Patients' and health professionals' views on primary care for people with serious mental illness:focus group study

Objective: To explore the experience of providing and receiving primary care from the perspectives of primary care health professionals and patients with serious mental illness respectively. Design: Qualitative study consisting of six patient groups, six health professional groups, and six combined focus groups. Setting: Six primary care trusts in the West Midlands. Participants: Forty five patients with serious mental illness, 39 general practitioners (GPs), and eight practice nurses. Results: Most health professionals felt that the care of people with serious mental illness was too specialised for primary care. However, most patients viewed primary care as the cornerstone of their health care and preferred to consult their own GP, who listened and was willing to learn, rather than be referred to a different GP with specific mental health knowledge. Swift access was important to patients, with barriers created by the effects of the illness and the noisy or crowded waiting area. Some patients described how they exaggerated symptoms ("acted up") to negotiate an urgent appointment, a strategy that was also employed by some GPs to facilitate admission to secondary care. Most participants felt that structured reviews of care had value. However, whereas health professionals perceived serious mental illness as a lifelong condition, patients emphasised the importance of optimism in treatment and hope for recovery. Conclusions: Primary care is of central importance to people with serious mental illness. The challenge for health professionals and patients is to create a system in which patients can see a health professional when they want to without needing to exaggerate their symptoms. The importance that patients attach to optimism in treatment, continuity of care, and listening skills compared with specific mental health knowledge should encourage health professionals in primary care to play a greater role in the care of patients with serious mental illness.

Internal market orientation and market/oriented behaviours

Purpose – The purpose of this empirical paper is to investigate internal marketing from a behavioural perspective. The impact of internal marketing behaviours, operationalised as an internal market orientation (IMO), on employees' marketing and other in/role behaviours (IRB) were examined. Design/methodology/approach – Survey data measuring IMO, market orientation and a range of constructs relevant to the nomological network in which they are embedded were collected from the UK retail managers. These were tested to establish their psychometric properties and the conceptual model was analysed using structural equations modelling, employing a partial least squares methodology. Findings – IMO has positive consequences for employees' market/oriented and other IRB. These, in turn, influence marketing success. Research limitations/implications – The paper provides empirical support for the long/held assumption that internal and external marketing are related and that organisations should balance their external focus with some attention to employees. Future research could measure the attitudes and behaviours of managers, employees and customers directly and explore the relationships between them. Practical implications – Firm must ensure that they do not put the needs of their employees second to those of managers and shareholders; managers must develop their listening skills and organisations must become more responsive to the needs of their employees. Originality/value – The paper contributes to the scarce body of empirical support for the role of internal marketing in services organisations. For researchers, this paper legitimises the study of internal marketing as a route to external market success; for managers, the study provides quantifiable evidence that focusing on employees' wants and needs impacts their behaviours towards the market. © 2010, Emerald Group Publishing Limited

Thoughts on L2 listening pedagogy

In this paper, I discuss some of the ideas raised by Renandya and Farrell (ELT Journal 65/1) related to extensive listening (EL) and the teaching of listening strategies. Function of extensive listening :The concept of EL emanated from extensive reading, an approach that aims to improve a variety of reading skills through exposure to materials that approximately match proficiency level. According to Renandya and Farrell (2011: 56), ‘like reading, listening is best learnt through listening’. These authors support EL as the answer to the issue of how to teach listening in L2 classrooms. Complementary role : EL can play a supportive role in L2 listening pedagogy. Through exposure to extensive and various listening texts, learners gain opportunities to practise and refine their listening processes, recognize linguistic and lexical features, and increase cultural knowledge related to the target language. The value of EL in this practice-oriented capacity cannot be overstated. It is difficult, however, to accept EL as the main component of L2 listening pedagogy, as Renandya and Farrell suggest. With listening materials readily available online (see Renandya and Farrell’s useful list of websites, p. 58) and on CDs, there is no shortage of practice material. EL provides the practice, but a question we should ask is: ‘What exactly are learners practising?’ Extensive listening dilemmas: For EL to be the predominant element in L2 listening pedagogy, several matters may need to be resolved.