How should teaching on whole person medicine, including spiritual issues, be delivered in the undergraduate medical curriculum in the United Kingdom?

Background

Although the General Medical Council recommends that United Kingdom medical students are taught ‘whole person medicine’, spiritual care is variably recognised within the curriculum. Data on teaching delivery and attainment of learning outcomes is lacking. This study ascertained views of Faculty and students about spiritual care and how to teach and assess competence in delivering such care.

A questionnaire comprising 28 questions exploring attitudes to whole person medicine, spirituality and illness, and training of healthcare staff in providing spiritual care was designed using a five-point Likert scale. Free text comments were studied by thematic analysis. The questionnaire was distributed to 1300 students and 106 Faculty at Queen’s University Belfast Medical School.

351 responses (54 staff, 287 students; 25 %) were obtained. >90 % agreed that whole person medicine included physical, psychological and social components; 60 % supported inclusion of a spiritual component within the definition. Most supported availability of spiritual interventions for patients, including access to chaplains (71 %), counsellors (62 %), or members of the patient’s faith community (59 %). 90 % felt that personal faith/spirituality was important to some patients and 60 % agreed that this influenced health. However 80 % felt that doctors should never/rarely share their own spiritual beliefs with patients and 67 % felt they should only do so when specifically invited. Most supported including training on provision of spiritual care within the curriculum; 40-50 % felt this should be optional and 40 % mandatory. Small group teaching was the favoured delivery method. 64 % felt that teaching should not be assessed, but among assessment methods, reflective portfolios were most favoured (30 %). Students tended to hold more polarised viewpoints but generally were more favourably disposed towards spiritual care than Faculty. Respecting patients’ values and beliefs and the need for guidance in provision of spiritual care were identified in the free-text comments.

Students and Faculty generally recognise a spiritual dimension to health and support provision of spiritual care to appropriate patients. There is lack of consensus whether this should be delivered by doctors or left to others. Spiritual issues impacting patient management should be included in the curriculum; agreement is lacking about how to deliver and assess.

Land wars in India: Contestations, social forces and evolving neoliberal urban transformation

Land wars in India: Contestations, social forces and evolving neoliberal urban transformation
The recent incidents of ‘land wars’ in India have highlighted the contradictions and challenges of the neoliberal urban transformation through a range of issues across governance, equity and empowerment in the development agenda. Simply put, a strong top down approach and corporate-political nexus have determined the modality of land acquisition, compensation and ultimately the nature of its consumption leaving out majority urban poor from its benefits. The paper focuses on the concept of neoliberalism as a modality of urban governance and emergence of the grassroots activism as a countermagnate to neoliberalist hegemony by examining the inequity and marginalization that embody these ‘land wars’ in India and the forms of resistance from the grassroots - their capacity, relationship and modus operandi. Emerging lessons suggest the potential for advancing governance from the bottoms up leading to more equitable distribution of resources. It is however argued that there is a need for a stronger conception of the ‘grassroots’ in both epistemological and empirical context. In particular, the preconditions for the ‘grassroots organisations’ to foster and play a more effective role requires a more inclusive notion of ‘institutionality and plurality’ within the current political economic context. The empirical focus of the paper is ‘land wars’ observed in Kolkata, West Bengal, however references to other examples across the country have also been made.

Contested urbanism: Access and control issues in Tundikhel, Kathmandu

Contested Open Spaces?: Access and control issues in Tundikhel, Kathmandu

Public spaces play a role of political, economic and cultural transformation of cities and the impact of these transformations on the nature of public space.

Urban open space(s) in Kathmandu have been an important part of the city’s urbanism. Historically they have played an important role in the city as spaces for religious, cultural, social and political and military activities during the 300 years of unified monarchy. Throughout the civil war period (Maoist insurgency between 1996 and 2006) they became material locations for political activities, and a site for protests and dharnas. In post-conflict Kathmandu, especially since the abolition of Monarchy in May 28, 2008, these spaces are increasingly seen being claimed by street hawkers, informal sellers and individuals reflecting a new set of users and functions, whereas a significant part of Tundikhel still remains under the military occupation posing important questions around access, identity and control of an important space.


Public spaces are broadly defined as crossroads where different paths and trajectories meet, sometimes overlapping and other times colliding (Madanipour, 2003). Using Tudikhel in Kathmandu, this research examines the increasing collision and contestations witnessed through social, political and neoliberal interactions. It explores how spaces are constantly
contested, negotiated and as a result reshaped through these interactions. It is observed that multiple forces are at play to gain control and access of this important open space, leading to increasing fragmentation of the space, and erosion of its historic significance both as cultural venue and a symbol of democracy in modern Nepal. It is argued that increasing disconnection of Tudikhel from wider urban setting has contributed to exacerbation of these contestations

An exploration of integrated data on the social dynamics of suicide among women

The gender based nature of suicide related behaviour is largely accepted.However, studies which report exclusively on female fatal suicides are rare.Here we demonstrate how female fatal suicide has effectively been ‘othered’ and appears ‘incidental’ in studies which compare female behaviour with that of their male counterparts. We highlight how recent studies of suicide have tended to be dominated by male only approaches,which increasingly link issues of masculinity with male death by suicide.Drawing on data collected from the GP and Coroner’s office, we then apply the Sociological Autopsy approach to a cohort of 78 deaths recorded as suicides in the UK between 2007 and 2009. By focusing on females in isolation from males, we demonstrate that as in male suicide only studies,it is similarly possible to draw out issues associated with the feminine identity which can be linked to death by suicide. We identify that bereavement, sexual violence and motherhood could all be linked to the lives and help-seeking of the females who died. In closing, we suggest are orientation towards sociological analytic approaches of female suicide may help to produce further reductions in the rate of female death by suicide.

Risk, Recovery and Capacity: Competing or Complementary Approaches to Mental Health Social Work

Mental health social workers have a central role in providing support to people with mental health problems and in the use of coercion aimed at dealing with risk. Mental health services have traditionally focused on monitoring symptoms and ascertaining the risks people may present to themselves and/or others. This well-intentioned but negative focus on deficits has contributed to stigma, discrimination and exclusion experienced by service users. Emerging understandings of risk also suggest that our inability to accurately predict the future makes risk a problematic foundation for compulsory intervention. It is therefore argued that alternative approaches are needed to make issues of power and inequality transparent. This article focuses on two areas of practice: the use of recovery based approaches, which promote supported decision making and inclusion; and the assessment of a person’s ability to make decisions, their mental capacity, as a less discriminatory gateway criterion than risk for compulsory intervention.

Using Audio-visual Presentation to Teach Global Mindedness in Social Work Education

Direct experience of social work in another country is making an increasingly important contribution to internationalising the social work academic curriculum together with the cultural competency of students. However at present this opportunity is still restricted to a limited number of students. The aim of this paper is to describe and reflect on the production of an audio-visual presentation as representing the experience of three students who participated in an exchange with a social work programme in Pune, India. It describes and assesses the rationale, production and use of video to capture student learning from the Belfast/Pune exchange. We also describe the use of the video in a classroom setting with a year group of 53 students from a younger cohort. This exercise aimed to stimulate students’ curiosity about international dimensions of social work and add to their awareness of poverty, social justice, cultural competence and community social work as global issues. Written classroom feedback informs our discussion of the technical as well as the pedagogical benefits and challenges of this approach. We conclude that some benefit of audio-visual presentation in helping students connect with diverse cultural contexts, but that a complementary discussion challenging stereotyped viewpoints and unconscious professional imperialism is also crucial.

Case study investigation of indoor air quality in mechanically ventilated and naturally ventilated UK social housing

There is a significant lack of indoor air quality research in low energy homes. This study compared the indoor air quality of eight
newly built case study homes constructed to similar levels of air-tightness and insulation; with two different ventilation strategies (four homes with Mechanical Ventilation with Heat Recovery (MVHR) systems/Code level 4 and four homes naturally ventilated/Code level 3). Indoor air quality measurements were conducted over a 24 h period in the living room and main bedroom of each home during the summer and winter seasons. Simultaneous outside measurements and an occupant diary were also employed during the measurement period. Occupant interviews were conducted to gain information on perceived indoor air quality, occupant behaviour and building related illnesses. Knowledge of the MVHR system including ventilation related behaviour was also studied. Results suggest indoor air quality problems in both the mechanically ventilated and naturally ventilated homes, with significant issues identified regarding occupant use in the social homes

Exploring communication between social workers, children and young people

A key issue for the social work profession concerns the nature, quality and content of communicative encounters with children and families. This article introduces some findings from a project funded by the Economic and Social Research Council (ESRC) that took place across the United Kingdom between 2013 and 2015, which explored how social workers communicate with children in their everyday practice. The Talking and Listening to Children (TLC) project had three phases: the first was ethnographic, involving observations of social workers in their workplace and during visits; the second used video-stimulated recall with a small number of children and their social workers; and the third developed online materials to support social workers. This paper discusses findings from the first phase. It highlights a diverse picture regarding the context and content of communicative processes; it is argued that attention to contextual issues is as important as focusing on individual practitioners’ behaviours and outlines a model for so doing.

Health and Social Care Workers Perceptions of Novel Psychoactive substances in Northern Ireland

Background: The EU Early Warning System currently monitors more than 450 new psychoactive substances (EMCDDA, 2015), far outweighing the total number of illicit drugs under international control (UNODC, 2013). Due to the recent emergence of NPS and rapidly changing nature of the market, evidence about the way in which the emerging drugs are managed in health and social care settings is limited. Methods: The study adopted a mixed methods design, utilising a cross sectional survey and follow up telephone interviews to capture data from staff working in drug and alcohol related services in statutory and voluntary sectors, across the five Health and Social Care (HSC) Trust areas in Northern Ireland. 196 staff participated in the survey and 13 took part in follow up telephone interviews. Results: Study respondents reported that addressing NPS related issues with service users was a key aspect of their daily role and function. Levels of injecting behaviours were also viewed as relatively high by the study participants. Almost all workers used harm reduction as their primary approach when working with service users and the majority of respondents called for additional practical training in relation to addressing drug interactions and intervening with NPS related issues.

‘Running with the Fox and Hunting with the Hounds’: Social Work Tutors' Experiences of Managing Failing Social Work Students in Practice Learning Settings

The paper explores the issues raised by social work students failing in practice learning settings from the perspective of university tutors, by drawing on existing literature in this area from social work and nursing, as well as findings from a small‐scale empirical qualitative study. The qualitative study was influenced by practitioner‐researcher and practice‐near paradigms; and is based on interviews with twelve social work tutors in England. The findings reveal that tutors are able to articulate the important tasks and functions of their roles when issues of failing students in practice learning settings arise, although the process can be challenging. The challenges include: supporting practice educator and student, concerns about other tutors’ practices, the difficulties in promoting appropriate professional standards and values within higher education contexts and frustrations with practice educators and placements. Only a third of the respondents (four) however, articulated their gate keeping roles and responsibilities although this was not without its difficulties. Given the current reforms in social work education in England at this present time, with greater emphasis on threshold standards at entry level, and at key stages throughout the programme of study, the research is timely in terms of the critical consideration of the tutor role and challenges inherent in promoting appropriate standards.

Revitalizing the PE social-justice agenda in the global era: Where do we go from here?

Critical theorists have called attention to the intensification of diversity that is now occurring inside and outside of school, while critically engaging with the detrimental effects of globalization on equity, diversity, and social justice. Globalization presents new challenges to education and to issues of social justice. In this article, we argue that there is a need for scholars in the field of physical education (PE) to re-think and re-frame the social-justice agenda to address current inequalities produced by globalization. To support this argument, first, we reflect on the impact of global neoliberalism on PE; second, we discuss the ways in which, as a result of global neoliberalism, public health discourses have an “othering” effect on ethnically diverse young people; third, we propose a theoretical shift from a focus on equality to a focus on difference; and finally, we conclude with considerations for future research and curricula in school PE.

Please Don't Make Me Ask for Help: Implicit Social Support and Mental Health in Chinese Individuals Living with HIV

Thesis (Master's)--University of Washington, 2013

A Bilingual Thesaurus of Everyday Life in Medieval England: Some Issues at the Interface of Semantics and Lexicography

This paper reports on issues at the interface between semantics and lexicography that arose out of the data collection and classification of vocabulary in Anglo-Norman and Middle English in order to create a bilingual thesaurus of everyday life in medieval England. The Bilingual Thesaurus project is based at Birmingham City University and the University of Westminster. Issues to be resolved included the definition of an occupational domain; the creation of a methodology of data collection; the delimitation of domain-specific vocabulary; making distinctions between sense and usage; and the categorisation of the lexical items. Some of these issues are general to thesaurus-making, some are specific to the making of historical thesauruses, while some are unique to the production of a thesaurus of two languages whose use overlapped for several centuries in the late medieval period in England.

Os projetos de literacia financeira como prática de responsabilidade social corporativa: caso Cetelem

Dissertação apresentada à Escola Superior de Comunicação Social como parte dos requisitos para obtenção de grau de mestre em Gestão Estratégica das Relações Públicas.

Study of Load Curves Concerning the Influence of Socioeconomic and Cultural Issues

The increase of electricity demand in Brazil, the lack of the next major hydroelectric reservoirs implementation, and the growth of environmental concerns lead utilities to seek an improved system planning to meet these energy needs. The great diversity of economic, social, climatic, and cultural conditions in the country have been causing a more difficult planning of the power system. The work presented in this paper concerns the development of an algorithm that aims studying the influence of the issues mentioned in load curves. Focus is given to residential consumers. The consumption device with highest influence in the load curve is also identified. The methodology developed gains increasing importance in the system planning and operation, namely in the smart grids context.