Background: Studies investigating the subjective experiences of long-term recovery from substance use disorder are scarce. Particularly, functional and social factors have received little attention.Objectives: To investigate what long-term recovered service users found to build recovery from substance use disorder.Material and Methods: The study was designed as a phenomenological investigation subjected to thematic analysis. We interviewed 30 long-term recovered adult service users.Results: Our thematic analysis resulted in five themes and several subthemes: 1) paranoia, ambivalence and drug cravings: extreme barriers to ending use; 2) submitting to treatment: a struggle to balance rigid treatment structures with a need for autonomy; 3) surrendering to trust and love: building a whole person; 4) a life more ordinary: surrendering to mainstream social responsibilities; and 5) taking on personal responsibility and gaining autonomy: it has to be me, it cannot be you.Conclusions: Our study sample described long-term recovery as a developmental process from dependency and reactivity to personal autonomy and self-agency. The flux of surrendering to and differentiating from authority appeared to be a driving force in recovery progression. Participants called for treatment to focus on early social readjustment. Knowledge of long-term recovery after substance use disorder (SUD) is essential to personalized care. Recovery from SUD can be understood as a person’s active processes in managing the disorder and its residual effects. Ideally, such processes lead to perceived empowerment and contributory citizenship , 2. EmpiCurrent evidence on recovery from SUD is mainly derived from short-term correlation studies of factors associated with reduced substance use or leading to abstinence –18. ContThis exploratory study is part of an ongoing prospective clinical cohort study investigating long-term course and outcome in a representative sample of individuals with SUD , 20. OurWe used a thematic analytic approach , 23 withThe sample was recruited from the ongoing STAYER study n = 202), a prospective, naturalistic follow-along SUD study of change trajectories in Rogaland, Norway. Service users were included between March 2012 and December 2015, recruited from outpatient and residential treatment facilities at the start of treatment. Inclusion criteria included: person starting a new treatment sequence, fulfilled criteria for a substance-related use disorder, and age ≥16. Further details of STAYER are published elsewhere 2, a pros.Results section, we refer to 20–30 participants as “most,” 10–19 as “many,” and to 5–9 as “some” participants   to assesDrug abstinence was operationalized as DUDIT-C score equal to 0 and AUDIT-C scores ≤2. Relapse was defined as above cutoff scores for either alcohol or drug use during the past 2 years.and adequate social functioning for the past 2 years.Social functioning was operationalized using four variables related to social functioning status: housing, income, friend without addiction, and work/school. Patients scoring “yes” on all four social variables were categorized as adequately socially functioning. Long-term recovery was coded as a single variable of “yes” for all individuals who met both criteria for stable substance abstinence mean duration: 57 min; range: 27–96 min) were conducted at Stavanger University Hospital (n = 25), at the participant’s home (n = 1), and by telephone (n = 4). Interviews were audio-recorded and transcribed verbatim for the purposes of analysis.Interviews were conducted between October 2017 and April 2018. Authors developed a semi-structured interview guide in line with the Miles et al.  recommenFor semantic analysis, we employed a seven-step meaning condensation procedure , outlineTES and AS were selected as critical auditors to review and provide detailed feedback during the analysis and writing process. In accordance with Hill , the criDemographic, clinical, treatment, psychological, and social variables are displayed in Long-term recovery was described as starting with detoxification and moving toward perceived citizenship. A recurring, dynamic process of surrender and differentiation seemed key to participants achieving this transition. Here, surrender refers to accepting and complying with certain structures of authority, community, social network, care, or belief systems, which were at some point perceived to facilitate recovery. Differentiation refers to a desire to disentangle from the very same structures, usually as a result of subjectively perceived progress. Dynamics of surrender and differentiation constitute the most abstract thematic level describing positive change in the result section. This overarching theme comprises five subthemes.All participants experienced a period of intense biological abstinence symptoms when coming off drugs. They described this as a state of physical terror and mental chaos, with intense negative emotions including paranoia, extreme anxiety, and self-hate. Cognitive impairment, identity confusion, and externalizing strategies were accompanied by low self-agency. Many participants performed extreme actions during this time, including treatment ward escapes and self-harm.I was sitting in there and everything had been taken from me and I wasn’t really motivated to come clean (…) But then (…) I think I understood how ill I was, because at that time I sort of became sober … I turned so ill in a way, I sort of did everything in order to get out, sober, to get out and get high again, I jumped out of windows landing several floors below, broke out the main door … sick things like … and the brain, well … I had no contact or control, I don’t know, it was very uncomfortable really, just to see how desperate I got, without even being high.Differentiating from the social context of active use was described as challenging, and in the early phase of recovery, most participants still saw drug use as part of their social identity. Many had idealized the positive effect of using drugs, and some said they enjoyed the chaos associated with this lifestyle. Moreover, drugs were described as their main strategy for coping with emotions and stressors. These perceived benefits fuelled a strong ambivalence: should they surrender and accept help, or start using drugs again?I like chaos. Go get some, sell some, get some more, and being in that, and maybe some war and a bit of hell, and, you know. I thought that just ruled, I found it so boring when there was no action around me.Submitting to a treatment setting and overcoming initial biological abstinence gave most participants an increase in self-agency and the belief that they might manage a drug-free life. Many highlighted that believing in change was a pre-condition for actual change and that an increase in agency thus became a catalyst for realizing positive change. However, greater agency led in most cases to a greater desire for autonomy. Over time, this required credible transcending roles (e.g. more advanced work tasks) and expectations they perceived as associated with structured treatment regimens  they had initially surrendered to. They perceived this early differentiation as necessary for progression. However, many felt particularly vulnerable at this stage as it was characterized by limited life skills, drug cravings, and a fragile, only partly committed psychological structure. A common end point to this struggle was the acknowledgement that structure was needed, but only alongside individually tailored treatment.One is heavy therapy. The other is heavy routine (…) To process it and get through it is more important than learning to pull your pants up and get out of bed, kind of. But routines also keep things in check. So I would say it’s a good mixture.As the acute biological abstinence symptoms ended, most participants wanted to focus more on finding suitable meaningful activities. They often described individual or group psychotherapy as positive in this regard. However, many participants saw other, more practical treatment forms as more helpful. They described having been mentally and physically restless and tense. Also, many participants were skilled in manual labor . They were motivated by the perceived transference value between treatment activities and potential future employment. Physical activity was also seen to alleviate feelings of emptiness and loneliness, as well as serving as a distraction from the state of abstinence. Several felt that recovery at some point had to arise from their own preferences and resources. To many participants, a lack of such relevant options from the treatment provider or social network sparked a need to differentiate.Yes, they had lots of you know psychologists and groups and blah blah, but I don’t feel that stuff has done much for me (…) But when I came to XX I got my hands dirty alongside that janitor guy, cutting the grass, doing some carpentry, laying some vinyl flooring and stuff, that’s dynamite for me. So that was important to me.Coming from a social environment in which paranoia was perceived as an adaptive requirement for survival, all participants found trust difficult in the beginning. Trusting or relying on others was almost unthinkable. Establishing trusting relationships or even acknowledging a need for social dependence was highly anxiety provoking. Experience of any strong emotion, from love and joy to sadness and frustration, often triggered a desire to use drugs rather than a need for relational closeness.That’s what costs me more than any of it almost, out of all I have been through, it is in a way working with letting people in and caring about people, and let them care about me and … so I haven’t sort of been ready for that either, until now. And then, when I’ve been drug free for shorter periods of time I’ve not been in a position to work with it, and maybe then it loses a bit of meaning too. If you didn’t have anyone close, it might have been easier to keep using.Later in the course, most participants explicitly expressed that expanding their emotional tolerance window was their main tool in establishing lasting, drug-free social networks, in remaining drug free, as well as in creating a meaningful life. In order to build emotional resilience, they described having to adapt a mindset that others could be trusted, alongside exposure over time to drug-free peers and normal social settings, such as sport clubs, school, etc.I’ve worked very hard to keep loneliness from … just because you are alone it doesn’t mean you are lonely. I feel … I do catch myself in it sometimes that I like to be around people, and if I spend too much time alone I have to go visit someone or hang with someone, you know, but it’s good to know … or know yourself at the level that “no, you can take quite a bit before it gets bad.”Trust and self-esteem were seen by most participants as key to coping with a full range of emotions. Intrusive feelings of shame, self-hate, and guilt meant that achieving this required tenaciousness. Emotional coping could not be developed solely through socializing. Where drugs previously blunted feelings, current sobriety made feelings available, which also meant having to cope with previous unprocessed losses and difficulties. Participants saw basic self-acceptance as the foundation for their next steps toward recovery.The first time I did it was completely weird. You have your own room and the door to the bathroom was closed. I remember standing there with my dentures in one hand and my toothbrush in the other, I turn around to check they can’t hear me. I squealed a few words there: “Love you, L.” I thought, “What a load of bull.” I started doing it every day and every time I passed a mirror: “I actually love you.” Then, it was also totally unbelievable, one morning I had done it so many times it started to seem normal. I felt nothing, it was just a thing I did. So when I stood there tired and awful with my dentures I said: “I love you, L.” Yes, and then I felt that I meant it. I stopped in my tracks and just “what the f*ck.” It made me a bit happy, right, but I then thought “what the h*ll is this.” I started feeling emotions. Again, and that’s some of what I’m working on now, I want to hold onto my emotions.In order to make sober life meaningful, drug-related elements of identity had to be replaced. Most participants initially felt hesitant to take on ordinary prosocial roles due to a conviction that “regular life” was boring and limited. However, alongside the integration of new roles, such as that of being an employee or drug-free friend, this conviction was gradually replaced with an appreciation of being accepted and needed. Throughout recovery, such personal affiliations gave rise to a wider sense of being a fully included member of society.The feeling that I am needed by others, I think that’s important. Because if I feel useless, I act useless. Working with my colleagues has made me take a role at work which makes it easier for me to stay away from drugs. My closest colleagues have meant a lot to me.Over time, most participants felt the need to distance themselves from initial work tasks. They came to see these as monotonous, too simple, and detrimental to growth. They felt treated as if they were second-best, which in some cases increased drug cravings. Most participants were explicit that they needed performance-based progress at work. They saw work as an arena for learning how to handle feedback and responsibility. Acceptance as an equal by work colleagues was a payoff for accepting the confines of a life more ordinary and for moving toward identification with their employee role. These processes were perceived as key to eventually seeing oneself as an on-par citizen.Before I got the new position I felt that “something has to happen now.” I don’t know what it will be, but I sort of need new things to learn, new challenges, to develop.Colleagues at work, and learning something at work, right, it was awesome to be able to tile a fat bathroom, right, or to build a chimney. I mean, I could drive around XX and point out: I worked there, I did that, a mall, you know, I tiled that sh*t. I did that, that’s quite cool.For most participants, later-stage recovery was described as living life flexibly yet in line with personal values and preferences. They described a feeling of personal wholeness, based on autonomy, resilience, and integration. These self-perceptions provided support for consistent self-agency and flexibility in the face of life challenges. Relapse was, at this point, mostly perceived as a minor issue.It’s myself. I am the captain of my ship. It would hurt as much the next time, if a life crisis like that were to come, that someone dies or … But my experience indicates that I most likely will do the right thing then. Because I have done so earlier.good enough. Combating self-stigma required letting go of negative prejudicial beliefs, such as, “Once a drug addict, always a drug addict” or “I have less value than other people.”For most participants, long-term recovery required self-acceptance and overcoming self-stigma. They had to accept themselves as reformed, drug-free persons with weaknesses and peculiarities and to internalize a feeling of being I could run a marathon every day, you know … I have so much energy it almost drives me nuts. But I get some of it out with the geckos, I get quite a bit out with the kids, and then I try to get some out with friends too. So it works, in a way. I am growing chillies at home at the moment. The world’s spiciest. So something is still left there, but you just have to change certain things a little. But a guy once said to me that you should never entirely stop being a criminal. You should always hold on to the devil inside, or you’ll go to hell again quickly. It gets too boring. When you’re used to hell on wheels. So I think that’s actually a bit smart.The later phases of recovery investigated in this study were often associated with a sense of citizenship, stable abstinence, and high-level functioning, including competitive work and a drug-free social network. Many participants had lost interest in their former addict lifestyle, and remaining drug-free required less effort than before. Many also ended their rehabilitation community memberships  during this phase. They explained that being a community member was incompatible with a fully autonomous life.I dunno (laughs). I don’t think about it much anymore, I just kind of get up and start the day. I don’t have many fixed routines. I am very down to earth, I just get up and drink coffee, and then I’m off really.Then it was the World Championship in Big Book knowledge. I couldn’t find my place there [in the NA]. At the beginning it was OK because it was nice just having someone who knew what it was all about, but as time passed and I started thinking more on my own and my head got clearer then “no, I don’t think so.”Reflecting previous research , 39, 40,transitions, resulting from progression and change of priorities and needs, seem to appear throughout the thematic content. Second, the recovery process entails a constant flux of surrender to authority followed by differentiating from that very authority. This rollercoaster of dependence on the one hand and independence and self-agency on the other permeates the entire recovery process and appears a motivational force moving the individual through each transition. Here, authority must be understood broadly as any external source of knowledge or instruction that is useful at one point in time, even if it is incompatible with independent thinking and actions in the long run.First, The model comprises two important differentiation phases resolved by individuals as they gradually gain improved self-agency , 42. A pNeeds seemed more uniform in the early stages of recovery, with most participants describing this core transition of surrendering to new authority. In this early phase, individualism seemed sacrificed in return for the safety provided by these authorities. Later, when withdrawal symptoms abated, these same new authorities often came to be experienced as limiting, de-humanizing, or irrelevant. For many, the maintenance and progression of successful recovery thus required differentiating from the patient role or NA and the negotiation of personal freedom. A failure to differentiate was seen as posing a risk of reduced self-agency, relapse, and failed recovery.In conclusion, recovery is described as the successful transition from immature authority support, involving problematic, but necessary, devotion to the support system’s approach, to mature authority support, involving a higher degree of independence, building on personal responsibility and individualized care. This pattern was particularly evident in the later phase of recovery, which was characterized by accounts of great variability in individual choice and values. This shift seemed to gradually build stable self-agency and constructive self-boundaries and allowed participants to grow into on-par social citizenship , 2. HoweRecovery was described as fragile and fluctuating, requiring combined structural change , such asAlthough the actual reduction of substance use is a cornerstone of recovery, our findings also highlight social factors as imperative to quality of life  and longIn this study, time-limited, short-term treatment seems ineffective for long-term social recovery. In fact, our findings illustrate that even in a SUD sample with good prognosis, recovery is dependent on intense, long-term, and individually tailored support. Current SUD treatment structures almost unanimously fail to offer such care. Our findings highlight how current policies of early treatment termination might very well be preventing people from attaining the later stages of recovery. In this study, only at a late stage does stronger self-agency allow recovering drug addicts to maintain recovery independently. As a consequence, our findings highlight a considerable problem for common clinical practice, where early termination and lack of individual tailoring and process awareness might sabotage any early recovery successes.The main limitation concerns representativeness of the sample. This is a clinical sample recruited in the beginning of a new treatment episode. We do not know if the same findings would be obtained in people who recover without formal treatment. A high percentage of participants had good functioning levels prior to SUD. Hence, this was a relatively homogeneous group of good-prognosis patients, as would be expected when using social recovery as an inclusion criterion. However, this is not to say that these patients were not at risk of long-term functional disability. Also, this does not compromise the validity of the findings, even if it limits generalizability to the most severe and prolonged SUD conditions. A second limitation concerns contamination. This study does not perform the isolation of single factors aiding recovery, e.g., that of therapy versus that of medication or social support.This study was reviewed and approved by the Regional Ethical Committee (2011/1877-REK Vest) and conducted according to its guidelines and those of the Helsinki Declaration (1975).Participants gave their informed written consent.All authors have made substantial contributions to all phases of the paper. JB, MV, CM, TSS, AE, JM, and SN contributed to concept development and interviews, performed analyses, and wrote the first draft. TES and AS performed the interviews and contributed in analysis. All authors were involved in study design, provided scientific oversight throughout the project, detailed comments on the paper across several drafts, and edited the paper.This work was supported by internal financing from the Centre for Alcohol and Drug Research at the Stavanger University Hospital. The funding source provided no input into the analyses or presentation of these data.The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.


Gender and Age were significant determinants of class membership. In less developed areas, consumers were classified as “Quality Sensitive” and “Brand Sensitive”, while Education, Pregnancy, and Health condition were significant determinants of class membership. The findings might be useful for the government in terms of encouraging dairy companies to implement safety management certification, and suggest that companies should design differentiated strategies in different areas.Fresh milk represents a major type of dairy product in China, while it remains at a low level in terms of consumption. Consumers’ preferences are a crucial factor determining consumers’ attitudes and behavior towards fresh milk consumption. However, little is known about what drives consumers’ preferences for fresh milk. This study intends to fill this gap based on a survey with a sample of 1248 respondents in ten cities in China. The best–worst scaling (BWS) method was employed to measure the importance of different attributes that consumers consider when selecting fresh milk. The BWS result indicates that safety certification, shelf-life, and nutrition were ranked as the most important attributes of fresh milk, whereas origin, purchasing location, and package were found to be the least preferred attributes. Furthermore, the study also explored heterogeneities by dividing all samples into a developed area and a less developed area, and a latent class model (LCM) was then applied to classify consumers based on their preferences and demographics in these two areas, respectively. In developed areas, consumers were divided into “Safety First” and “Taste Sensitive”, and  Dairy and milk consumption is considered a crucial element in a healthy and balanced diet . It provPrevious evidence indicates that many factors can influence the consumption of dairy products, including income, price, preference, education, advertising, marketing channels, and convenience ,6,7, as There are many discussions about consumer characteristics, in which the consumers’ preferences have been identified as an important factor . HoweverThis study aims to fill these gaps by measuring urban consumers’ preferences towards fresh milk in both developed areas and less-developed areas. The objective of this study is three-fold: first, to measure the importance of attributes that Chinese urban consumers consider when choosing fresh milk; second, to answer what drives consumers’ preferences for fresh milk; and third, to explore whether economics and regional differences influence consumers’ choices of fresh milk. A BWS approach was applied to measure consumers’ preferences for attributes of fresh milk, since it could avoid the shortcomings of a ranking approach  and acquire a more authentic result compared with other ranking approaches ,18,19,20The remaining sections of this paper are structured as follows: n attributes, the number of possible pairs is n (n-1)/2, and the respondents have heavy burdens to complete all ranking tasks when n becomes large.Many approaches, like rating and ranking, can be used to evaluate the importance or preference for attributes of products or services. For rating, a typical form is the Likert-type scale, where a person responds on a scale of “not important” to “very important” or 1 to 5, with 1 being not important and 5 being very important. However, respondents sometimes do not use ratings in the same way, due to different understandings of the categories ,18,19. FThe best–worst scaling (BWS) approach, also known as maximum-difference scaling, was developed by Louviere and Woodworth  and firsThe best–worst scaling approach has recently been used in many areas to evaluate people’s preferences for attributes of products or public services. For example, it was used to analyze whether the waiting time length is more important than the quality of care , as wellv attributes is denoted as , r is the repetition per level, k is the number of items in each choice set (block size), and bk = vr [As shown in  = v × r . Conside = v × r .Data was obtained from nationwide face-to-face interviews conducted in July and August 2016. Respondents were chosen in a random way. We first selected five provinces, including from the north, south, east, and middle of China. Then, we chose developed cities  and less developed cities  located in these five provinces as the survey cities. They are Shijiazhuang and Chengde in Hebei Province, Guangzhou and Qingyuan in Guangdong Province, Hangzhou and Huzhou in Zhejiang Province, Chengdu and Ziyang in Sichuan Province, and Wuhan and Xianning in Hubei Province . These sFirstly, a supermarket  in each district of the target city was randomly selected, where actual dairy purchasing decisions take place ;Secondly, respondents were recruited, following the principle of randomness and voluntariness ;Thirdly, the research assistant introduced the procedure of an interview to ensure that the respondents fully understood the rules of answering the BWS survey, that is, only one most preferred attribute and one least preferred attribute can be chosen; Fourthly, introduced the detailed explanation of each attribute; respondent made choice;Finally, after the BWS question, the respondent finished the rest of the questionnaire. The questionnaire included three sections: the first part included BWS questions, the second part consisted of the demographic characteristics of respondents, and the last part included the consumption habits of dairy products.J items, or attributes in our case, then there are J(J−1) possible best–worst pairs that respondents can choose; second, evaluating the difference of importance for every pair. In our case, respondents evaluated the underlying importance of all dairy attributes; Third, choosing the pair that maximizes the difference between the ‘worst’ attribute and the ‘best’ attribute in importance from all J(J−1) possible pairs [b (best) and w (worst) can be defined asb and w on the underlying scale, and bw in the situation t is therefore given byij ≠ bw in situation t. Assuming that i.i.d. type I extreme value, then this probability takes the familiar multinomial logit (MNL) form:ij ≠ bw in situation t. Changing the form of observable difference bw) on the scale of importance, The BWS choice theory assumes that the probability that a respondent chooses a pair in a particular choice set is proportional to the difference between the ‘best’ and ‘worst’ item on the scale of importance . Respondle pairs . The prole pairs . Formallij ≠ bw in t. In the estimation procedure, a reference location must be defined from which other items will be evaluated. The The choice probability is then expressed asp and attributes j can be specified asIt is presumed that consumers are heterogeneous and have different preferences. The logit form of the probability can be further specified using the Random Parameter Logit (RPL) model, which is widely used in the literature and acknowledges the preference heterogeneity of consumers ,32,33. Si can be defined as Since there is no natural interpretation of results from the MNL and RPL models, following Lusk and Briggeman , we usedi on a ration scale, meaning that if one attribute has a shared value that is twice that of another attribute, it can accurately be said that the former attribute is twice as important as the latter [These shares of preference must sum to one across all 13 attributes. Equation (7) reports the importance of the attribute e latter . In a woTwo major choice models are usually applied to model individual respondent differences for BWS data. One is the RPL model introduced above, which assumes that respondents’ preferences differ along a continuum and estimates a mean and variance for each attribute. The other is the latent class model (LCM), which assumes that there are unique segments (latent classes) of consumers, who have similar preferences within segments, but significantly differ in their preferences across segments. LCM used in the study can predict and explain heterogeneity in preferences that we cannot directly observe ,35, whicTherefore, LCM was applied to obtain further insights into the nature of the heterogeneity in respondents’ preferences for attributes of fresh milk. LCM analysis is a clustering technique which assumes that individuals belong to one of k latent classes, of which the size and number are unknown a priori to the researcher . HoweverAs the choice sets can be different in particular applications, we use q is the number of classes and iZ indicates individual characteristics [According to Greene and Hensher , we chaneristics . The likeristics (10)lnL=No. B and W, for each attribute, representing the number of times it was picked as ‘most important’ minus the number of times it was picked as ‘least important’. Finn and Louviere  showed t(B−W), sqrt(B/W), and relative sqrt(B/W) to analyze attribute importance, in which the relative sqrt(B/W) means that the square root of (B/W) for all attributes (sqrt(B/W) is scaled by a factor such that the most important attribute with the highest sqrt(B/W) becomes 100. All attributes can then be compared to each other by their relative sqrt (B/W) ratio. The result is interpreted as X per cent  being likely to be chosen as the most important. The average (B − W) can be expressed as Following Cohen , we usedp-value of the t-test was significant.Overall, 1248 consumers from 10 cities of five provinces were interviewed. We divided all respondents into two sub-samples: those from five developed cities which have a higher GDP, and those from five less developed cities. The summary statistics for samples are given in The last column in One interesting finding in our results was that price was perceived as one of the least important attributes, which was not consistent with the previous literature . BW scorIn this paper, consumers from developed areas and less developed areas exhibit differences in terms of demographics, as shown in LCM was adopted to explore the preference heterogeneities for attributes of fresh milk in the two groups, i.e., the capital cities and non-capital cities. Based on Latent Gold choice 5.0 software, we observed two clusters in both regions based on Bayesian Information Criteria (BIC), shown in However, 78.70% of the sample were placed in the “Safety First” cluster, while just 21.30% were placed in the “Taste Sensitive” group, which indicates that most of the consumers in developed cities pay more attention to safety attributes of fresh milk.In the “Quality Sensitive” cluster, respondents gave a distinctively high rating for safety certification, shelf life, taste, and nutrition attributes, and price also played an important role. That is to say, these consumers not only pay attention to quality attributes, but also place some attention on price. The characteristics of consumers in this cluster tend to be those with a lower education, a pregnant family member, or a perceived bad health condition. This is probably because they are vulnerable groups. It is common sense that pregnant women tend to pay more attention to their daily diet, and have stringent requirements for their food safety and nutrition levels, as well as taste. Meanwhile, consumers without a good health condition might attach more importance to food safety and nutrition as well. The second cluster was called “Brand Sensitive”, since this type of consumer has a relatively high score for brand compared to cluster 1. Although safety certification and shelf life have a larger score than brand, they did not show many differences. Consumers in the “Brand Sensitive” cluster tend to have a higher level of education, no pregnant women in the family, and a good situation in terms of health. Conversely, in less developed areas, a local brand dominates the fresh milk markets, whilst a national brand has a lower market share. A possible reason for this might due to the less developed cold chain logistics and inconvenient transportation. Although the size of the sample in these two clusters shows no large difference, with values of 46.55% and 53.45%, respectively, more actions should be taken by both the government and companies to meet consumer demands, such as the construction of logistics infrastructure and development of brands.Overall, we can see that some differences exist in terms of dairy consumption in developed cities and less developed cities. In developed cities, consumers were divided into two clusters: “Safety First” and “Taste Sensitive” clusters. Comparatively, in less developed cities, consumers were classified as “Quality Sensitive” and “Brand Sensitive”. A large population of consumers in capital cities tended to be in the “Safety First” cluster. However, in less developed cities, there was not a large difference in the size of the sample between “Quality First” and “Safety Sensitive”.Recently, the food consumption pattern in China has shifted from grains to higher-protein products such as dairy products, especially in urban areas. The dairy demand has exhibited significant growth and has ample space to increase . HoweverFirstly, the BWS score shows that safety certification, shelf life, and nutrition are considered the most preferred attributes, followed by taste, brand, organic, fat, sterilization technique, traceability, and price. However, origin, purchasing location, and package are perceived to be the least important attributes. These results indicate that safety certification, nutrition, and freshness play an important role in consumers’ purchase decision. Therefore, the regulation authority and dairy industry should spare no effort to encourage dairy companies to adopt safety certification and management to decrease consumer concerns about dairy products. Then, dairy enterprises should place an emphasis on the quality of raw milk and adopt advanced processing technology to retain nutrients. Moreover, in order to keep the freshness of fresh milk, dairy enterprise and the supply chain should develop cold-chain transportation and improve the transportation efficiency, in order to shorten the retail distance, which is also an effective approach. Such measures would provide safety assurance  and guarSecondly, the LCM results found that Chinese consumers have heterogeneous preferences for the consumption of fresh milk. In developed areas, most of the consumers can be placed in the “Safety First” cluster, which tends to include elderly and female consumers. By contrast, in less developed areas, about half of the consumers can be placed in the “Quality Sensitive” cluster and a half in the “Brand Sensitive” cluster, and special populations such as pregnant woman and people with bad health conditions tend to be in the “Quality First” group.Overall, Chinese consumers have consistent preferences for attributes of fresh milk across different regions. However, differences exist in terms of factors influencing consumers’ preferences. This finding has an implication for milk companies, suggesting that they should identify target customers and design marketing strategies combining the fresh milk preferences.


Many members of the public express a desire for farm animals to have a good quality of life. Yet, when it comes to purchasing higher welfare products which would support this, many consumers do not ‘walk their talk’. This paper introduces the concept of ‘nudging’ as a means to help consumers align their actions with their intentions and support their desire to engage in pro-animal welfare behaviours. ‘Nudging’ is a collection of behaviour change tools designed to hint to, or suggest, a choice most closely aligned with an individual’s self-interests or intentions. Their purpose is to simplify the decision-making environment by working in concert with the behavioural flaws known to influence human decision-making. Four specific behavioural ‘nudges’ are outlined: self-nudges, choice architecture, social norms and pre-commitments, along with examples of how they can be applied to animal welfare. Inspired by effective applications of ‘nudging’ to close the consumer attitude–behaviour gap in other relevant domains, this paper seeks to highlight how similar initiatives might be applied to better support higher welfare choices amongst consumers and in turn, enhance the lives of farm animals.Citizen concern for the welfare of farm animals is well documented. However, there is a notable gap between people saying they want improved farm animal welfare and how they actually behave as a consumer. This is known as the citizen–consumer attitude–behaviour gap. As improvements in farm animal welfare can be affected by market demand, the choices consumers make become important. This paper introduces the concept of ‘nudging’ and discusses how it could be applied to reduce the attitude–behaviour gap amongst consumers. By designing the choice environment to better reflect the behavioural biases known to impact human decision-making, ‘nudge’ tools function to prompt individuals to make choices that are aligned with their stated intentions. Four ‘nudge’ tools: self-nudges, choice architecture, social norms and pre-commitments are discussed. The behavioural rationales for their use are reviewed and examples of how they might be applied to animal welfare provided. Improved farm animal welfare arguably requires improved pro-welfare consumer behaviour. This paper highlights how this might be encouraged by: self-nudging the salience of an ethical self-image; altering the choice architecture to influence decision-making; articulating social norms to impact behaviour; and using pre-commitment devices to overcome self-control issues. Increasing public concern for the welfare of farm animals is well documented ,2,3. Yet‘Nudging’, a behaviour change tool of behavioural economics, is now a well-recognised and effective policy tool to align individual intention and action . A ‘nudgWhen it comes to animal welfare, consumers are offered an array of ‘animal-friendly’ food choices  and can access numerous information sources to educate themselves on how to make ‘animal-friendly’ purchases ,14. HoweThe aim of this paper is to highlight the potential of ‘nudging’ to align citizen intention and consumer action in the context of farm animal welfare . The ‘nudge’ literature would suggest that if citizens are expressing pro-animal welfare intentions but not pro-animal welfare behaviours , then asTo understand the concept of ‘nudging’ and how such tools are proposed to work; it is beneficial to explore its theoretical origins in the field of behavioural economics.Behavioural economics developed from a recognition that the behaviour of individuals often deviates from the neoclassical economics’ characterisation of people as rational actors . One of A further prediction of neoclassical economics is that an individual’s decisions are made according to a consistent set of stable preferences  . HoweverAn additional issue with the neoclassical economic framework is that it predicts that a ‘rational’ individual will seek out further or missing information if they do not already have enough to make an appropriate decision . HoweverThe issue, from a policy design or behaviour change point of view, is that the neoclassical economic framework has continued to influence models and predictions of human behaviour, despite awareness of the limits of its predictive power . The rel“Nudges are ways of influencing choice without limiting the choice set or making alternatives appreciably more costly in terms of time, trouble, social sanctions and so forth. They are called for because of flaws in individual decision-making, and they work by making use of those flaws”.‘Nudging’ is a term which refers to a collection of behavioural economics tools (for a comprehensive list see Sunstein ) which iIn other words, nudges are tools which influence behaviour by harnessing behavioural economics’ understanding of what drives human behaviour . One of the key ways in which nudges do this is by changing the ‘choice architecture’ of a decision context. This involves reshaping the environment in which a decision is made, usually by changing the way in which choice options are presented. The logic for this is derived from the previously outlined tenets of behavioural economics; that an individual’s choices are influenced by behavioural biases such as how information is presented, the information they have available and the social norms or rules made salient by the context (amongst others). As such, by adhering to the innate features of human decision-making, nudges function to make decisions easier and help individuals behave in their own self-interests without compromising their freedom of choice  . The anaability to process all of the complex and multiple information sources being thrown at them”  that they lack the at them”  (p. 5). at them” . This isat them”  (p. 265)The relative success achieved by bringing such behavioural insights into policy-making has challenged and led many to rethink the “traditional view that behaviour change should be achieved by informing, convincing, incentivising or penalising people”  (p. 4). The main attractions for using nudges is that they are; (a) not coercive and; (b) they are more cost-effective, relative to other more administratively burdensome policies (such as legislation) . The forby making salient certain self-images which favour ethical consumption” (p. 115). This approach may be particularly relevant to the sub-set of consumers who value their image as ethical consumers and have been found to pay more for foods with specific ethical attributes, such as being more ‘animal-friendly’  tend to approach socially sensitive topics, such as animal welfare, in a way that conforms to perceived social norms , whereas as consumers, individuals will often buy products obtained from systems criticised about their welfare standards, even when alternative products are available”.As demonstrated above, most successful social norm interventions are based on telling people what others normally do or what others expect them to do in a given situation . HoweverThus, even though a desirable social norm does exist, it does not appear to spill-over and positively influence consumer behaviour. As such, making this desirable norm more salient in a consumer context may help close the attitude–behaviour gap.In this effort, the grocery store would appear the likely context. However, based on negative results from using normative messages to increase purchases of sustainably caught fish, social norm messages are argued to be ineffective in supermarkets because consumers are time-short and already have too many messages to process . Yet, reOnline grocery shopping has also increased in recent years and provides a fruitful environment to nudge ‘animal-friendly’ purchases via social norms. In this regard, Demarque et al.  found thTelling people what not to do, what they do not do or what others are not doing, often reinforces or encourages undesired behaviours . Within In sum, framing pro-animal welfare behaviours as something ‘others’ do and value  is a simA close friend and ally of social norm interventions are pre-commitments. In a desire to maintain a positive reputation and consistent self-image, people try to be “as consistent as possible in their commitments, choices and behaviours… [as such] the need to be consistent with one’s commitments is a powerful influential tool”  (p. 11).Pre-commitments are most effective when the cost of failure is high. Committing publicly to a goal, choice or behaviour is one powerful way to increase the cost of failure, as reputational damage is risked when an individual shows a lack of consistency with public promises . FurtherPublic commitment campaigns such as ‘Veganuary’, provide some insight into how pre-commitment devices could be used to enhance pro-animal welfare behaviours, particularly as animal-related reasons are often the primary motivation for following a vegan diet . During The ‘veganuary’ campaign is quite an extreme and controversial example. However, it provides inspiration as to how pre-commitments could be used to encourage greater consumer commitment to purchasing higher welfare products. There is huge potential for public bodies, farm assurance schemes or other relevant groups to design pre-commitment devices encouraging consumers to commit to buying produce  of a higher welfare standard for a specified period. Many already run marketing campaigns to inform consumers, so the addition of a pre-commitment device such as a public pledge, would be a simple, yet effective way to encourage higher welfare consumer behaviours. Once this commitment is made, additional educational material outlining how to buy such products and what labels to look for are likely to have greater impact. As discussed, a public pre-commitment device, potentially supported by social media platforms, is likely to be the most effective method ,94 and cPre-commitment devices work because they create accountability and they offset the self-control problems most decision-makers face  by increDespite the rapid rise in the popularity of ‘nudging’ as a behaviour change tool, particularly amongst policy-makers and governments, it is not without its critics . Many quSelf-nudges rely on consumers having an awareness that they often digress from their intentions, and to work effectively, consumers must want to reduce such digressions and align their behaviours with their intentions . HoweverOf all the nudge tools, choice architecture is perhaps the most well-known and analogous to the central premise of nudging; that changing the way in which information is conveyed in an environment can influence individual decision and behaviour. For this reason, choice architecture has received the most criticism, with many questioning the ethics of deliberately designing an environment to ‘take advantage of’ the innate biases of human behaviour without the individual’s awareness ,75,107. “Both nudges and choice architecture are inevitable, and it is therefore pointless to wish them away…many forms of choice architectures are defensible and even required on ethical grounds, whether we care about welfare, autonomy, dignity, self-government, fair distribution, or some other value”. (p. 4)In response to such criticisms and ethical questions, Cass Sunstein, one of the seminal authors  on nudging and choice architecture, argues that:What he means by this is that every decision a person makes is done against a background of choice architecture; every choice environment has a design and that design affects choice. As such, the critical argument for the use of choice architecture is that it is better to deliberately design this environment in a way that supports the welfare or best interests of individuals and society, rather than leaving it to chance . A critiThe communication of social norms, both descriptive and injunctive, is a behaviour change tool with a rich empirical research base ,112,113.A further limitation of social norms is that some consumers may not fully process or notice the social norm message, “as in-store decisions are characterised by time pressure and the use of simple heuristics, expecting consumers to read a relatively long text might not be realistic in this type of environment”  (p. 10).The use of pre-commitments to overcome self-control problems  has a strong empirical base ,94,99. HOverall, the primary ethical issue associated with nudging is that the very interventions which can be used to help consumers align their actions with their intentions, may be misused to manipulate them . ArguablAs the market-driven nature of animal welfare continues to rise in many countries, encouraging consumers to engage in greater pro-animal welfare behaviours is arguably of importance. However, despite the increasing availability of higher-welfare products and the palpable rise of interest in farm animal welfare, demand for ‘animal-friendly’ products does not appear to reflect the stated desire for them ,26. If pThe behavioural initiatives introduced in this paper are by no means a definitive list of ‘nudges’ or behavioural economic tools. Rather, they were chosen for their potential applicability to reducing the citizen–consumer attitude–behaviour gap. Each of the nudges presented in this paper are somewhat interconnected and can reinforce one another. For instance, self-nudges work by making salient to an individual the desire to be consistent with their self-image when buying products. Pre-commitments work similarly by harnessing the desire to be consistent with an individual’s self-image, but further reinforce this by imposing a penalty for lack of consistency. Social norm interventions further contribute to this by communicating what others do or what others consider acceptable, in order to nudge individuals into making positive choices. Finally, choice architecture supports decision-making at critical times by ensuring that the way in which information is presented supports, rather than hinders, ‘animal-friendly’ decisions. As Sunstein  notes, aThis paper was intended as a mere introduction to some of the ways in which nudge interventions could enhance consumer behaviour in relation to farm animal welfare. The examples of how nudges could be applied to animal welfare, although grounded in empirical findings, are purely hypothetical and are included to illustrate where they could be applied, how they work, and why they may be effective. It is hoped that others will be inspired to think about how they could be applied to other areas where behavioural change relevant to animal welfare is needed and, indeed, to critique the examples suggested here.


Circular RNAs (circRNAs) have recently emerged as a novel class of transcripts, characterized by covalently linked 3′–5′ ends that result in the so-called backsplice junction. During the last few years, thousands of circRNAs have been identified in different organisms. Yet, despite their role as disease biomarker started to emerge, depicting their function remains challenging. Different studies have shown that certain circRNAs act as miRNA sponges, but any attempt to generalize from the single case to the “circ-ome” has failed so far. In this review, we explore the potential to define miRNA “sponging” as a more general function of circRNAs and describe the different approaches to predict miRNA response elements (MREs) in known or novel circRNA sequences. Moreover, we discuss how experiments based on Ago2-IP and experimentally validated miRNA:target duplexes can be used to either prioritize or validate putative miRNA-circRNA associations. Caenorhabditis elegans and plants) [During the past decades, the field of RNA biology experienced an incredible evolution dictated by the discovery of long non-coding RNAs, the elucidation of the silencing pathways of short non-coding RNAs and, more importantly, of their regulatory functions . Recentl plants) ,30,31,32 plants)  and sali plants) ) has gre plants)  and, fol plants)  such as  plants) ,40,41,42In this review, we explore one of the hypothesized functions for circRNA, i.e., miRNA binding. Particularly, we will first address the definition of “sponging”, which, so far, has been quite an appealing but misleading term, and then discuss the different computational approaches to predict miRNA-circRNA binding sites and the strategies to prioritize/validate such interactions.The high stability and the presence in different body fluids make circRNAs extremely promising disease biomarkers. Given their diagnostic relevance, a lot of efforts have been put in the functional characterization of circRNAs, as this is critical to understand their role in disease development or progression and to provide crucial insights into their physiological role. It has been shown that nuclear circRNAs can be involved in regulating mRNA expression at the level of transcription by interacting with RNA polymerase or with members of the spliceosome machinery , for exaAlthough circRNAs cannot be considered “sponges”, it is clear that these molecules fulfill their regulatory function also through the interaction with miRNAs ,63,64,65C. elegans. Additionally, this workflow is effective only when the circRNA has been previously identified and annotated in other databases (like circBase) and, finally, it also requires a differential expression analysis for all components of the network . Moreover, validating MREs with luciferase assay has two major drawbacks: i) it does not always provide a clear proof of direct interaction [In the past years, several databases have been released with the main goal of collecting all possible information regarding known circRNAs in different species eraction ) that wieraction ,99,100.As mentioned previously, circRNAs have been shown to have a time- and tissue-specific expression pattern ,23,30. TNo matter which method is used to design the prediction algorithm, the major reason behind the high rate of observed false positives and false negatives is the fact that miRNA-target recognition already is effective with a seed length of six nucleotides ,105. RedThe approach presented in this example uses a basic step-wise filtering system that takes the output of different prediction programs and sequentially reduces the pool of MREs according to the presence/absence of specific criteria . As shown, this system already is effective in reducing the amount of data that can be considered for further validation and functional characterization, but we still might be missing valuable information given by the pool of MREs that are specific to each algorithm but that still overlap an Ago peak . To overcome this limitation, a possible alternative is the construction of a scoring function that evaluates the probability of a predicted MRE to be real by considering the validated data (presence of an Ago peak/binding motif) and the initial prediction information  . WeightiCircular RNAs have recently emerged as a novel class of transcripts characterized by covalently linked 3′–5′ ends called backsplice junctions. Studies have shown their relevance in physiological and pathological conditions, in particular as disease biomarkers and potential therapeutic targets. However, the functional characterization of these sequences is still in its infancy and the role of relatively few circRNAs has been described to date. Recently, great effort has been put toward understanding one specific mechanism, i.e., miRNA sponging. Due to the combined overall low expression of circRNAs and the low number of MREs predicted within their sequence, only a handful of transcripts really can be considered true “sponges”. Nevertheless, it is undeniable that circRNAs are capable of binding miRNAs but, more than a “sponge” for a single small RNA, they might function as a scaffold for several different ones. Regarding this, it is crucial to develop appropriate pipelines that allow a more accurate prediction of the miRNA targets, thus facilitating an overall assessment of miRNA binding and, possibly, leading to the identification of a more general function.


This is a pragmatic approach that appreciates scientific measurements of metal objects as essential empirical evidence whilst recognising that a considerable share of these archaeometric data are inapt or too detailed for an understanding of skill. This empirical approach towards skill is relevant to our knowledge of the role of crafts and materials in the past. After all, skill is a fundamental asset for the production of material culture, and a distinct human-material relationship characterised by an intimate form of material engagement.This paper introduces the methodology of perceptive categories through which an empirical analysis of skill is achievable, taking European Bronze Age metalworking as a case study. Based on scientific data provided by the material sciences, in this case compositional and metallographic analyses of Late Copper Age and Early Bronze Age axes, the thresholds to categorise and interpret these data, and organise them in a  There are two distinct frameworks in which prehistoric technologies are studied: a material framework and a social framework. The former is universal, the latter contextual. Typically, these frameworks have little to no overlap in terms of methodologies, focus, and understandings Dobres . In a rein response to their material. What is important is that this response occurs on the level of perceivable qualities rather than properties of a material  to finished object.In the following, I will work through three main arguments: that skill needs to be incorporated in our archaeological investigations of Bronze Age metalwork, because skills have been given much weight in our conceptualisation of the Bronze Age from Childe  onwards.e.g. Apel et al.Skill is considered both cause and effect as well as a signpost for specialists and craft specialisation  is one of the few attempts to explore prehistoric metalworking from a theoretically informed approach coupled with an in-depth and comprehensive sampling of prehistoric artefacts. In this manner, he challenges the gap between the social archaeologists’ interpretations of metalworking and the material scientists’ body of factual data (Pollard and Bray The research undertaken by Kienlin (i.e. skill), came into being in the first place. A more analytical and structured exploration of metalworking skill is preferred. Such an approach would define more precisely what this skill entailed, what it was based on, how it was applied, and to which extent skills can be read from the prehistoric objects.Kienlin’s work together with Junk’s  investige.g. Butler and van der Waals et al.et al.et al.cf. Northover approximation and is aimed at a compositional range in which the alloy behaves in a certain manner. An observation that allows us to rethink how to interpret compositional analyses.Compositional analyses and the intentionality of certain copper-compositions are a constant topic of debate , there is a high probability that the different behaviour of arsenical-rich copper was recognised and utilised , which inevitably seems to result in scholars that entrench on either side of this dichotomy , I use them to organise and analyse the data. The distinctions made, however, are unmistakably etic constructs.By definition, this means that the perceptive category itself is interpretive as not all sensate features of a material are equally interesting. Presupposing that the constructed categories could have been noticed by prehistoric metalworkers , and annealing are given in Tables Metalworking is narrowly defined here as the process in which raw metal is transformed to an object. Mining, smelting, use and deposition are all part of the life cycle of metal, but not included in the metalworking  Kienlin , 2010, w Kienlin . Space dchaîne opératoire is the raw material. I deliberately avoid the word ‘choice’ here. What I intend to analyse is whether different copper-compositions were recognised, from which we should not uncritically infer that they were deliberately chosen or alloyed. I assume that most metalworkers recycled scrap material or worked with impure ingots, and that re-melting took place at the expense of control over composition , 5–12% (yellow), 12–20% (golden) and 20% > (silver). With regards to copper-compositions that contain one or more of the elements antimony, arsenic, nickel and/or silver, which I lump together for reasons discussed above, the following groupings are surmised: 0–3% (red), 3–7% (orange) and 7% > (white). All of these may additionally contain traces of other elements, but these are considered irrelevant. The discussed colours are based on polished samples. I make no claims that any of these compositions were intentionally alloyed, some certainly were, some were not. For some, we might never know. Co-smelting and arsenic loss complicates the discussion for arsenical bronzes  distinguishable from each other through sensory cues only. They, therefore, potentially were recognised as unalike materials, each which its own distinct behaviour and ‘rules’ of how they may be worked cf. Junk , p. 4. Tet al. Any copper-composition with less than in total 3% arsenic, antimony, nickel and/or silver, or less than 5% tin, is considered to be type I metal.The differences in hardness of compositions with a combined weight of < 3% (As/Sb/Ni/Ag) are likely not noticed Coghlan , p. 78. With these fairly ‘pure’ coppers Type II are the compositions that hold in total 3–7% arsenic, antimony, nickel and/or silver. This category is partly based on Junk’s findings that prehistoric metalworkers recognised and separated ‘ingot torque copper’, typically holding around 4–5% arsenic and antimony, from ‘low-impurity copper’ , but rapidly increasing if cold-worked Junk , p. 172.et al. The colour of type II metal differs from the red of pure copper, but we cannot speak of a distinct colour change Fig. a. Dependet al.  and is easily distinguishable from the types above . However, this easily leads to fractures as the metal quickly embrittles, even with frequent annealing. Berger , p. 26 fet al. ) . Only a very small group of axes was made of orange coppers (type II) that would behave perceptibly distinct. From a craft perspective, metalworkers during the LCA thus encountered few difficulties as the metal generally behaved in a similar—predictably difficult—manner. This perceived similarity of the raw material may partly explain the straightforward working of this material, with little variation in how techniques were applied. The typical average casting quality of these axes is remarkable because type I coppers are susceptible to (heavy) gas uptake leading to high amounts of porosity and oxides. Principally, explanation of the average casting quality should be sought in a skilled application of melting and casting techniques, and the preparation of a well-made mould. Furthermore, the malleability of copper allows for some porosity to be ‘removed’ afterwards because strong hammering to some extent deforms oxides and closes porosity making them less visible in the metallographic sample Kienlin , p. 31. ied Fig. . This ischaîne opératoire, one particular observation is evident: metalworking in this period was motley, to say the least , and in light of the fact that copper metallurgy of the late 5th and early 4th millennium did differ in applying hot-working , the same material is now in need of a more intense hammer-hardening in order to push the hardness towards the standard of the time of this period (i.e. between 138 and 199 HV)  can be considered a logical progression. The quality that we perceive as ‘better’—in this case increased hardness—needed to be recognised and expressed first and its discovery is therefore fully dependent on skill.I would like to draw three conclusions from the above observations.Firstly: attention is drawn to the complex relationship between material, skill and quality. The craft perspective followed in this paper emphasises the role of the material. A high level of skill does not necessarily result in a high-quality object if the material does not afford it.other raw materials are worked. This is especially interesting as one can envision how a similar interaction might have taken place between stone and bronze, or bronze and iron.Secondly: certain raw materials influence the standard of the time and thus, in turn, how material that is the mother of innovation and it is through skill that these innovations are brought about.Thirdly: in the dialogue between material and maker, the material has the first word, because it provides us with qualities and potentials, as well as the last word, because it also sets the limitations of what can be done with it. It is


Women who exercise intensively, whether competitive or recreational, devote a lot of time and energy into exercise, which requires high levels of ambition and motivation. The aim of the study is to investigate the self-understanding and bodily identity of different  forms of exercise, and to investigate the role of important others  for this self-understanding.A qualitative study using semi-structured interviews. An interactional psychodynamic framework informed the development of the interview questions focusing on the influence of their family, peers, and the meaning of exercise for their identity. Participants were recruited via local training centers and via the Danish Athletic Sports Association. A total of twenty highly physically active female athletes were interviewed, ten of whom participated in competitions (“competitve athletes”) and ten of whom did not .Self-related and social similarities and differences between competitive athletes and recreational athletes were found. Recreational athletes had supportive but not ambitious parents and used sport to reinforce their bodily self-efficacy and identity, while competitive athletes had highly engaged parents, especially fathers, and competed to externalize their identities as athletes. Correspondingly, the meaning of exercise was the activity itself, for recreational athletes, while competition was the means to the end of achievement, for competitive athletes.All athletes are affected and triggered by their biography and their environment. The biographical tradition of sport culture must be recognized as important for the engagement in different forms of physical activity in health and competition settings. If research can make the conflicts and relations of the self visible in sports culture, this could strengthen the recognition that the overall bodily well-being of athletes is important for women’s health. Competitive athletes are sporting persons who are interested in outperforming other athletes. In this paper they consist of youth, adult and master members of the Danish national team in athletics (track and field). In Denmark, competition sports are organised by local clubs, and not by higher education institutions. Therefore, athletes are often dependent for many years on support from their parents. Competitive sports require a high degree of engagement, and athletes often have challenging lives. They have to meet their own ambitions, integrate time-consuming exercise into their daily lives, make decisions of how to combine career and education, and fulfil the high expectations of their surrounding networks, often represented by an ambitious trainer or a parent . They ofThere also exists a growing group of young women who exercise regularly and vigorously, but without engaging in competition. We refer to them hereafter as recreational athletes, although “recreational” perhaps belies the intensity with which many young women exercise. Competitive and recreational sportspersons have previously been investigated regarding cognitive aspects of motivation , especiaThis paper will focus on the role of the self and of others relevant for exercise motivation. The self is hereby seen as a union of elements that constitute the identity of a person. We apply the interactional theory of the self of George Mead , 7, spliOur interest takes its starting point from this interactive self-understanding. Which role is played by the interaction with other relevant people and siblings for the development of a competing versus a recreational self? In developing the desire to compete versus to exercise non-competitively but just as intensely, what impact does the feedback of others have, and the cohesion or the group climate? The psychoanalyst Stierlin  highlighIn sports psychology there exists a broad body of research on motivation, both for recreational and competitive athletes, and for men and women in sports in general , often oTo our knowledge, the differences in self-understanding and bodily identity between intensive recreational and competitive sportswomen have not been investigated before, outgoing from a mostly interactional approach. However, interactional aspects can facilitate the comparison of these two environments for finding out the role of an important other for choosing your sports environment. When taking an interactional self-understanding as a point of departure, we would like to know how attitudes of the surrounding environment influence the athlete.A recent cross-sectional study reported that highly motivated girls exercise more when their parents participate in the same activities, an association not seen among boys . PsychodIn this study, twenty high-intensity, highly motivated sportswomen were interviewed. Half were elite Danish track and field athletes , and half were sportswomen who did not compete, but exercised on a regular basis more than four times a week . Both competitive and recreational athletes devote many hours per week to exercise and have done so for many years, except one group chooses to compete and the other doesn’t.The aim of this paper is to explore the self-understanding and bodily identity of different  forms of exercise, and to investigate the role of important others  and the social context for this self-understanding.exercise background by gathering descriptive data on former and current exercise or competition experience. Part II focused on the participant’s motivation to exercise or compete. Part III focused on the role of exercise in the family, and in the social context. We had specific interest in the parents’ and siblings’ exercise and competition behaviour, and in the feedback provided by their social environment (e.g. classmates). Finally, part IV examined participants’ body image and visibility in a sporting context. The interview guide finished with a question on the body image, and the athletes were asked how their bodies’ visibility when training or competing influenced their self-image, self-confidence and self-identity.The interview guide . A member of DAF’s main office was identified as contact person and sent a list of potentially relevant competitive athletes to the project leader. The number of active Danish elite athletes on a high national or international level is quite limited, so the list included about 15 names of athletes who had represented Denmark on the youth or adult national team. The project leader contacted all athletes on the list, and ten agreed to participate. The project leader decided not to contact the two athletes participating in the Olympic Games due to problems of granting anonymity.The recreational athletes were recruited by a written advertisement in two local fitness centres serving the local university population. The study was described to potential participants as an interview study on high-intensity athletes’ exercise habits and motivation. Twelve recreational athletes volunteered, but two were ultimately excluded because of participating in competitions during the last year aside from their primary recreational sport. Most of the recreational athletes had participated in some form of competitive sport in their childhood, as a part of after school occupation organised in local sports clubs. A high percentage of Danes are members of local sports associations when they are children, especially when they were brought up in the countryside.Twenty sportswomen participated in the study, aged 18 to 53 (see Table N = 10) were in their twenties and were primarily college students within psychology and medicine, two highly selective university programs that require consistently high grades and achievement. The competitive group (N = 10) included both high school and university students (N = 7), and adult women working full-time (N = 3). Competitive athletes exercised either individually or in a group, but always supervised by a professional trainer. Their starting age for competition sport was between five and 14. Competitive athletes’ groups were club-based, with larger clubs having separate training groups per activity and smaller clubs combining athletes with different specialties. All members of the groups knew each other because they regularly exercised together. Recreational athletes also trained individually or in groups, but none had trainers. Their exercise groups were not static and varied from week to week . Competitive athletes ran or jumped in athletic events, while half of the recreational athletes ran longer distances. All reported at least one type of regular exercise.The participants in the recreational group  were mentioned occasionally, but seldom appeared as a primary expectation. The recreational athletes in particular were “My family never took part in my decision for choosing a certain sport. I could start or stop whatever I liked to do. Probably, my brothers were influenced by my choice to choose football.” (R7).“My father went riding, too. But he would never watch me when I was riding!” (laughs) (R4).All interviewed participants in the recreational group, except one, were older sisters, and reported that exercising was a way to demonstrate healthy lifestyles and be role models for their younger siblings. The recreational athletes remember their parents as caring, interested, and supportive in their childhood athletic activities. It was noticeable that almost all participants showed the same emotion when talking about their parents. They smiled, had positive attitudes, and seemed to have relaxed relationships to their parents. It also seemed to be a common rule that the parents supported their children’s wish for exercise. Athletes who grew up outside of urban areas reflected on the time their parents had spent time driving them to different activities. However, parents mostly showed no specific preferences for a certain sport but were supportive in general.“As children, we had to participate in a sport. Sport was seen as something positive and healthy. When we had chosen a sport, we should participate on a regular basis, even if we didn’t feel up to go to training a certain day; it was a way to learn discipline” (R5).Only one participant described the praise of her father as her motivation for staying in competitive gymnastics when she was a child. Most of our participants came out of well-functioning families. Sport, even when not performed as competition sport, had the role of character-building.All parents were described in the same way: they liked their girls to be active and healthy, but the parents didn’t have a certain fondness for a certain sport. They neither seemed to have conscious or unconscious wishes for their children to be successful in sport. The interviewees seldom expressed negative emotions when referring to their childhood.fighter genes than most of other families; we always had to compete, even during holidays. (…) But we have always been happy for each other’ success. (…) But my age records are still better than hers.” (smiles)(C8).“Especially me and my sister, we have more In the group of competitive women, the parents and siblings took another form of influence. The siblings were often described in relation to their physical achievement – for example if they had been faster in running or jumping. Half of them were eldest sisters, all having at least one sibling.“My father asked my trainer: ‘How far can she make it? Which level will she reach?’ (...) and at a certain point I had to push him back and to say, ‘you have no idea what I am doing; please, stay out of my sports life.’” (C3).For many of them, the parents had been part of “the club system”, knowing the training schedules, disciplines and environment. Their parents’ focus was so intense that, for some, it became very important to develop their own training routine and keep a certain distance from their parents’ wishes and considerations. In almost all interviews with competitive women, the fathers had been very engaged in their daughters’ sports careers. Sometimes the women enjoyed the fatherly attention and support, but often they had to stand up for themselves and get away from their fathers.For the recreational athletes, in contrast, parental interest in a specific form of exercise was not a part of their family context growing up. As most Danish children, they participated in extracurricular activities when they were aged eight to twelve years. And typical to girls in general, they tended to stop when reaching puberty. These women began exercising recreationally again after leaving their parents’ homes.“I was not very popular at school, so sport gave me an identity, a niche!” (C2).Another important motivational aspect was the possibility to be well liked for the competitive athletes, who often described themselves as lonely when children.They named the sports club as an environment where they could “fit in” as girls, in contrast to their school environments, where they often felt as outsiders. When in their early twenties, they described themselves as ambitious and goal-oriented in contrast to their peers, who were more interested in parties and alcohol. They expressed their need to be part of a training group, where all were ambitious, and to form a larger network of social relations including a club, supportive parents, and training communities, which supported exercising.“My first trainer (…) has known me since I was five years old, he knows exactly, how I am thinking, and he knows how to treat me, I trusted him, and I trained maybe seven times a week for 1.5 hours.” (C5).A particular close relationship that was mentioned as important for many of the competitive women was with their  trainer:This athlete (C5) described a dependent relationship to her trainer, a relationship that was an important part of her identity. For some competitive athletes, the trainer was part of the inner dialogue of an athlete (“he knows me better than my parent”) and became a person the athlete could approach at almost every time of the day. A close, supportive relationship to their trainer was expected, as were such relationships in their club. One participant felt unimportant to her trainer, and when she felt the environment in the training groups became too competitive and unhealthy, she lost motivation to compete.None of the recreational athletes reported periods of isolation in school or other examples of unhappy social phases during childhood. In fact, social factors – either historical or current – were rarely mentioned as relevant to why exercised. Two of the recreational athletes mentioned that they liked the social atmosphere in their training environments. However, they preferred to exercise alone, even when participating in a group class, and did not report needing peer support to maintain their motivation.self” (C1);“It is great to exercise, you feel good about yourself, when I have been exercising” (R7).“I feel better about myThe self is mentioned by all participants, both in the way they act towards others but also in the way they act towards themselves. Here, competitive athletes and recreational athletes sound almost identical: Exercising is making your “self” comfortable.“If I have to look really good before going to a party, I push myself in the gym beforehand” (R7).“I shave my legs the day before a competition; if I don’t, I will run slower, because I am heavier. I have also the ritual of fixing up my nails, as a form of competition preparation” (C8).We also find a high interest in the bodily appearance – however, the recreational women use it as a kind of self-production, while the focus on the body for the competitive athletes is more a medium for interaction with other sport participants.“I hate to train by myself; I need to compete with others under the training” (C1);“I also like the way I look naked when I have been exercising.” (R7).Taken at face value, these two quotes seem to show the same interest in the bodily appearance. However, in the first case the body is instrumentalised as a part of the self – when my body looks good, I look good, as I am my body. In the second case, the “preparation” of the body before a competition is part of a confidence-building ritual of the self. When I look good, I will run faster. So, here we find differences in the role of the self.“The most important part was to become better at something, by myself.” (C5).Both groups have a strong focus on their bodily appearance, though with different targets.“Your self-worth gets better when you look into the mirror and think your abs are just great!” (R7).Rather than family roles or social influences, most recreational athletes were clearly focussed on their own appearances. They showed a high preoccupation with their bodies as embodied selves, differentiated in certain parts of muscles.Recreational athletes expressed a substantial need for body control in order to maintain their participation. Exercise was a tool to make them feel good about themselves physically, and they needed evidence of improvement – feedback in the form of more muscles and lower fat – in order to continue to exercise.“I am using my head the whole day (...), sometimes it is really nice to do something with your muscles.” (R1).“[Exercise] is a distraction for me. To come into your body and out of your head.” (R8).In addition to giving them physical self-confidence, exercise represented a “me-world”, a time slot belonging to themselves, without any influence of others.Using the body allows for mental relaxation, as one participant framed it. The meaning of exercising was placed in the self, but in two different ways. For the recreational group, the meaning of exercising was to combine movement with renewed energy, less stress, wellness, and relaxation. These effects could almost initiate an addiction to a physically active lifestyle, including everyday exercising.The bodily self-understanding, i.e. “being in shape”, were not goals in and of themselves for competitive athletes but were tangential benefits. They were highly aware of being in shape, but in a non-narcissistic way more targeted to achievement than to their looks. The benefits of exercising that were the goals for recreational athletes were a by-product, or evidence, of their hard work which allowed them to be competitive.For the competitive athletes, the meaning of exercising was threefold: firstly, a concrete specific event as goal ; secondly, an external view of themselves ; thirdly, a rejection and contempt of Danish youth life, including heavy alcohol consumption . Participation in competitive sports implied benefits: it gave them a valuable meaning of how to organise their spare time in a meaningful way, and the positive reward of having success and being able to run fast.“I would like to have that six-pack, but I can’t use it for my running. You are more focused on what you actually need. I would not profit from losing some pounds, I would lose muscles instead. Of course, I would enjoy less weight, but that would reduce my speed, so I don’t care. I don’t need a flat tummy; I just want to run fast!” (C1).For the competitive athletes, the meaning was more dependent upon their achievement in competitions. “I always wanted to be the best!” said C1. One could have good days or bad days, depending on their bodily performance. The competitive athletes described the importance of having an external goal, such as a certain championship or becoming part of the national team. They all agreed that it was less important to have a body shaped in a specific way than to have muscles, which they can use for achieving their goals.Another more unusual aspect in motivation was the role of overcoming injuries, not once mentioned by the recreational athletes. Every competitive athlete told about periods of injury when they hadn’t been able to train or to compete, sometimes followed by periods of psychological imbalance or depression; injuries often happened multiple times within an annual training cycle. Overcoming the injury and re-gaining the fitness lost was described as a motivation in and of itself.We started our investigation by asking for individual differences in the self-understanding and bodily identity in two groups of exercising females. Our two groups differed regarding to age and exercise intensity, however, they show more similarities than differences regarding their socialisation, such as a low rate of parental divorce, a positive relation to their parents, and a positive attitude regarding exercise. For all women – exercising both competitively and recreationally – sport was an important part of their childhood life. All women exercised when they were children, often competitively as a part of their normal extracurricular activities, and especially in the rural areas, where club life is an important element of social participation.When they exercised, they exerted and maintained a sense of self to themselves - exercise was thus an internal validation of their bodily self. We started our paper citing Mead’s definition of the sociality of the self, and Kohut’s psychodynamic way of defining narcissim. Following Kohut, narcissistic patients are suffering from “the realm of the self and of those archaic objects cathected with narcissistic libido (self-objects) which are still in intimate connection with the archaic self . But while the recreational athletes mostly focussed on these parts as expression of a lack of perfection, the competitive athletes were more worried about the functions of these body parts. When running 100 or 200 m, thighs are extremely vulnerable. Both groups can focus on their thighs, but while one group is concentrated on their form and appearance, the other group looks at their function. The almost nervous concentration and fixation on the body parts of competitive athletes is here more of caring character. Competitive athletes describe and understand their bodies like mothers their children – always slightly worried, listening and looking, but also proud. Here, the narcissistic fixation aims at achievement, while the recreational body covers the danger of a loss of perfection.The question remains, in which way can a psychodynamic view contribute to sport research and health? This study might be understood as a supplement to recent studies on the culture of sports , especiaAll investigated women showed several similarities, such as spending a lot of time exercising and a certain degree of dependency on physical activity for retaining a stable bodily identity. Physical exercise and bodily control seemed here to give the recreational athletes especially a feeling of control over life in general, sometimes in the risk zone for getting injured or developing exercise addiction , 27. ButThe most challenging difference was the dynamics of parental delegation. Parental delegation aims at owning the inner life of a child in an intrapersonal and interpersonal way. Parental delegation can hinder the successful inner ownership of goals and attitudes. A healthy development requires three conditions: a capacity for self-object differentiation, a tolerance of ambivalence, and a sense of integrity having a cohesive ego . This inOur findings regarding motivation are different to those reported by Healey et al. , who desWhen producing knowledge for the health benefit of the athletes and sports environments, it will be important to include research that reveals their practices as seen from their internal and self-oriented perspective. If athletes do not find meaning in physical activity or competition, they will not give priority to investing time and energy in it. If research can make the conflicts and relations of the self visible in sports culture, this could strengthen the recognition that the overall bodily well-being of athletes is important.