'Everything I enjoy doing I just couldn't do': Biographical disruption for sport-related injury.

This article draws on interview data with a population of non-elite sport/exercise participants (n = 20) to illustrate the interrelationship between biographical disruption and sport-related injury. It argues that contrary to the significance implied by their lack of prominence on current public health agendas, sport-related injuries can have a devastating personal impact, comparable to the more extreme variants of biographical disruption depicted in the literature on chronic illness. It seeks to explain the apparent incongruence between biophysical severity and subjective assessment of impact, by invoking notions of community normalisation and imagined futures, and identifying the unavailability of what subjects evaluate as effective medical support. These factors combine to problematise the attainment of biographical repair. It further highlights how biographical contingencies such as youthfulness, distinction through exhibiting responsible citizenship and the sense of failure to exert bodily self-management through exercise, perpetuate and escalate both biographical disruption and chronic illness. The paper thus illustrates the aetiological interdependence of biographical disruption and chronic illness as exercisers exacerbate relatively minor ailments due to their reluctance to modify habitual routines.

The experiences of cancer patients within the material hospital environment: Three ways that materiality is affective.

Improving the patient experience is widely recognised as an important goal in the delivery of high-quality healthcare. This study contributes to this goal with a particular focus on the role of the material hospital environment for patients being treated for cancer. Extending the burgeoning literature utilising materialist theoretical approaches in social science and medicine, we report on qualitative data with 18 participants who had received cancer treatment from one UK hospital. Our analysis offers a typology of ways in which the material hospital environment is affective: through patients' direct intra-actions with nonhuman materiality; through providing shared spaces within which human-human assemblages are actualised; and through being the material component of the practices of treatment. Within each process in this typology, the analysis highlights how the affective feeling states which play a critical role in patient wellbeing are in many ways contingent, fluid and context-sensitive. Amidst ambitions to improve the patient experience, these findings underline the significance of materialities of care and offer a broad explanatory typology with analytic and practical potential for healthcare staff, patient groups, architects and designers.

How effective is the integration of sport and exercise medicine in the English National Health Service for sport related injury treatment and health management?

BACKGROUND: Regular participation in sport, exercise and physical activity (PA) is associated with positive health outcomes and form a mainstay of British public health policies. However, regular participation in sport and exercise can result in sport related injury (SRI) which, in turn, is a key cause of exercise cessation. The integration of Sport and Exercise Medicine (SEM) in the English National Health Service (NHS) aims to provide a specialist service for public populations and thus reduce the impact of SRI on exercise cessation and associated negative health outcomes. More broadly it aims to both support PA health promotion policies and improve healthcare organisations efficiencies through providing the most condition-appropriate treatment. METHODS: This qualitative interview study examines patients' (N.=19) experiences of accessing and receiving SEM treatment within the English NHS. RESULTS: The research demonstrates that referral pathways into SEM were often prolonged, characterised by multiple general practitioner (GP) visits and referrals into other musculoskeletal services, demonstrating an inefficient use of healthcare resources. Prolonged pathways fostered only limited recovery back to previous PA levels and other negative health behaviours, yet on accessing the SEM clinic, patients experienced progressive rehabilitation back into sport and exercise participation. CONCLUSIONS: This study highlights the importance of more fully integrating SEM services into public healthcare as a way of improving the organisational capacity of healthcare in treating SRI and ensuring that citizens comply with state interventions which orchestrate health management through raising PA levels across the population.