence microscopy, cell surface-bound A/Iran/87 A- was rapidly internalised (within 5 mins), and co-localised with markers of early endosomes. This was characteristic of clathrin-mediated endocytosis and this conclusion was supported by observations that entry was inhibited by clathrin- and dynamin-inhibitors. However A/Iran/87 A- also co-localised with caveolin-1, a marker of caveolae, suggesting it may use more than one entry pathway. Taken together, this research may pave the way for future studies into rationally designed vaccine-viruses.

Parkinson’s is a common, progressive, neurodegenerative movement disorder of the central nervous system, presenting with particular impairment of the motor system. Despite a growing body of literature recommending the use of dance for the treatment and management of Parkinson’s, the exact impact and effect on turning ability has not been investigated. In addition, the experience of those teaching dance has also received little attention. The purpose of this research study was to explore the experience of teaching ballroom and Latin American dance classes for people with Parkinson’s (PwP) from a qualitative perspective alongside the main aim of investigating effects on turning in PwP from a quantitative perspective. Qualitatively, three dance teachers were approached to participate in semi-structured interviews before and after teaching dance classes for PwP over one year. A thematic analysis was undertaken using a framework approach, informed by the principles of Interpretative Phenomenological Analysis. Two dance teachers participated, with analysis generating four themes: 1) the role of adaptation, 2) the context and 3) practical application of the class and 4) how achievement was measured and the impact of the teacher. Quantitatively, twenty-four PwP were randomly allocated to receive either twenty, one-hour dancing classes over 10-weeks (n=12), or usual care (n=12). Using 3-dimensional movement analysis before and after the intervention period, measures of latency and horizontal movement of the eyes, head, thorax, shoulders, pelvis and feet, centre of mass displacement, and the total time of a 180 degree on-the-spot turn were taken alongside clinical measures. Statistical analysis (4-way ANOVA) demonstrated a significant four-way interaction for head latency (p=0.008), with mean values showing longer latency in the usual care. Similar trends were also shown in pelvis latency (p=0.077), first (p=0.063) and second (p=0.081) foot latency, with mean values suggesting longer pelvis latency and slower foot movement in the usual care group, although all results were affected by prediction and preference of turn direction. Significant between-group differences were also found for pelvis rotation (p=0.036), with the usual care group showing greater rotation. No differences were found in the centre of mass displacement, turn time or clinical measures. As a result of interpretation the main findings suggest a tighter coupling and greater co-ordination of all segments following dance. In conclusion, teachers’ expectations and experiences suggest a multidimensional impact of dance for PwP with importance of socialisation, increased confidence, level of achievement and participation, knowledge of which will support the development of dance classes for PwP. Specifically, body segments (head, pelvis and feet) appear more coordinated in time and sequence following dance in PwP, suggesting a more ‘en bloc’ turning pattern with greater inter-segmental coordination. However, this is influenced by direction of turn preference and prediction, with further research required to comment on the clinical implications.

The ability of physiotherapists to make clinical decisions is understood to be a vital component of achieving expertise and is part of being an autonomous practitioner, yet this complex phenomenon has been under-researched in cardiorespiratory physiotherapy. Educators in this field need to understand what method of clinical reasoning clinicians are using, so that educational strategies can be designed to facilitate the development of clinical reasoning by undergraduate physiotherapy students prior to them going on clinical placement. This study explored the clinical reasoning of eight expert cardiorespiratory physiotherapists by observing their actions and behaviour whilst they assessed a simulated patient with respiratory complications in a simulated environment. The assessments were video-recorded. The physiotherapists were encouraged to think-aloud to verbalise their thought processes and had a debrief interview afterwards. The videos and the verbal transcripts from the assessment were analysed using a framework analysis and compared to other models of clinical reasoning. The study has confirmed that clinical reasoning is a complex, multi-dimensional phenomenon and the model produced shares some similarities with other models of clinical reasoning. Four key concepts have been identified as requirements for clinical reasoning development: knowledge acquisition; knowledge storage and retrieval; information processing and cognitive skill development; and metacognition and reflection. These concepts have been incorporated into a new conceptual model of clinical reasoning and embedded into a simulation learning strategy to facilitate clinical reasoning across all three years of the undergraduate physiotherapy programme.

The role of the extended scope physiotherapist has developed relatively recently within health-care. The extended role has utilised the skills of allied health professionals including physiotherapists, and given them autonomy to use knowledge and clinical acumen to request investigations such as Magnetic Resonance Imaging (MRI) as part of the diagnostic process. These requests and processes are delivered outside their traditional scope of practice. Further knowledge on how these practitioners clinically reason is therefore needed as there is little within the literature regarding reasoning in this specific group of clinicians. This research aids in the development of future roles, the governance of services, whilst supporting the training of clinical reasoning for new recruits to this work. This qualitative study has explored the processes by which extended scope physiotherapists clinically reason decisions regarding patients reporting low back pain. The study has used a multiple case study design informed by grounded theory methodology with focus groups and semi-structured interviews as a method to investigate these processes. The themes identified included prior thinking, patient interaction, formal testing, time, safety and accountability, external/internal and gut feeling. Subtle differences in clinical reasoning were seen in the focus group study between ESP and non-ESP clinicians. The processes of clinical reasoning are presented that suggests how these clinicians reason whilst highlighting how they differ to non-extended scope physiotherapists.