Search results

Libraries do not have a reputation for being the most exciting places on earth. Usually depicted as quiet, sleepy halls filled with dusty books they hardly fit the image of a leading light when it comes to technology. And yet behind the facades of the British Library a team of people are hard at work supporting one of the most advanced library information networks in the world, while at the same time coping with the prospect of a site reorganisation large enough to daunt even the most experienced data processing manager.

Orthopaedics, rheumatology, pain management, specialist radiology and therapy services were brought under one umbrella to form Northwest Surrey integrated musculoskeletal (IMSK) services and introduced advance clinical practice, a multi-disciplinary team triage with a formalised straight to test (STT) process defined in 2018. Historically, prior to these services' integration, there were a primary and second care triage systems within individual specialities. The aim of this service evaluation is to assess the impact of a single IMSK multidisciplinary triage (MDT) system and the efficacy of STT from triage, which allows patients to be sent for diagnostics based on the cluster of symptoms and past medical history in order to achieve early identification of serious pathologies. This is a complex adaptive system with pathways spanning into the core areas of orthopaedics, rheumatology, therapies, pain management services, radiology and some less frequent specialities such as neurology, oncology, vascular and gynaecology. One of the objectives of this study was to identify how many referrals were triaged to consultants, Advance practice and therapies. In addition, the authors wanted to highlight the proportion of referrals that were sent straight to test from triage and the percentage of these that had sinister pathology identified. This information would then be compared against existing red flag literature to identify common themes. This study aims to discuss the aforementioned objectives.

Data were extracted retrospectively from a hospital database from January to December 2019 for all the adult musculoskeletal service referrals. The data collected were analysed on a Microsoft Excel sheet with information including date of triage, hospital number, ordering clinician, body part, type of diagnostic, indications for scanning, outcome for STT, serious pathology findings (named code 5 within our trust) and outcome of appointment.

A total of 47,039 referrals were received into the IMSK service. Of these referrals 19,967 were directly referred to therapies, with 27,072 referrals received into the IMSK service MDT process. Within triage, 718 patients were directed to STT to rule out serious pathology. A total of 28 patients (3.9%) had sinister pathology identified on their investigation. A total of 46% of patients were discharged from their first consultation following STT. Overall, 50% of the total number of referrals into the IMSK service was seen by advanced practitioners with 16% of patients directed to consultants with pre-consultation diagnostic work up.

This service evaluation highlights that STT allows early access to diagnostics, resulting in quicker access to identification of sinister pathology. A one stop MDT system has been shown to be effective in guiding the referral to the right place with increased referrals into allied health advance practice clinics and access to therapies directly. It has resulted in a reduction of unwarranted referrals to consultant care, duplication of investigations and identified patients on multiple pathways.

Many treatment methods for intra-articular fractures of the proximal interphalangeal (PIP) joint are described in the literature without a consensus on the most effective approach. The purpose of this study was to investigate the methods of treatment of PIP joint fractures being used by trauma surgeons in the Republic of Ireland currently and the timing of referral to therapy.

A cross-sectional descriptive study methodology was used to survey trauma surgeons, occupational therapists and physiotherapists in Ireland. An online platform was used. A total of 21 surveys were returned by surgeons and 37 by therapists. Descriptive statistical analysis was used to present the results.

Buddy strapping was reported as the primary treatment method for stable PIP joint fractures. All levels of fracture severity were reported to be treated using traction constructs, which include static and dynamic fixation and orthoses. Unstable fractures were managed using open reduction with internal fixation by 50 per cent of surgeons. Early timing of referral to therapy is reported by more surgeons than therapists. The majority of therapists indicated that they did not have the resources to see patients at the optimal time.

To the authors’ knowledge, this study provides the first description of the management of PIP joint fractures across the Irish health service. The findings of this study suggest that additional therapy resources are required within the health service executive to facilitate the desired early referral to therapy and to enable service development for this category of hand fractures.

The Polish economy is continuing its expansion through the adoption of free market economics in the post‐communist era. To encourage this growth in a future where difficult global economic conditions are likely to persist, it is essential that entrepreneurial activity is encouraged within the next generation of graduates. This study aims to explore the attitudes and motivations of Polish students towards an entrepreneurship education programme.

To achieve the research objectives the methodological approach adopted for this study involved semi‐structured interviews undertaken with 122 Polish students. Each student undertook an interview within which they were asked to reflect on the impact of an entrepreneurship education programme on their entrepreneurial attitudes and motivations.

This study builds on Jones et al., whose “snapshot” study found that Polish students had limited prior entrepreneurial experiences and expectations and welcomed the opportunity to undertake entrepreneurship education. The findings here confirmed the results of the prior study, but also provided greater insight regarding the reasons underpinning respondent behaviour.

The data collected within this study are limited to the experience of Polish students. It is questionable whether the results are generalisable to different nationalities. Additional research must be undertaken to explore this further.

The results have implications for the construction and delivery of entrepreneurship education to student groups.

The study contributes to the extant knowledge in the context of the experience of enterprise education in a developing country. The paper will be of value to enterprise education providers in aiding the construction and delivery of such programmes.

This paper explores how policy-level stakeholders tackle digital inclusion in the context of UK rural communities.

Semi-structured interviews were conducted with stakeholders that operate nationally in government departments, government funded organisations and third sector organisations that provided a policy-level perspective on digital inclusion initiative provision across England, Scotland and Wales. Activity theory (AT) was utilised as a theoretical framework, where a variety of factors–tools, rules, community, division of labour and contradictions–were found to have an influence on digital inclusion initiative provision.

Digital inclusion initiative provision in UK rural communities is organised through the multi-stakeholder involvement of national organisations, and collaboration with intermediary organisations to provide digital skills training and support. The process is fraught with difficulties and contradictions, limited knowledge sharing; reduced or poor-quality connectivity; lack of funding; lack of local resources; assumptions that organisations will indeed collaborate and assumptions that intermediary organisations have staff with the necessary skills and confidence to provide digital skills training and support within the rural context.

This study highlights the benefit of using AT as a lens to develop a nuanced understanding of how policy-level stakeholders tackle digital inclusion.

This study can inform policy decisions on digital inclusion initiative provision suitable for rural communities.

The contribution of this paper provides new insights into the understanding of how policy-level stakeholders tackle digital inclusion and the provision of digital inclusion initiatives; it builds on the use of AT to help unpick the complexity of digital inclusion initiative provision as a phenomenon; it reveals contradictions in relation to trust, and the need for knowledge sharing mechanisms to span and align different interpretations of digital inclusion across the policy-level; and reveals an extension of AT demonstrated through the “granularity of the subject” which enables the multi-actor involvement of the stakeholders involved in digital inclusion at policy-level to emerge.

This paper aims to appraise the delivery of an enterprise education course to a cohort of Polish students evaluating its impact in encouraging entrepreneurial activity. The Polish economy continues its expansion with adoption of free market economies post communism. To encourage this growth, entrepreneurial activity must be encouraged within the next generation of entrepreneurs namely the student community. The course entitled Starting a New Enterprise (SANE) was developed to provide entrepreneurial skills and knowledge of the business planning process. The enterprise education literature questions its effectiveness in encouraging entrepreneurial activity. This study profiles the SANE course focusing on students entrepreneurial motivations, prior experiences and future intent.

This study presents a quantitative review of the Polish students' reflections on the experience of enterprise within the SANE course. The basis for this investigation involved two semi‐structured questionnaires undertaken prior to and on completion of the course. In total, 59 students completed the first questionnaire and 50 respondents the second.

The study found that Polish students had limited prior entrepreneurial experiences and expectations and welcomed the opportunity to undertake enterprise education. The findings suggested an equal proportion of male and female students aged 18‐24 favoured a future entrepreneurial career. Moreover, a quarter of all respondents welcomed an immediate entrepreneurial career on graduation and found value in the development of a business proposal. The findings suggested that entrepreneurial education informs entrepreneurial intent and career aspirations.

This study provides evidence into the effectiveness of enterprise education courses as a mechanism to encourage nascent entrepreneurial activity.

This paper proposes that owner‐managers of growth firms are more likely to have developed or acquired managerial practices that facilitate such expansion. The paper, therefore, examines how growth oriented firms in Wales have adopted management practices to build the necessary entrepreneurial capacity to sustain growth.

A group interview technique was utilised to examine the management development process in 18 growing firms across the manufacturing, construction sectors.

The research highlighted that whilst firms argued that the management practices they had implemented were to facilitate further growth, the relative importance of practices such as marketing, financial management and planning varied across sectors. Furthermore, it was apparent that growth firms identified in this study were more inclined to look at the adoption of management practices from a strategic perspective.

The exploratory nature of this study means that it is difficult to generalise these findings outside the boundaries of the adopted research strategy. In addition, links between performance and managerial action are always very difficult to demonstrate conclusively as this process is often dependent on owner‐managers recounting and recognising cause and effect relationships. Nevertheless, the study does strengthen existing academic argument that key management practices outlined in this paper are regularly adopted by growing firms.

The findings will assist policy makers and owner/managers with regard to identifying and understanding why certain management practices engender small business growth.

The paper adds its support to the growing literature which examines the process of management development in small growth firms. Moreover, given Wales' current dearth of growth oriented firms, the paper implies that policy makers should support training and initiatives that develop entrepreneurial and managerial competencies that are industry specific.

This paper reviews evidence about the relationships between NHS services and nursing and residential homes in England and Wales. Since the transfer in 1993 of responsibility for funding nursing and residential home care for less affluent older people to local authority social services departments, nursing and residential care has been widely assumed to constitute part of ‘social care’ services. This obscures the fact that residents of nursing and residential care homes frequently have substantial and complex healthcare needs. While some of these healthcare needs may be met through the care provided within homes themselves, most will require substantial contributions from NHS medical, nursing, pharmaceutical and other services. The National Service Framework for Older People (Department of Health, 2001) prioritises reinvestment in intermediate care services, building on the expectation in The NHS Plan (Department of Health, 2000a) that residential and nursing homes will play a major role in the development of these services. This expectation has been further reinforced by the Concordat with the private and voluntary healthcare provider sector (Department of Health, 2000b). However there is little evidence about the NHS services which are currently provided to nursing and residential homes, nor about the capacity of mainstream NHS services to meet the projected development of intermediate care services within the independent institutional sector. This paper reviews the evidence which is available and highlights some of the priorities which primary care groups in England (local health groups in Wales) will need to consider if they are to develop integrated and good quality services for frail older people.

Given the high unemployment rates being experienced by graduates, the importance of small business start-up has increased significantly, with greater priority being placed upon the development of entrepreneurial skills across the educational sector. However, there is a limited literature considering the student experience and issues involved with supporting non-Business discipline students attaining entrepreneurial competencies. The purpose of this paper is to explore the attitudes and experience of Sports Development and Sports Management students towards entrepreneurship education, highlighting best practice from a pedagogical perspective.

Over 120 Sports Development and Sports Management students on an undergraduate degree were interviewed over a two year period using a semi-structured research instrument. The focus and content of the questionnaire was developed from prior studies undertaken in the field, measuring the impact and value of entrepreneurship education upon attitudes, knowledge and career choice.

The results found that Sports Development and Sports Management students were typically enterprising by nature due to their prior experience in coaching and training within their respective sports disciplines. The majority of students indicated that they were attracted to a future entrepreneurial career in a sports-related discipline. This was driven by the potential of an entrepreneurial career option and the limited alternative choices. Sports Development and Sports Management students were characterised by their mature attitudes towards their career development and future inclination regarding an entrepreneurial career choice.

The results will inform the teaching of entrepreneurship education to non-Business discipline specialist students in terms of the effective construction of entrepreneurship curriculum. Best practice in terms of customised subject informed teaching material, guest talks and interactive pedagogical practice are highlighted.

This study will be of interest to entrepreneurship education providers delivering content to non-Business disciplines at all levels and aid them in the construction of their curriculum to provide fit for purpose provision.

This paper examines entry barriers to involvement in public procurement of small and medium-sized enterprises and the role of training in dismantling those barriers. We find that firms' perceptions of barriers are of five main types. Regression analysis shows that a lack of ongoing training is associated with SMEs' perceptions of resource constraints and practical skills that hinder their participation in public procurement. We also observe a positive connection between a positive attitude toward training and SMEs' participation rates in public procurement. As a managerial implication, the value of training should be appraised at the firm level, and organizing training and providing information concerning public procurement could be a recommended policy to improve the SME participation rate in public procurement.