Can Cycling Be Addictive? A Qualitative Interview Study Among Amateur Female Cyclists

Exercise and healthy eating are proposed as a recommended lifestyle by the World Health Organization with several positive outcomes, including a decrease in pathologies such as diabetes and reduction in mortality rates. However, research suggests that there is the potential for exercise behaviour to become addictive among a small minority of individuals, which detrimentally impacts their lives. The risk of exercise addiction increases for endurance sports, of which cycling is considered one, given the intense physical and psychological demands, due to elevation and distance, in amateur cycling events. Understanding the risk factors specific to cycling is worthy of investigation, as it is not clear whether cycling can become an addiction. Using the ‘addiction component model’ as a framework, qualitative analysis was used to determine whether symptoms of addiction were present among a sample of eight female cyclists. Through the use of thematic analysis, the results showed that symptoms of addiction were reported by participants. Three themes were generated from research interviews comprising ‘addiction components’ (i.e. salience, conflict, mood modification, tolerance, withdrawal, and cycling despite health problems), ‘enabling infrastructure’ (i.e. supportive work, supportive family and friends), and ‘striving for excellence’ (i.e. needing to be the best, pushing too far, and having unrealistic expectation), currently measured in the ‘addiction component model’. There were also novel themes including ‘cycling above health’ where the participant continues to cycle against medical advice; ‘enabling infrastructure’ where work, family, and friends are accepting of cycling; and ‘striving for excellence’ where the participants ‘needing to be the best’ when comparing themselves to their peers, ‘pushing too far’ to achieve the goal set, and finally ‘unrealistic expectations’ resulting in negative comparison to peers. These findings suggest that addiction to cycling should be investigated further, and implications may necessitate clinical intervention to find alternative coping mechanisms when exercise is not available to an individual as there is a likelihood that individuals will continue to exercise in spite of injury and against medical advice.

EFFECTIVENESS OF PEACE EDUCATION MODEL FOR ALLEVIATING ACADEMIC ANXIETY OF LEARNERS

The students' life being complicated and at the same time competitive trying hard to remain alive in this competitive world and trying to solve many complicated problems in academics through the competitive mind ultimately takes a roll and the mind becomes unstable and directionless. In the process, the student develops academic anxiety related to academic circumstances, like failure in exams, time constraint; unrealistic expectation. Hence the researcher felt the need to develop peace strategies to lessen the academic anxiety among the engineering and medical learners. The quasi – Experimental pre-test post -test nonequivalent group design was used to evaluate the development of peace education among engineering and medical learners. The Peace modules were designed by the researcher and were implemented on the Experimental group of learners.The Inferential analysis was done by using the independent 't test'.The findings of the study indicated that the peace strategies used were successful.

Zimbabwe: A History of the Military in Politics, 1980–2019

In post-conflict states, the establishment of institutions, as part of state formation, is carefully managed in order to prevent the resumption of fighting amongst former armed groups. In the transition from colonial Rhodesia to present Zimbabwe, the process was guided by the provisions contained in the December 2, 1979 Lancaster House Agreement (LHA) reached in London by parties in dispute. The LHA provided for a finely balanced political power sharing arrangement during the first decade between the minority white and the majority African population. This was divided and embedded for the next ten years, in a ratio of 20 to 80 seats, respectively, in the new National Assembly. The accord’s underlying assumption was, therefore, that the African majority represented a cohesive and united group. Given the end of the conflict with a ceasefire signed by the political entities, each with a highly charged armed group—comprising the Rhodesian Security Forces (RSF), former combatants of the Zimbabwe African National Liberation Army (ZANLA), and the Zimbabwe Peoples’ Revolutionary Army (ZIPRA)—an urgent, parallel process to establish an integrated force was also in support of the new administration that would emerge from the two scheduled electoral processes. Since the creation of the Zimbabwean state, in April 1980, the security establishment has evolved into a highly politicized institution in support of the ruling party and executive, ultimately serving as the alternative to electoral legitimacy, placing them at odds with the citizenry. In examining the transformation over nearly four decades, the evidence reveals three distinct steps that began by invitation, between 1980 and 2001, against actual and perceived political opposition. This was followed by the second step, made explicit on January 9, 2002, when the full repertoire of top generals in full regalia appeared on television redefining the criteria of the presidency, outside the electoral norm but in support of the incumbent in an incestuous relationship. This position persisted from January 2002 until November 2017. On November 21, 2017, President Robert Mugabe was compelled to tender his resignation following his isolation after the violent seizure of power through Operation Restore Legacy on November 14–15. From that moment on, the military establishment in Zimbabwe, working closely with a political faction of the Zimbabwe African National Union Patriotic Front (ZANU PF), fully grasped political power. On December 18, 2017, a formal announcement ending Operation Restore Legacy was made together with the parallel retirement and appointment of the Chief of Defence Staff (CDS), Lieutenant General Constantine Chiwenga as the new first Vice President of the country, accompanied by the Air Marshall, Perence Shiri, who became the Minister of Agriculture, and Major General Sibusiso Moyo who, at dawn on the November 15th had appeared on television announcing what has since been described as the military-assisted transition (MAT), appointed as the new Minister of Foreign Affairs among others. All the senior officers cited also became members of the ruling party, ZANU (PF)’s highest decision-making echelons of the politburo and central committee, which was now headed by Major General Engelbert Rugeje, also immediately retired, to become the new commissar or secretary general. Relying on secondary sources, observation, and minutes of confidential meetings, the discussion provides a better understanding of why and how the political role of the military emerged almost in parallel with independence in 1980, how the institution evolved, away from the LHA plan, and what it became following the reticent and acrimonious departure of Mugabe, expelled from ZANU (PF) and compelled to resign after 38 years in power and at the helm. In the aftermath, the military has become the arbiter and kingmaker, again continuing to negate the electoral processes while observing minimally constitutional and normative provisions for purposes of retaining sub-regional, SADC, and African Union continental, multilateral support. Significantly, even with the naked politicization of the military amid the militarization of Zimbabwean politics, woven into revolutionary neo-colonial rhetoric, there has been no sufficient expectation or resolve to have Mugabe or the country’s institutions observe norms of democratic governance, particularly as leaders of the majority of African states appear convinced that, in fact, the crisis in Zimbabwe is about the continuing decolonization agenda against which revolutionary, violent methods are justified. To this end, the involvement of the political opposition receiving explicit support from the former colonial power—for instance, Joshua Nkomo exiled in Britain during the 1980s, and later the expressed support by British Prime Minister, Tony Blair, for Morgan Tsvangirai and the Movement for Democratic Change (MDC)—only reinforced these impressions. Consequently, amongst the African member states, there is an unrealistic expectation that political changes will emerge from ZANU PF reforming and aligning itself to the democratic agenda. In their view, the opposition MDC is but merely a protest movement, not credited as a possible alternative government in waiting.

Can the "Yelp Effect" Be Reversed? Dealing with Patients' Expectations for Antibiotics (Preprint)

BACKGROUND The overuse of antibiotics has rapidly made antimicrobial resistance a global public health challenge. There is an emerging trend where providers who perceive that their patients expect antibiotics are more likely to prescribe antibiotics unprompted or upon request.1 Particularly, health care providers have expressed concern that dissatisfied patients will provide disparaging online reviews therefore threatening the reputation of the practice.2 To better deal with the negative reviews and inform patients, some health care staff directly respond to patients' online feedback.3 Engaging with patients’ online reviews gives providers an opportunity to prevent reputational damage and improve patients’ understanding of the antibiotic resistance problem. OBJECTIVE We aim to suggest and test the effectiveness of different response strategies to the negative patient online reviews on the readers’ perceptions of the health care provider and their perceptions related to antibiotics resistance. METHODS Two experimental surveys were conducted to examine the impact of message tactics (apologizing, inducing fear or guilt) that can be employed by healthcare providers when responding to patients’ negative online feedback related to not receiving an antibiotic. RESULTS Overall, our results demonstrated positive impacts of responding to patients’ online reviews. In Study 1, we found an apologetic messaging and using emotional appeals in the response were effective in making readers feel more favorable toward the message. Readers also expressed greater credibility perception toward the provider when emotional appeals were used. Findings from study 2 largely supported the effectiveness of fear-inducing response in improving the readers’ misconception and unrealistic expectation for antibiotics. CONCLUSIONS This paper demonstrated that a strategic response to patient online complaints can prevent reputational damage and help to minimize the potential negative impacts of the review. The results also glean insight into the step toward developing a novel intervention--crafting a persuasive response to patients’ negative feedback that can help to improve the understanding of antibiotic resistance problems.

The Value of All-Cause Mortality as a Metric for Assessing Breast Cancer Screening

Although screening mammography has been demonstrated to contribute to reducing mortality due to breast cancer, some have suggested that reduced all-cause mortality should constitute the burden of proof for effectiveness. Using a microsimulation model of the development, detection, and treatment of breast cancer, it is straightforward to demonstrate that this is an unrealistic expectation for trials of practical size and period of observation, even where the reduction of breast cancer mortality is substantial. Estimates of all-cause mortality will depend not only on the efficacy of the screening intervention but also on the alignment between the age distribution of the effect of screening on reduction of deaths and that of the other major causes of death. The size of a randomized trial required to demonstrate a reduction in all-cause mortality will, therefore, depend on the length and timing of the observation period and will typically be at least 10 times larger than the size of a trial powered to test for a reduction in deaths due to breast cancer. For breast cancer, which represents a small fraction of overall deaths, all-cause mortality is neither a practical nor informative metric for assessing the effectiveness of screening.

The Emotional Impact of Social Media in Higher Education

College and university students have been observed increasing their usage of social media applications as it has become central to everyday life. Students can use different forms of social media to connect, share, and view a myriad of content. When influenced by posts, social media can have a significant impact on their lives. Social media can be a form of social support, but it can also have a negative effect on mental health. With the increase in use, social media can provoke individuals to begin self-comparing or gain an unrealistic expectation of themselves and other individuals. This can lead to lower self-esteem, self-confidence, and self-worth. This exploratory study attempts to determine the relationship between social media use and its impact on depression, anxiety, and stress amongst students in higher education.

„Społeczeństwo dla wszystkich”, czy tylko „szkoła dla wszystkich” – opinie nauczycieli szkoły specjalnej, integracyjnej i ogólnodostępnej

Teachers play a vital role in students’ intellectual and personal development, hence they help to prepare citizens. Therefore, it is worth asking what their views are on a “perfectly inclusive” world vision. To analyse the teachers’ perception, the study explored two areas: their outlook on an inclusive society and the importance of an inclusive education for marginalised groups. The research comprised teachers working with Special Educational Needs (SEN) students: 55 from integration schools, 48 from regular schools, 45 from special schools (those with intellectual disability (ID) and autism). The data was collected using a questionnaire. The findings highlighted that all groups thought that people with disabilities primarily needed help and support, special school teachers felt most strongly about this. Special educational needs teachers most strongly disagreed that their group were afraid of the disabled or felt hostility towards them compared to the other two groups. All groups had milder opinions regarding other types of marginalised people. The majority of special school teacher’s had views similar to general society regarding that the presence of refugees in society could pose a danger, whilst most teachers from regular schools thought that refugees were here for work and social care. In light of the study, all groups agreed that regular schools were not the best place for pupils with SEN, however they would make an exception for students with mild disabilities, the children of refugees, and those from national and ethnic minorities. Special schools teachers working with students with severe disabilities strongly agreed that students with an ID and autism generally, should stay in the separated model of education. All groups regarded that the goal of an “education for all” was an unrealistic expectation especially in the near future, just as the goal of an “inclusive society”.

The Myth of the Perfect Pregnancy

The Myth of the Perfect Pregnancy is a history of why Americans came to have the unrealistic expectation of perfect pregnancies and to mourn even very early miscarriages. The introduction explains that miscarriage is a common phenomenon and a natural part of healthy women’s childbearing: approximately 20 percent of confirmed pregnancies spontaneously miscarry, mostly in the first months of gestation. Eight topical chapters describe childbearing and pregnancy loss in colonial America; the rise of birth control from the late eighteenth century to the present; changes in parenting from the early nineteenth century to the present that increasingly focused attention on the emotional relationship between parent and child; the twentieth-century rise of prenatal care and maternal education about embryonic growth; the twentieth-century blossoming of a consumer culture that marketed baby items to pregnant women; the abortion debates from the mid-twentieth century to the present; the late twentieth-century introduction of obstetric ultrasound and its evolution into a pregnancy ritual of “meeting the baby” as early as eight weeks’ gestation; and the late twentieth-century introduction of home pregnancy testing and the identification of pregnancy as early as several days before a missed period. The conclusion offers suggestions for how women and their families, health-care providers, and the maternity care industry can better handle pregnancy and address miscarriage.

Planning the Baby

The American Revolution brought with it not just a visionary new form of government but also the radical new sensibility that individuals might reasonably strive to have control over their fate. Women began to imagine smaller families and to make explicit plans to limit the size of their families. This shift in intention came long before any meaningful innovations in contraceptive technology or knowledge. During the nineteenth century, couples used crude means—withdrawal, douching, abortion, and abstinence—to carry out their newfound intentions to become the masters of their reproductive destiny. In the twentieth century, modern birth control made fine-grained control of fertility more practical, and couples’ expectations and intentions ramped up accordingly. This new intention to control fertility, realized with ever-greater precision using sophisticated new modes of contraception, eventually resulted in an unrealistic expectation of near-perfect control of conception and pregnancy outcomes.

Participatory Democracy or State-Induced Violence? Resettling the Displaced People of Hatirjheel in Dhaka

This article discusses the trajectory of project implementation in the development of the Hatirjheel lake area in Dhaka, which involved forced relocation and socio-economic deprivation for most project-affected people. It raises questions over the extent to which such processes need to be seen as state-induced violations of basic justice, asking whether more justice-focused management of such projects is becoming an unrealistic expectation in an increasingly crowded Bangladesh. The article discusses the socio-political dynamics and community-related issues affecting different stakeholders during the implementation of the project. Despite the official presence of participatory planning techniques, the forceful imposition of the development plans and the drastic ramifications of forced land acquisition are shown to have violated basic principles of good governance. It is suggested that less violent and more inclusive approaches are possible despite resource scarcities and that lessons can be learned from such experiences for the future.