Most discussions of the relationships between 'the East', 'the West' and writing have, following Edward Said, involved interpreting the representations of people and places within travel writing, novels and other literary forms. This paper argues that this restricted engagement with practices of reading and writing limits the ways in which the relationships between people involved in the global geographies constructed since the fifteenth century can be understood. Through presenting a detailed discussion of the role of royal letters within the voyages of the English East India Company in the early seventeenth century, it argues that an analysis of 'how writing travels' which concentrates on the production, carriage and use of texts as material objects can foreground the active and collective making of global geographies as a contested enterprise involving multiple agents in a variety of sites. This paper presents writing as a global cultural practice and traces its place in the making of an early modern trading network.key words global historical geography writing English East India Company seventeenth century
Background: Cognitive Muscular TherapyTM (CMT) is an integrated behavioural intervention developed for knee osteoarthritis. CMT teaches patients to reconceptualise the condition, integrates muscle biofeedback and aims to reduce muscle overactivity, both in response to pain and during daily activities. This nested qualitative study explored patient and physiotherapist perspectives and experiences of CMT.Methods: Five physiotherapists were trained to follow a well-defined protocol and then delivered CMT to at least two patients with knee osteoarthritis. Each patient received seven individual clinical sessions and was provided with access to online learning materials incorporating animated videos. Semi-structured interviews took place after delivery/completion of the intervention and data were analysed at the patient and physiotherapist level.Results: Five physiotherapists and five patients were interviewed. All described a process of changing beliefs throughout their engagement with CMT. A framework with three phases was developed to organise the data according to how osteoarthritis was conceptualised and how this changed throughout their interactions with CMT. Firstly, was an identification of pain beliefs to be challenged and recognition of how current beliefs can misalign with daily experiences. Secondly was a process of challenging and changing beliefs, validated through new experiences. Finally, there was an embedding of changed beliefs into self-management to continue with activities.
Conclusion:This study identified a range of psychological changes which occur during exposure to CMT. These changes enabled patients to reconceptualise their condition, develop a new understanding of their body, understand psychological processes, and make sense of their knee pain.
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