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ABSTRACTDrawing on interview data, we use gender and embodiment literature to understand the experiences, attitudes, and behaviours of women rugby players in relation to tackle performance and safety. Sampling, data collection, and data analysis were guided by principles and techniques of the grounded theory method. Participants’ experiences illustrate the processes through which women struggle to claim space in rugby. Constraining gender norms, the inferiorisation of women’s athletic achievements, and inequitable playing conditions are at the centre of this struggle. Organisational support and cultural acceptance are predicated on conformity to masculinist models of performance and behaviour whilst preserving the ideals of femininity. However, women’s embodied persistence and agency can challenge the gendered status quo in rugby and reshape the field of play. Revising rugby structures to include more nuanced models for performance development, including commensurate support for the women’s game both in financial sense and in terms of identity could enhance safety and performance in women’s rugby.

ObjectivesPatients with advanced illness and their family caregivers can be mutually supportive. However, what facilitates and/or restricts supportive relationships between patients and family caregivers in palliative care remains unclear. We aimed to identify key barriers to and facilitators of supportive relationships between people with advanced illness and family caregivers in specialist palliative care.MethodsA qualitative study using grounded theory methodology was conducted. Semistructured interviews were undertaken with 15 patients with advanced illness and 21 family caregivers purposively and theoretically sampled from a large regional specialist palliative care service. Verbatim transcripts were analysed in line with grounded theory coding procedures.ResultsMutual support was underpinned by mutual concern and understanding. Facilitators of supportive relationships included patients and family caregivers already having a close relationship, caregivers assuming caregiving duties by choice, caregivers feeling competent in a caregiving role, patients valuing caregiver efforts, availability of respite for the caregiver and direct support from healthcare professionals to help both patients and caregivers adjust to advanced illness. Barriers to supportive relationships included absence of support from the wider family, prior mutual conflict between the patient and caregiver, caregivers feeling constrained in their caregiving role and patient and caregiver distress induced by mutual loss.ConclusionsMultiple factors at both a micro (eg, relationship based) and mesolevel (eg, assistance from services) impact patient and family caregiver ability to support one another in specialist palliative care. Supportive relationships between patients and family caregivers are mediated by feelings pertaining to both control and loss.

ObjectivesTackle-related injuries account for up to 67% of all match injuries in women’s rugby union. The perspective of women players on tackle injury can help key stakeholders understand psychosocial determinants of tackle injury risk and prevention. We aimed to capture psychosocial processes that explain tackle injury experiences and behaviours in women’s rugby union.MethodsWe conducted a qualitative study using a grounded theory approach. Adult women players, with at least 1-year senior level experience, were recruited from Europe, South Africa and Canada between December 2021 and March 2022. Data were collected through semistructured interviews and analysed in line with grounded theory coding procedures.ResultsTwenty-one players, aged 20–48 years with a mean 10.6 years of rugby playing experience, participated. In our analysis, we identified three categories central to participants’ experiences of tackle injury: (1) embodied understandings of tackle injury, (2) gender and tackle injury risk and (3) influences on tackle injury behaviours. Participants reported a sense of fear in their experience of tackling but felt that tackle injuries were an inevitable part of the game. Tackle injury was described based on performance limitations. Tackle injury risks and behaviours were influenced by gendered factors perpetuated by relations, practices and structures within the playing context of women’s rugby union.ConclusionWomen’s tackle injury experiences were intertwined with the day-to-day realities of marginalisation and under preparedness. Grounded in the voices of women, we have provided recommendations for key stakeholders to support tackle injury prevention in women’s rugby.

BackgroundDecision-making in palliative care usually involves both patients and family caregivers. However, how concordance and discordance in decision-making manifest and function between patients and family caregivers in palliative care is not well understood.ObjectivesTo identify key factors and/or processes which underpin concordance and/or discordance between patients and family caregivers with respect to their preferences for and decisions about palliative care; and ascertain how patients and family caregivers manage discordance in decision-making in palliative care.MethodsA systematic review and narrative synthesis of original studies published in full between January 2000 and June 2021 was conducted using the following databases: Embase; Medline; CINAHL; AMED; Web of Science; PsycINFO; PsycARTICLES; and Social Sciences Full Text.ResultsAfter full-text review, 39 studies were included in the synthesis. Studies focused primarily on end-of-life care and on patient and family caregiver preferences for patient care. We found that discordance between patients and family caregivers in palliative care can manifest in relational conflict and can result from a lack of awareness of and communication about each other’s preferences for care. Patients’ advancing illness and impending death together with open dialogue about future care including advance care planning can foster consensus between patients and family caregivers.ConclusionsPatients and family caregivers in palliative care can accommodate each other’s preferences for care. Further research is needed to fully understand how patients and family caregivers move towards consensus in the context of advancing illness.

Background/AimsFatigue is the most common symptom of multiple sclerosis. Evidence supports the effectiveness of fatigue management interventions for people with multiple sclerosis. This review aimed to identify how people with multiple sclerosis experience fatigue and to examine their perceptions of fatigue management interventions.MethodsThe review was conducted systematically, searching the following electronic databases: AMED, CINAHL Complete, eBook Nursing Collection, ERIC, Health Source: Nursing/Academic Edition, MEDLINE, APA PsycArticles, and APA PsycInfo for original peer-reviewed empirical research published in English between January 2000 and June 2020. Qualitative and mixed-methods studies that captured the perspectives of people with multiple sclerosis on their fatigue and/or their perceptions of fatigue management interventions were included. A narrative synthesis was used to synthesise the findings.ResultsA total of 23 qualitative and eight mixed-methods studies were extracted comprising a total of 662 people with multiple sclerosis (relapsing remitting n=293; secondary progressive n=129; primary progressive n=73; relapsing progressive n=3; benign n=2; fulminant n=1; type of multiple sclerosis not reported n=161). Fatigue was perceived by people with multiple sclerosis as a debilitating symptom of the condition and which they felt impacted adversely on their lives. A lack of understanding from others about multiple sclerosis fatigue was challenging for people with multiple sclerosis. People with multiple sclerosis valued the physical and psychosocial-based content of fatigue management interventions and felt fatigue management interventions enabled them to legitimise their fatigue and feel more in control of their fatigue.ConclusionsFrom the perspective of people with multiple sclerosis, fatigue is a central and debilitating feature of the everyday experience of living with multiple sclerosis. Research on the potential of fatigue management interventions to foster control for people with multiple sclerosis to help them manage their fatigue is warranted. Healthcare professionals should consider how they can empower people with multiple sclerosis to educate others about their fatigue. Some evidence being generated for practice might not be sufficiently contextualised to different forms of multiple sclerosis.

Environ 80 millions d’enfants vivent avec un handicap du développement et les systèmes de santé ne répondent pas à l’ensemble de leurs besoins. Si disponibles, les services de rééducation sont invariablement sous-financés et sous-développés [1]. De plus, les services de rééducation sont souvent séparés des systèmes de santé. Représentant 1 naissance sur 500 et 11 millions de YLDs dans le monde, la Paralysie Cérébrale (PC) nécessite des soins de rééducation à vie. Le Global Burden of Disease2019 identifie la région du Pacifique Ouest (PO) comme celle avec le plus de besoins de rééducation insatisfaits [2].

Traditionally, amyotrophic lateral sclerosis (ALS) has been viewed as a degenerative disease, selective to the motor system. Until recently, research into cognitive impairment in ALS was confined primarily to a small proportion of patients with overt and clinically evident frontotemporal dementia (ALS/FTD). However, evidence from contemporary neuropsychological analysis and functional imaging studies, as identified in this review, indicates that a significantly higher percentage of patients with ALS presents with milder cognitive impairment in frontotemporal function. These deficits are considered progressive in nature, with increasing disability. Disturbances within the supervisory attentional system or central executive are thought to be responsible.It would appear that patients diagnosed with ALS may not be equally susceptible to developing cognitive deficits. The relationship between bulbar-onset ALS and increased cognitive decline is noteworthy. In ALS, the impact of cognitive disturbance on occupational performance must be considered in addition to physical disability.

People diagnosed with a progressive neurological disorder represent a significant proportion of the population that lives with a neurological disease. Neurological impairment may vary between different conditions and the rates of progression differ. However, progressive impairment has a direct effect on activity, participation and wellbeing. The occupational therapy process attempts to alleviate and/or remedy the direct effects of impairment in order to maximise activity and participation. The basic premise of neurorehabilitation and the International Classification of Functioning, Disability and Health fit well with occupational therapy practice.

Motor neurone disease is a fatal neurodegenerative disorder and from disease onset health care intervention is palliative in nature. Numerous studies on wellbeing in motor neurone disease are consistent with the palliative care literature, where the values assigned to non-physical life domains increase with disease progression. Occupational therapists should consider all components of wellbeing for people with motor neurone disease and not physical disability alone. A better understanding of motor neurone disease and an awareness of the service needs important to this client group are necessary to improve the quality of care and to assist occupational therapists in meeting care needs.

Motor neurone disease (MND) is a rapidly progressive neurological disease of unknown cause, which results in relentless loss of function and, conversely, high levels of disability. There has been a significant increase in quality of life (QoL) literature in recent years and the philosophy of the occupational therapy process may be considered consistent with the QoL construct. However, little is documented in occupational therapy literature that promotes consideration of the QoL construct in practice. This may be explained by the profession's adherence to the medical model of health care intervention.Expectations and desires continually shift for people with MND and individual-perceived QoL is determined by a continuous process of adjustment to increasing disability. In order to promote wellbeing, occupational therapists must identify what people with MND consider important in their lives.