Culture, authenticity and sport : a study of event motivations at the Ulaanbaatar Naadam Festival, Mongolia

Drawing on the results of an empirical study, this chapter examines the case of the Ulaanbaatar Naadam within the framework of the literature on cultural authenticity and with reference to the contribution of sporting events and competitions to the latter. Differences between overseas and domestic markets attending the event are investigated and conclusions are drawn on the role of cultural authenticity in motivating visitors to attend the Naadam festival

Lifelong learning and lifelong education: a critique

It is suddenly fashionable in political circles in the United Kingdom (and elsewhere) to talk about lifelong learning and lifelong education. This seems to be the direct result of the present economic climate which has called into question many previous assumptions: job security has become an effective myth for most of those who can actually get work; long-term unemployment seems to have become structural and permanent. Consequently, the notions of lifelong learning and lifelong education have taken on dimensions far removed from the almost Utopian ideals of their supporters in the years following the publication of the report Learning to Be. Given the current economic gloom, the popularity of the terms with politicians and the fact of being in the European Year of Lifelong Learning, it is perhaps appropriate to take stock of the whole notion of lifelong learning and lifelong education and to see just what meaning (if any) lies behind these words and where they might take us in the future. This essay lays its foundations in the historical background to the ideas of lifelong learning and lifelong education before moving onto a critique of the post-Faure advocates of the principles. It discusses various problems inherent in the concepts (such as lifelong inadequacy) before concluding that, although many of the difficulties in the concepts are due to the confused nature of adult education itself (e.g. is it education or leisure?), there is a greater need than ever for sustained efforts in favour of lifelong education to help to restore the hope which seems to have become a rare commodity among an all too large section of society

Alleviating unprecedented pressures faced by the General Practice workforce: a conceptual framework based on the extent to which Wessex GPs think that patients presenting with one condition could have been seen and appropriately managed by another healthcare professional [HCP]

1. Outline of the problem/contextThe number of patients who are finding it difficult to make a GP appointment has increased due to a lack of sufficient resourcing for general practice (i.e. shortage in workforce: GPs and nurses, decreased funding and increased costs) in a context of rapidly growing demand, brought about by the rising demographics, especially, but not exclusively, ageing population with long-term and complex conditions (RCGP 2015; Goodwin et al, 2011; Rosen and Parker, 2013; Deloitte, 2014; Baird et al, 2016).2. Assessment of problem and analysis of its cause/ literature reviewVarious solutions have been proposed to decrease the GP workload while also increasing the accessibility of primary care: promoting NHS Choice website (Nelson et al, 2010); improving health and self-management (Goodwin et al, 2011); collaboration between GP practices (Naylor et al, 2013); multi-specialty or multi-disciplinary new integrated models of care (Smith et al, 2013; NHS England 2015; Snow-Miller, 2015; Roland et al, 2015; Matheson, 2016b, 2016c); telephone consultations (Longman, 2012); emails (Atherton et al, 2012) and e-consultations (Adamson and Bachman, 2010; Madan 2014; Longman and Diggines, 2014).NHS Choice website was deemed in need of more marketing (Nelson et al, 2010). Multi-specialty or multi-disciplinary new integrated models of care have proven to be successful (Langridge, 2015; NHS England 2015; Liles, 2016a, 2016b; Matheson, 2016b, 2016c). Improving health initiatives (Goodwin et al, 2011; HSIC, 2015) and collaboration between GP practices (Naylor et al, 2013) have been slower to show progress. Although deemed convenient and useful, physicians have been slow to adopt secure patient messaging (Wallwiener et al, 2009). Limited evidence, variable results and shortcomings in data in relation to email has been such that it could not be adequately assessed (Atherton et al, 2012). Telephone-based consultation have shown conflicting evidence: from popular and successful (NHS England, 2015, p38) to ineffective and leading to increased workload (Campbell et al, 2014). Despite various claims (Adamson and Bachman 2010; Madan et al 2014; Longman and Diggines, 2015) of increased access for patient and decreased GP workload, evidence for online consultations has demonstrated a lack of significant benefit and low uptake (NHS England, 2015; Matheson, 2016d).3. Strategy for change/aims and objectivesTo try and identify ways of closing this gap between demand and supply by investigating, from the perspective of GPs, the extent to which HCPs could replace GPs re face-to-face consultations with patients who presented with one condition. 4. Measurement of improvement/methods/outcome measuresA survey questionnaire one side of A4 would be sent via a Wessex LMCs mailing to be completed discretely by hand by GPs ‘live’ during a consultation using 5-bar gate tallies to count the number patients presenting with one condition who could have been seen and appropriately managed by another Healthcare Professional [HCP] and to indicate which HCP (out of a choice of 4) could best do this with free text too for choice of HCP.5. Effects of changes/resultsA total of 212 questionnaires were received from a total of 23 practices spanning 9 Wessex CCGs that recorded 4,303 patient visits with 35% assessed as could have been seen and appropriately managed by another HCP: 18.5% could have been seen by an advanced nurse practitioner; 5.4% by an extended scope physiotherapist; 3.6% by a practice nurse; 3.1% by a MH nurse; 2.6% by a clinical pharmacist; and 1.7% by other HCPs or elsewhere. Of the 35% of consultations that could have been undertaken by an HCP: just over half (52.5%) could have been managed by advanced nurse practitioners; 15.5% by extended scope physiotherapists, 10.4% by practice nurses, 8.9% by MH nurses; 7.4% by clinical pharmacists and 5% by others/elsewhere. 6. Lessons learnt/discussion/strengths and limitations6.1. Strengths-First time that GPs have actually been asked to audit their practice ‘live’ to determine how many patients could have been seen and managed by another HCP and to identify which HCP could actually have done this-The sample represented 13.7% of GP practices in West Hampshire and 15% of GP practices in North Hampshire.-The survey enabled a dashboard to be built based on the results of the survey that can be populated by individual GP practices so visualise expanding the role of HCPs 6.2. Limitations-No respondents from Portsmouth CCG and Isle of Wight CCG.-The results entirely based on the conceptualisation by GPs of the ability of other HCPs to see patients presenting with one problem and to manage them appropriately for one -Does not take into account patients presenting with more than one problem -A very brief snapshot lacking in depth and does not take into account the interplay of complex factors. 7. Message for others/recommendations-The project could be replicated on a larger scale and supplemented by focus group with GPs or an additional electronic survey.-Involve patients and other HCPs in the design of interventions.<br/

The views of doctors in their first year of medical practice on the lasting impact of a preparation for house officer course they undertook as final year medical students

<p>Abstract</p> <p>Background</p> <p>The UK General Medical Council recommends that medical students have the opportunity of shadowing the outgoing new doctor whose post they will soon undertake. At the University of Nottingham the two-week shadowing period was preceded by two weeks of lectures/seminars wherein students followed sessions on topics such as common medical/surgical emergencies, contracts, time management, surviving the first two years of clinical practice, careers advice and so on.</p> <p>The present study aimed to gain a better knowledge and understanding of the lasting impact of a four-week preparation course for new Foundation Year 1 doctors [F1 s - interns]. The objectives chosen to achieve this aim were:</p> <p>1/ to determine the extent to which the lecture/seminar course and shadowing period achieved their stated aim of smoothing the transition from life as a medical student to work as a new doctor;</p> <p>2/ to evaluate perceptions of the importance of various forms of knowledge in easing the transition between medical student and new doctor</p> <p>Method</p> <p>In the spring of 2007, 90 graduates from Nottingham were randomly selected and then emailed a link to a short, online survey of quantitative and qualitative questions. Of these 76 responded. Analysis of quantitative data was carried out using SPSS 16.0 and employed McNemar's test. Analysis of the qualitative data was carried out using the constant comparative method.</p> <p>Results</p> <p>Only 31% of respondents strongly agreed or agreed that the lecture/seminar part of the course prepared them well for their first FY1 post; 14% agreed that during their first job they drew on the knowledge gained during the lecture/seminar course; 94% strongly agreed or agreed that the shadowing part of the course was more useful than the lecture/seminar part.</p> <p>Experiential knowledge gained in the shadowing was the most highly valued, followed by procedural knowledge with propositional knowledge coming far behind.</p> <p>Conclusions</p> <p>Our study shows that new doctors retrospectively value most the knowledge they are able to transfer to the workplace and value least material which seems to repeat what they had learned for their final exams.</p

Perceptions and experience of racism in the workplace by health and social care staff in Shropshire, Wrekin and Telford

A report produced for Shropshire, Telford and Wrekin Integrated Care Board.Shropshire, Telford and Wrekin Integrated Care Boar

‘The Genie's Out of the Bottle’: The Impact of Working Online with Individual Psychodynamic Psychotherapy for Therapists and Clients, and its Lessons for Psychodynamic Training

The forced move to online work in 2020 was initially greeted with consternation by many in the psychoanalytic world, but adaptation was subsequently accomplished by many with successful results for clients. At WPF Therapy where individual psychodynamic psychotherapy is offered by therapists in training, we did a qualitative and participative study with clients, trainees and supervisors to explore how these groups felt about online work. A participative and pluralistic approach was chosen to achieve a fuller and more balanced understanding. Eighteen trainees interviewed each other, 19 supervisors contributed through focus groups and individual interviews, and eight clients’ perspectives were explored in individual interviews. The findings were that working online offered different and exciting opportunities for therapy, including the unconscious processes which are central to the psychodynamic modality. This has implications for future psychodynamic training since new phenomena need to be incorporated into psychoanalytic thinking and practice. While results did not support replacing in-person therapy, there was support for a combined approach in future. As one participant said: ‘The genie's out of the bottle now’, something has happened which cannot be stopped