Journal articles on the topic 'Physical education and training, examinations, questions, etc'

Health is the inevitable requirement to promote the all-around development of people. Middle school physical education and high school physical examination are important links to improve the physical quality of teenagers, improve people’s health level, enhance people’s happiness, and promote the construction of healthy China. The research purpose of this paper is to discuss the market positioning of folk sports training and put forward questions. This paper explores the market development strategy under the background of the increasing scores of PE middle school examinations after the reform of PE middle school examinations in recent years, even higher than in some subjects. This paper argues that the current reform of physical education examination has brought new challenges to physical education teaching and training. At the same time, it has provided new opportunities for physical education training institutions. However, there are still serious problems in the current physical training, such as backward management concepts and lack of innovation ability. The training quality is not high, and the development ability is insufficient; The training is not specialized and has no pertinence to different sports events, which can easily affect the development of the industry. In view of these problems, the author puts forward improvement ideas, including market-oriented innovation development mode; Re-orientation of training institutions in the market.

Background The reliability of GPT-4, a state-of-the-art expansive language model specializing in clinical reasoning and medical knowledge, remains largely unverified across non-English languages. Objective This study aims to compare fundamental clinical competencies between Japanese residents and GPT-4 by using the General Medicine In-Training Examination (GM-ITE). Methods We used the GPT-4 model provided by OpenAI and the GM-ITE examination questions for the years 2020, 2021, and 2022 to conduct a comparative analysis. This analysis focused on evaluating the performance of individuals who were concluding their second year of residency in comparison to that of GPT-4. Given the current abilities of GPT-4, our study included only single-choice exam questions, excluding those involving audio, video, or image data. The assessment included 4 categories: general theory (professionalism and medical interviewing), symptomatology and clinical reasoning, physical examinations and clinical procedures, and specific diseases. Additionally, we categorized the questions into 7 specialty fields and 3 levels of difficulty, which were determined based on residents’ correct response rates. Results Upon examination of 137 GM-ITE questions in Japanese, GPT-4 scores were significantly higher than the mean scores of residents (residents: 55.8%, GPT-4: 70.1%; P<.001). In terms of specific disciplines, GPT-4 scored 23.5 points higher in the “specific diseases,” 30.9 points higher in “obstetrics and gynecology,” and 26.1 points higher in “internal medicine.” In contrast, GPT-4 scores in “medical interviewing and professionalism,” “general practice,” and “psychiatry” were lower than those of the residents, although this discrepancy was not statistically significant. Upon analyzing scores based on question difficulty, GPT-4 scores were 17.2 points lower for easy problems (P=.007) but were 25.4 and 24.4 points higher for normal and difficult problems, respectively (P<.001). In year-on-year comparisons, GPT-4 scores were 21.7 and 21.5 points higher in the 2020 (P=.01) and 2022 (P=.003) examinations, respectively, but only 3.5 points higher in the 2021 examinations (no significant difference). Conclusions In the Japanese language, GPT-4 also outperformed the average medical residents in the GM-ITE test, originally designed for them. Specifically, GPT-4 demonstrated a tendency to score higher on difficult questions with low resident correct response rates and those demanding a more comprehensive understanding of diseases. However, GPT-4 scored comparatively lower on questions that residents could readily answer, such as those testing attitudes toward patients and professionalism, as well as those necessitating an understanding of context and communication. These findings highlight the strengths and limitations of artificial intelligence applications in medical education and practice.

There are different apprehensions regarding the contemporary assessment system. Often, I listen to my colleagues saying that multiple-choice questions are seen as easier to score. Why can’t all assessments be multiple-choice tests? Some others would say, whether the tests given reflect what students will need to know as competent professionals? What evidence can be collected to make sure that test content is relevant? Others come up with concerns that there is a perception amongst students that some examiners are harsher than others and some tasks are easier than others. What can be done to evaluate whether this is the case? Sometimes, the students come up with queries that they are concerned about being observed when interacting with patients. They are not sure why this is needed. What rationale is there for using workplace-based assessment? Some of the students worry if the pass marks for the assessments are ‘correct’, and what is the evidence for the cut-off scores? All these questions are important, and I would deliberate upon them with evidence from the literature. Deliberating on the first query of using multiple-choice questions for everything, we know that assessment of a medical student is a complex process as there are multiple domains of learning such as cognition, skills, and behaviors (Norcini and McKinley, 2007)(Boulet and Raymond, 2018). Each of the domains further has multiple levels from simple to complex tasks (Norcini and McKinley, 2007). For example, the cognition is further divided into six levels, starting from recall (Cognition level 1 or C1) up to creativity (Cognition level 6 or C6) (Norcini and McKinley, 2007). Similarly, the skills and behaviors also have levels starting from observation up to performance and practice (Norcini and McKinley, 2007). Moreover, there are different competencies within each domain that further complicates our task as an assessor to appropriately assess a student (Boulet and Raymond, 2018). For instance, within the cognitive domain, it is not just making the learning objectives based on Bloom’s Taxonomy that would simplify our task because the literature suggests that individuals have different thinking mechanisms, such as fast and slow thinking to perform a task (Kahneman, 2011). We as educationalists do not know what sort of cognitive mechanism have we triggered through our exam items (Swanson and Case, 1998). Multiple Choice Questions is one of the assessment instruments to measure competencies related to the cognitive domain. This means that we cannot use multiple-choice questions to measure the skills and behaviors domains, so clearly multiple-choice questions cannot assess all domains of learning (Vleuten et al, 2010). Within the cognitive domain, there are multiple levels and different ways of thinking mechanisms (Kahneman, 2011). Each assessment instrument has its strength and limitations. Multiple-choice questions may be able to assess a few of the competencies, also with some added benefits in terms of marking but there always are limitations. The multiple-choice question is no different when it comes to the strengths and limitations profile of an assessment instrument (Swanson and Case, 1998). There are certain competencies that can be easily assessed using multiple-choice questions (Swanson and Case, 1998). For example, content that requires recall, application, and analysis can be assessed with the help of multiple-choice questions. However, creativity or synthesis which is cognition level six (C6) as per Blooms’ Taxonomy, cannot be assessed with closed-ended questions such as a multiple-choice question. This means that we need some additional assessment instruments to measure the higher levels of cognition within the cognitive domain. For example, asking students to explore an open-ended question as a research project can assess the higher levels of cognition because the students would be gathering information from different sources of literature, and then synthesizing it to answer the question. It is reported that marking and reading the essay questions would be time-consuming for the teachers (McLean and Gale, 2018). Hence, the teacher to student’s ratio in assessing the higher levels of cognition needs to be monitored so that teachers or assessors can give appropriate time to assess the higher levels of cognition of their students. Hence, we have to use other forms of assessment instruments along with multiple-choice questions to assess the cognitive domain. This will help to assess the different levels of cognition and will also incite the different thinking mechanisms. Regarding the concerns, whether the tests given reflect what students will need to know as competent professionals? What evidence can be collected to make sure that test content is relevant? It is one of an important issue for medical education and assessment directors whether the tests that they are taking are reflective of the students being competent practitioners? It is also quite challenging as some of the competencies such as professionalism or professional identity formation are difficult to be measured quantitatively with the traditional assessment instruments (Cruess, Cruess, & Steinert, 2016). Moreover, there is also a question if all the competencies that are required for a medical graduate can be assessed with the assessment instruments presently available? Hence, we as educationalists have to provide evidence for the assessment of required competencies and relevant content. One of the ways that we can opt is to carefully align the required content with their relevant assessment instruments. This can be done with the help of assessment blueprints, or also known as the table of specifications in some of the literature (Norcini and McKinley, 2013). An assessment blueprint enables us to demonstrate our planned curriculum, that is, what are our planned objectives, and how are we going to teach and assess them (Boulet and Raymond, 2018). We can also use the validity construct in addition to the assessment blueprints to provide evidence for testing the relevant content. Validity means that the test is able to measure what it is supposed to measure (Boulet and Raymond, 2018). There are different types of validity but one of the validity that is required in this situation to establish the appropriateness of the content is the Content Validity. Content validity is established by a number of subject experts who comment on the appropriateness and relevance of the content (Lawshe, 1975). The third method by which the relevance of content can be established is through standard-setting. A standard is a single cut-off score to qualitatively declare a student competent or incompetent based on the judgment of subject experts (Norcini and McKinley, 2013). There are different ways of standard-setting for example Angoff, Ebel, Borderline method, etc. (Norcini and McKinley, 2013). Although the main purpose is the establishment and decides the cut-off score during the process, the experts also debate on the appropriateness and relevance of the content. This means that the standard-setting methods also have validity procedures that are in-built in their process of establishing the cut-off score. These are some of the methods by which we can provide evidence of the relevance of the content that is required to produce a competent practitioner. The next issue is the perception amongst students that some examiners are harsher than others and some tasks are easier than others. Both these observations have quite a lot of truth in them and can be evaluated following the contemporary medical education evaluation techniques. The first issue reported is that some examiners are harsher than others. In terms of assessment, it has been reported in the literature as ‘hawk dove effect’ (McManus et al, 2006, Murphy et al, 2009). There are different reasons identified in the literature for some of the examiners to be more stringent than others such as age, ethnic background, behavioral reasons, educational background, and experience in a number of years (McManus et al, 2006). Specifically, those examiners who are from ethnic minorities and have more experience show more stringency (McManus et al, 2006). Interestingly, it has been reported elsewhere how the glucose levels affect the decision making of the pass-fail judgments (Kahneman, 2011). There are psychometric methods reported in the literature, such as Rasch modeling that can help determine the ‘hawk dove effect’ of different examiners, and whether it is too extreme or within a zone of normal deviation (McManus et al, 2006, Murphy, et al, 2009). Moreover, the literature also suggests ways to minimize the hawk-dove effect by identifying and paring such examiners so the strictness of one can be compensated by the leniency of the other examiner (McManus et al, 2006). The other issue in this situation is that the students find some tasks easier than others. This is dependent on the complexity of tasks and also on the competence level of students. For example, a medical student may achieve independent measuring of blood pressure in his/her first year but even a consultant surgeon may not be able to perform complex surgery such as a Whipple procedure. This means that while developing tasks we as educationalists have to consider both the competence level of our students and the complexity of the tasks. One way to theoretically understand it is by taking help from the cognitive load theory (Merrienboer 2013). The cognitive load theory suggests that there are three types of cognitive loads; namely, the Intrinsic, Extraneous, and Germane loads (Merrienboer 2013). The intrinsic load is associated with the complexity of the task. The extraneous load is added to the working memory of students due to a teacher who does not plan his/her teaching session as per students' needs (Merrienboer 2013). The third load is the germane or the good load that helps the student to understand the task and is added by using teaching methods that helps students understand the task (Merrienboer 2013). The teachers can use different instructional designs such as the 4CID model to plan their teaching session of the complex tasks (Merrienboer 2013). One of the ways to understand the difficulty of the task can be to pilot test the task with few students or junior colleagues. Another way to determine the complexity of the task can be through standard-setting methods where a cut-off score is established after the experts discuss each task and determine its cut-off score based on their judgments (Norcini and McKinley, 2013). However, it is important that the experts who have been called for setting standards have relevant experience so as to make credible judgments (Norcini and McKinley, 2013). A third way to evaluate the complexity of tasks is by applying the post-exam item analysis techniques. The difficulty of the task is evaluated after the performance of students in the exam. Each item’s difficulty in the exam can be measured. The items can be placed from extremely easy (100% students correctly answered the item) to extremely difficult (100% students failed on that specific item). The item analysis enables the teachers to determine which tasks were easier in exams as compared to more difficult tasks. Another concern that comes from students is about their observation when interacting with patients. Health professions training programs require the interaction of students with patients. The student-patient interaction is not very often in initial years of student’s training due to the issues of patient safety, and due to the heavy workload on clinical faculty. However, with the passage of time in the training program, these student patient interactions increase. There is also a strong theoretical basis for better learning when the students are put in a context or a given situation (Wenger, 1998). For example, infection control can be taught through a lecture however the learning can be more effective if the students practically learn it in an operation theatre. Moreover, the undergraduate students or foundation year house job doctors are yet not competent enough to practice independently and require supervision for the obvious reasons of patient safety. Although, some of the students may not like being observed it is one of the requirements for their training. The examiners observing them can give them constructive feedback to further improve their performance (Etheridge and Boursicot, 2013). Feedback is one of the essential components of workplace-based assessments, and it is suggested in the literature that the time for feedback to the student should be almost equal to one-third of the procedure or task time (Etheridge and Boursicot, 2013), that is, for a fifteen minutes tasks, there should be at least five minutes for the feedback hence having a total of twenty minutes time on the whole. Further, it is important for the examiners and senior colleagues to establish trust in the competence of their students or trainees. The ‘trust’ is one of the behavioral constructs that also starts initially with an observation (Etheridge and Boursicot, 2013). Hence, observation of students or house officers by senior colleagues or teachers during clinical encounters is important to establish trust in student’s competence levels. Additionally, in the workplace, there are different skills that are required by the students to demonstrate, and each skill is quite different to others. There are different workplace-based assessment instruments and each of them assesses only certain aspects of student’s performance during clinical practice. For instance, the Mini Clinical Evaluation Exercise (Mini-CEX) can primarily assess the history taking and physical examination skills of students (Etheridge and Boursicot, 2013). Similarly, the Directly Observed Procedural Skills (DOPS) is required to assess the technical and procedural skills of students (Etheridge and Boursicot, 2013). More so, the Case-based Discussion (CBD) is required to assess clinical reasoning skills, decision-making skills, ethics, and professionalism (Etheridge and Boursicot, 2013). Further, multi-source feedback (MSF) or 360-degree assessment collects feedback about a student on their performance from multiple sources such as patients, senior and junior colleagues, nursing staff, and administrative staff (Etheridge and Boursicot, 2013). All these workplace-based assessments require observation of students so they can be given appropriate feedback on their technical and nontechnical skills (Etheridge and Boursicot, 2013). Hence, clinical encounters at the workplace are quite complex and require training of students from different aspects to fully train them that cannot be accomplished without observation. Some students also worry whether the pass marks for the assessments are ‘correct’, and what is the evidence for the cut-off score in their exams? A standard is a single cut-off score that determines the competence of a student in a particular exam (Norcini and McKinley, 2013). The cut-off score is decided by experts who make a qualitative judgment (Norcini and McKinley, 2013). The purpose is not to establish an absolute truth but to demonstrate the creditability of pass-fail decisions in an exam (Norcini and McKinley, 2013). There are certain variables related to standard setters that may affect the creditability of the standard-setting process; such as age, gender, ethnicity, their understanding of the learners, their educational qualification, and their place of work. Moreover, the definition of competence varies with time, place and person (Norcini and McKinley, 2013). Hence, it is important that the standard setters must know the learners and the competence level expected from them and the standard setters must be called from different places. This is one of the first requirements to have the profile of the standard setters to establish their credibility. Moreover, the selection of the method of standard setting is important, and how familiar are the standard setters with the method of standard-setting. There are many standard-setting methods for different assessment instruments and types of exams (Norcini and McKinley, 2013). It is essential to use the appropriate standard-setting method, and also to train the standard setters on that method of standard setting so they know the procedure. The training can be done by providing them certain data to solve it following the steps of the standard-setting procedure. The record of these exercises is important and can be required at later stages to show the experience of the standard setters. Further, every standard-setter writes a cut-off score for each item (Norcini and McKinley, 2013). The mean score of all the standard setters is calculated to determine the cut-off score for each item (Norcini and McKinley, 2013). The total cut-off score is calculated by adding the pass marks of each individual item (Norcini and McKinley, 2013). The cut-off scores for items would also help in differentiating the hawks from doves, that is, those examiners who are quite strict from those who are lenient (McManus et al, 2006). Hence, it is important to keep the record of these cut-off scores of each item for future records and to have a balanced standard-setting team for future exams (Norcini and McKinley, 2013). Additionally, the meeting minutes is an important document to keep the record for the decisions made during the meeting. Lastly, the exam results and post-exam item analysis is an important document to see the performance of students on each item and to make comparisons with the standard-setting meeting (Norcini and McKinley, 2013). It would be important to document the items that behaved as predicted by the standard setters and those items that would show unexpected responses; for example, the majority of the borderline students either secured quite high marks than the cut-off score or vice versa (Norcini and McKinley, 2013). All the documents mentioned above would ensure the creditability of the standard-setting process and would also improve the quality of exam items. There are many other aspects that could not be discussed in this debate on the contemporary assessment system in medical education. Another area that needs deliberations is the futuristic assessment system and how it would address the limitations of the current system? Disclaimer: This work is derived from one of the assignments of the author submitted for his certificate from Keele University. -------------------------------------------------------------------------- References Boulet, J. and Raymond, M. (2018) ‘Blueprinting: Planning your tests. FAIMER-Keele Master’s in Health Professions Education: Accreditation and Assessment. Module 1, Unit 2.’, FAIMER Centre for Distance Learning, CenMEDIC. 6th edn. London, pp. 7–90. Cruess, R. L., Cruess, S. R., & Steinert, Y. (2016). ‘Amending Miller’s pyramid to include professional identity formation’. Acad Med, 91(2), pp. 180–185. Etheridge, L. and Boursicot, K. (2013) ‘Performance and workplace assessment’, in Dent, J. A. and Harden, R. M. (eds) A practical guide for medical teachers. 4th edn. London: Elsevier Limited. Kahneman, D. (2011) Thinking, fast and slow. New York: Farrar, Straus and Giroux. Lawshe, CH. (1975) A quantitative approach to content validity. Pers Psychol, 28(4), pp. 563–75. McLean, M. and Gale, R. (2018) Essays and short answer questions. FAIMER-Keele Master’s in Health Professions Education: Accreditation and Assessment. Module 1, Unit 5, 5th edition. FAIMER Centre for Distance Learning, CenMEDIC, London. McManus, IC. Thompson, M. and Mollon, J. (2006) ‘ Assessment of examiner leniency and stringency (‘hawk-dove effect’) in the MRCP(UK) clinical examination (PACES) using multi-facet Rasch modelling’ BMC Med Educ. 42(6) doi:10.1186/1472- 6920-6-42 Merrienboer, J.J.G. (2013) ‘Instructional Design’, in Dent, J. A. and Harden, R. M. (eds) A practical guide for medical teachers. 4th edn. London: Elsevier Limited. Murphy, JM. Seneviratne, R. Remers, O and Davis, M. (2009) ‘Hawks’ and ‘doves’: effect of feedback on grades awarded by supervisors of student selected components, Med Teach, 31(10), e484-e488, DOI: 10.3109/01421590903258670 Norcini, J. and McKinley, D. W. (2007) ‘Assessment methods in medical education’, Teaching and Teacher Education, 23(3), pp. 239–250. doi: 10.1016/j.tate.2006.12.021. Norcini, J. and Troncon, L. (2018) Foundations of assessment. FAIMER-Keele Master’s in Health Professions Education: Accreditation and Assessment. Module 1, Unit 1. 6th edn. London: FAIMER Centre for Distance Learning CenMEDIC. Norcini, J. and McKinley, D. W. (2013) ‘Standard Setting’, in Dent, J. A. and Harden, R. M. (eds) A practical guide for medical teachers. 4th edn. London: Elsevier Limited. Swanson, D. and Case, S. (1998) Constructing written test questions for the basic and clincial sciences. 3rd Ed. National Board of Medical Examiners. 3750 Market Street Philadelphia, PA 19104. Van Der Vleuten, C. Schuwirth, L. Scheele, F. Driessen, E. and Hodges, B. (2010) ‘The assessment of professional competence: building blocks for theory development’, Best Practice & Research Clinical Obstetrics and Gynecology, pp. 1-17. doi:10.1016/j. bpobgyn.2010.04.001 Wenger, E. (1998). Communities of practice: Learning, meaning, and identity. Cambridge university press.

The problem and the aim of the study. Modernization of higher education opens up new prospects for the use of electronic resources in ensuring the quality of foreign language education. The use of interactive tools (simulators, flash cards, virtual boards) meets the requirements for training programs of physical education teachers and the challenges of the international sports movement. The purpose of the work is to study the possibilities of using digital flash cards in training future physical education teachers to develop their foreign language communicative competence. Research methods. The study involved 54 first- and second-year students of Vyatka State University (Faculty of Pedagogy and Psychology) (Russian Federation). Training program: 44.03.01 Pedagogical education, Physical education and sports (bachelor's degree level). The Quizlet online platform was used to work with digital flash cards. The test contains questions grouped into the blocks “Digital educational technologies” and “Foreign language in communication (physical education and sports)”. For statistical processing of data, the Pearson's chi-squared test was used. Results. The system of working with flash cards in foreign language professional communication of physical education teachers is described: studying the functionality, working with ready-made sets of cards, automating and improving lexical units, developing thematic sets. A special feature of the program is the adaptation of its content to the specifics of the field of study. In independent work and online collaboration, students of the experimental group used Flashcards, Speller, Scatter, Quizlet Live modes. Statistically significant differences in the qualitative changes that occurred in the level of foreign language training were determined (χ2 = 8.179; p < 0.05). In conclusion, the possibilities of including flash cards in the training of physical education teachers are formulated: competition and receiving positive emotions; resources for self-development, etc. Difficulties are also highlighted: low initial level of language qualification and digital skills; different motivation; dependence of the learning process on sports specialization.

This article explores the application of artificial intelligence (AI) technology in Go level examinations and its impact on Go education and evaluation systems. With the advancement of science and technology, especially the rapid development of AI technology, Go, as an ancient strategic game, has experienced revolutionary changes in its competitive scenes and learning methods. After AlphaGo defeated world Go champion Lee Sedol in 2016, the application of AI in the field of Go received widespread attention. AI has not only demonstrated capabilities beyond humans in high-level Go games, but has also played an increasingly important role in Go teaching and training. The global spread of the COVID-19 epidemic has forced Go level examinations to find new ways to adapt. The Go online intelligent test came into being, providing a new, efficient and objective assessment method. Although the introduction of online intelligent examinations has brought convenience, it has also raised issues in organizational structure adjustment, revenue distribution, and examination fairness. Challenges faced by the Go online intelligence examination in terms of fairness, including lack of face-to-face supervision, possible cheating, etc., pose new challenges to the fairness and authority of the Go level examination. This article compares the differences between intelligent Go exams and traditional exams, including assessment format, exam content and passing rate. The online intelligent examination has added test questions and raised the requirements for candidates’ computing power. It also shows a higher passing rate than traditional methods. However, the authenticity and fairness of online intelligent examinations have been challenged, including the adaptability of AI game difficulty and the lack of examination supervision, leading to the emergence of cheating. The positive impacts of implementing online smart exams include improving the convenience and efficiency of exams, simplifying event organization, and promoting the development of Go players’ skills. But at the same time, this new form has had an impact on the original Go organizational structure and benefit distribution, causing concerns and adjustments from local associations. In order to solve these problems, this article puts forward a series of suggestions, including setting up a supervision mechanism for intelligent examinations, optimizing the assessment system, and adjusting the revenue distribution ratio to ensure the long-term sustainable development of online intelligent examinations. In summary, the use of artificial intelligence in Go level examinations not only reflects the persistence of the interaction between technology and traditional cultural activities, but also poses ongoing challenges to the fairness and validity of education and assessment methods. By deeply understanding these impacts and taking corresponding countermeasures, we can find a balance between innovation and tradition, and provide support for the development of Go education and evaluation systems.

The article deals with the actual problem of introduction of distance learning during lockdown. Quarantine measures in educational institutions made it impossible for traditional forms of education and direct contact of lecturers with students at the classroom. Acceptance of this fact indicated the distance learning is the only way of in the current circumstances, and forced skeptics to change their views and beliefs about distance learning and to take possession of its technologies. The authors carried out a careful analysis of the legal documents that became the basis for the introduction of distance learning in educational institutions of Ukraine, in particular at universities. World education and science trends in distance learning are explored and other countries’ experiences of using technological innovations in educational services was examined. The review of the psycho-pedagogical literature on the organization of distance learning helped to distinguish such basic features: interactivity; using of new achievements of information technologies in the educational process; business communication skills during video communications, and during group video conferencing. The conducted survey of students showed that the advantages of distance learning are: the lack of a rigid time frame for mastering the learning material; the opportunity to independently organize your time intended for training; access to training materials and educational services at any time; the use of modern means of communication with teachers; the opportunity to get advice at a convenient time, quickly get an answer to questions through chat services of instant messengers or video communication technology; lack of transportation and accommodation costs and etc. The article provides examples of use by teachers of the National University of Civil Defence of Ukraine of such web resources as Zoom, Skype and etc. for educational online lectures, online practical classes, and technology of 3D-virtual tours to production enterprises during quarantine.

The article discloses sports and pedagogical support with the means of athletics, characterizes the content and structure of the educational discipline «Theory and methods of teaching athletics», in accordance with the educational and professional training program for first (bachelor) level higher education applicants in the specialties 014 Secondary Education (Physical Culture) and 017 Physical Culture and Sports, which was introduced into the educational process of the Faculty of Physical Education and Sports of Poltava V.G. Korolenko National Pedagogical University as a component of the content of professional training of future specialists in the field of physical culture and aims to help future specialists acquire theoretical and practical knowledge of sports and pedagogical improvement, to know the history of the appearance of athletics, to study the theory and methodology of athletics, as well as the organization and judging of competitions.The content of the material from the academic discipline «Theory and methods of teaching athletics» includes both practical classes and theoretical sections aimed at forming the physical culture of students of the first (bachelor’s) level of higher education, based on deep knowledge and beliefs, striving to achieve a harmonious unity of physical and spiritual in a person, the habit of independently taking care of one’s health and physical improvement.The expected results of training in the discipline are to reproduce the terminology of athletics; to describe the technique of the types of athletics being studied and the method of teaching athletics exercises, the history of the development of athletics; name the rules of athletics competitions, their organization and conduct; plan educational material on athletics at school, children’s recreation camps, etc.; develop a plan-summary for athletics; demonstrate the conduct of a lesson on athletics and the ability to communicate in Ukrainian in a professional environment; positively perceive the need for professional ethical standards, value the desire to work independently, the ability for physical self-improvement; participate in discussions with fellow students, teachers, ask questions, listen in the process of learning about athletics; repeat, imitate the main technical elements during training in athletics exercises in the process of learning the type of athletics; to assess the level of theoretical knowledge and development of physical qualities in athletics.

When quality is referred to in clinical chemistry and laboratory medicine, the focus is mainly on the analytical process. But good professional quality starts with a sound education. In an attempt to describe the practice of clinical chemistry and laboratory medicine in the 15 member states of the "old" European Union, it was noticed that (sometimes) large differences existed in the way professionals are being trained (see: Sanders et al, Clin Chem Lab Med 2002; 40: 196-204). With that outcome, a survey of the Websites of the different Member Societies and Corporate Members of IFCC was conducted. It showed that less than one third of either two groups paid attention to, or offered, education. This led to a series of questions to a non-representative group of colleagues outside the former EU who were willing to give more insight in the educational system of their country. All colleagues were known to be involved actively in clinical chemistry and laboratory medicine. The outcome did not give a uniform pattern, since every country regulates health care in its own way, according to its own historical development, needs, social vision, etc. From that a number of conclusions have been drawn: a. Proper University Training is required to enter vocational training b. Regulated Vocational Training seems to be necessary (4 years) c. A clear Syllabus as an indicative guide to the vocational training is important d. Management training should be included since a clinical chemist will have organizational responsibilities as well e. Examinations may help in improving the quality of the education f. Official Register, recognized by Law, is essential, but not always existing h. Re-Registration can be seen as part of the Quality Cycle. Finally, some attention is being paid to the activities of the EMD. This Division of the IFCC provides the membership of IFCC and the health-care community with education which it considers relevant to Clinical Chemistry and Laboratory Medicine. It is the intention of EMD to improve the quality of the profession by educational activities in molecular biology, evidence based laboratory medicine, quality assurance, distance education, and laboratory management. Specific projects are a Master Course in Laboratory Science, a course in Flowcytometry, and the Visiting Lecturer Program which supports national societies in inviting lecturers on specific topics. More information can be found on the IFCC Web-site (www.ifcc.org). In the future, it is to be expected that emphasis on education in our profession will be on the clinical use of tests, modern media and e-learning, and specific courses in new technologies. EMD works continuously to improve the quality of clinical chemistry and laboratory medicine. The input from all National Societies is appreciated to discern topics most relevant to the membership of IFCC. .

This article is devoted to the study of social phenomena of physical culture and sports, as one of the significant and promising areas of modern sociological research. Starting with a reference to the understanding in Russian legislation of the content of the concepts of “physical culture” and “sport”, as well as their relationship with each other, the author of the article draws attention to the importance of studies of ideas about social phenomena of physical culture and sports that have developed among various groups of the population, in particular, among young people. To identify these ideas in youth, and above all, in its most active part – student youth from September 4 to 8, 2023, he conducted an author’s pilot empirical study “Social phenomena of physical culture and sports” among bachelor students of the sociological faculty of Moscow State University named after M.V. Lomonosov 1–3 courses in two areas of training – “Sociology”, as well as “Public policy and social sciences”. As part of this study, students were asked to answer blocks of questions aimed at identifying the motivation and involvement of student youth in physical education and sports. The author’s analysis of the results of the study showed that between physical education and sports, students of the sociological faculty of Moscow State University do not see much difference, actually identifying them, and more than half of students actually identify physical education with the discipline taught by him at the university. At the same time, the process of communication in virtual space (in networks, chats, blogs, etc.), communication with friends, as well as walks in the fresh air, for students of the sociological faculty of Moscow State University are more priority than the activities of physical education and sports themselves.

Relevance. Students are vulnerable in terms of maintaining their health while studying at a university. In modern programs, the number of hours devoted to physical education has been greatly reduced. The data of medical examinations conducted annually in student polyclinics indicate a large number of young people with diseases of varying severity. Visual impairment and the presence of iron deficiency anemia are diagnosed in most medical students and soon threaten to become normal. The purpose of the study. To find out how responsible students are about their health, the author set a goal to analyze the self-assessment of the health of students of the 1st, 2nd and 3rd courses of the programs "Medicine" and "General Medicine". Methods and organization of research. To conduct the study, questions reflecting the objectives of the study were selected and a questionnaire of 16 questions with several options was compiled. There were several answers to two questions. Using the GOOGLE Internet resource, the questionnaire application, students of the first, second and third years of study at the M. Ospanov West Kazakhstan Medical University were surveyed. The results of the study. It was revealed that by the third year, neglect of one's own health appears, expressed in non-compliance with the diet, irregular physical activity. A third of the students do not take care of their health at all. Most second-year students have trouble sleeping and consistently report insomnia. The number of students experiencing constant nervous stress and stress, as well as having a habit of eating irrationally, is alarming. This indicator increases from course to course. Conclusions. It is necessary to provide students with access to normal and timely meals, and little time is allocated for this in the class schedule, in addition, the only canteen cannot cope with so many students. As for the sleep and rest regime, it is necessary to carry out prevention in all training courses.

Background:Musculoskeletal ultrasonography (MSUS) is a valuable imaging modality for the practicing rheumatologist. In everyday practice, physical examination is limited by its sensitivity and subjectivity of assessment. MSUS is inexpensive, available, and allows repeat examination as soon as necessary. Thus, MSUS has become the “third eye” of the rheumatologist, in that it allows more detailed examination of muscles, bones, and joints, just as the stethoscope provides further details about the respiratory and cardiovascular systems. Most ultrasound examinations in Russia, including abdominal and vascular sonography, echocardiography, are conducted by trained physician - radiologist, called “ultrasonography specialists”. Nevertheless, it is very difficult to perform MSUS, mainly because standardized ultrasound protocols fore same region are different for various diseases and often do not provide physicians with the information they need, and also may been mistake. The conduct of MSUS by rheumatologists themselves is limited to the need for 4-month radiology (ultrasound) certification. However, the number of rheumatologists conducting MSUS themselves is increasing. Training week small group courses are provided by VA Nasonova Research Institute of Rheumatology for the practicing rheumatologist and other physicians.Objectives:We analyzed the training and awareness of the rheumatologists and radiologists in MSUS, as well as their commitment for participation in our courses.Methods:We studied a one and a half-year period, from June 2018 to December 2019. During this time, 57 applications were submitted to participate in the courses. All participants who arrived were tested before starting the course. Test included 40 general questions about MSUS. Test results as well as commitment to training were analyzed in two groups: rheumatologists and radiologists. Nonparametric statistics were used for data processing.Results:Among 57 applications submitted for the courses, 26 were from rheumatologists and 31 from radiologists, but the courses were attended by 13 rheumatologists and 26 radiologists (68%). Thus, commitment was reliably higher in radiologists (84%) than in rheumatologists (50%). Fisher’s methods show high statistically significance (Χ2= 7,51, p = 0,006). Although the test focused on ultrasound, it was surprise for us that the median percentage of correct answers was higher in rheumatologists - 64 (54; 80)%, than radiologists (“ultrasonography specialists”) 48 (40; 62)%. Difference also were significantly (p = 0,04).Conclusion:Thus, despite better preparedness of rheumatologist, motivation to study MSUS prevails among radiologists. It is necessary to actively introduce MSUS into general rheumatologic educational programs in order to motivate rheumatologists to study MSUS. Changes in professional standard will also encourage wide use of MSUS by rheumatologists.Disclosure of Interests:None declared

The term nature deficit disorder describes the “human costs of alienation from nature” (Louv, 2019). While not meant to be a medical diagnosis, Louv argues that the condition has, “profound implications, not only for the health of future generations but for the health of the earth itself” (Louv, 2008). Children most at risk are those who live or go to school in an urban setting, as well as students diagnosed with Emotional and Behavioral Disorders (EBD). Students diagnosed with EBD are often kept indoors as their teachers and caretakers are frequently trained in the indoor use only of behavior management techniques (Riden et al., 2022). This means that during professional development training, any that pertain to behavior management techniques, procedure, or protocol are routinely taught inside of a classroom, conference room, or recently home office, using an indoor scenario (classroom, auditorium, cafeteria, etc.) as an example of when and how to use these behavior management tools. Outdoor professional development, equipping students with natural tools that can help improve not only their physical but also their mental health, as well as connecting students with nature in a way that teaches them to advocate for the health of the earth, thus becoming citizen stewards are all themes that are part of the massive, currently dysfunctional system that is outdoor education in schools. This study shows that when students are encouraged to interact with nature on their own terms on-task behaviors and motivation increase. Students also retained lesson information and asked follow-up questions after the lesson when taught outside using hands-on activities.

The article describes the structure and content of the physics textbook «Laboratory work using cloud technologies» for students of vocational higher education institutions. The importance of modernizing the educational process in physics in general and approaches to conducting laboratory work in particular using the methods of modern information and communication and cloud technologies are analyzed. The importance and advantages of digitization of the educational process in physics through the use of cloud services, virtual laboratory works, simulators, mobile applications, flash animations, etc. are substantiated. The theoretical and practical blocks of the manual are described in detail. The theoretical unit is represented by three sections and is filled with didactic and methodical materials that contain recommendations, advice and rules for organizing, preparing and conducting a physical experiment. The practical unit of the manual is represented by one section «Laboratory works», which presents instructions for seven laboratory works. A feature of such works is the use of virtual laboratories, simulators, and cloud environments for testing physical laws, researching physical phenomena, and determining physical quantities. The article provides an example of instructions for laboratory work «Determining the index of refraction of light at the boundary of separation of two media». The research presented in this experiment is carried out using the «Refraction of Light» physical simulator of the website Phet.colorado.edu - the website of the University of Colorado. The process of measuring the refractive index of light at the boundary between two media is described in detail and step by step. The order of performing some tasks is illustrated by the corresponding screen images of the «Refraction of Light» physics simulator. The materials for surveying and monitoring the educational achievements of students are given, among which three directions of questions and tasks are singled out for the didactic purpose: to check the assimilation of knowledge, to check the formation of skills and abilities, to check the formation of beliefs. This manual has been tested in groups of students of the humanitarian profile of institutions of vocational pre-higher education. At the All-Ukrainian competition «Pedagogical OSCAR – 2023», the manual won the 2nd place in the nomination «Innovative approaches to the organization of practical training of students of vocational pre-university education».

What helps teachers overcome technological barriers to Information and Communications Technology (ICT) implementation in their subject domains? Can a disciplinary professional development model help reduce these disciplinary barriers? To answer these questions, this mixed-methods case study examines the change in digital ICT implementation and its barriers among secondary school first language teachers after the utilization of a holistic model for disciplinary professional development (language, science, etc.). Ninety-two first language teachers participated in a professional development program that included a unique instructor profile, theoretical and practical training, technical support, and ongoing individual and school-wide didactic and pedagogical support. The teachers’ experiences and changes in their personal general experience during their professional development were then assessed via interviews and open-ended questionnaires. The findings indicate that the unique professional development model largely removed the teachers’ disciplinary barriers. Specifically, during their professional development, the teachers changed their perceptions of the purposes of ICT in first language teaching in general and teaching writing in particular, indicating that they realized that ICT promotes their discipline and is not merely a tool for lesson diversification or intrigue. Furthermore, they recognized that ICT is not an option but an integral part of teaching in the 21st century.

<p align="center"><strong>Abstrak</strong><strong> </strong></p><p><em>Pengabdian masyarakat berjudul Pelatihan dan Pendampingan Kader Posyandu Lansia di Desa Cimuning Wilayah Kerja Puskesmas Cimuning bertujuan untuk </em><em>membangun kesadaran masyarakat mengenai kesehatan pada usia lanjut. Metode pelaksanaan kegiatan pengabdian ini yaitu </em><em>pendekatan persuasive dengan tahapan-tahapan pelaksanaan yaitu (1) melakukan pendekatan persuasive kepada masyarakat sebagai kader posyandu, (2) Penyuluhan kesehatan/ceranah interaktif, diskusi kelompok, tanya jawab, dan simulasi, (3) pemeriksaan fisik (4) serta pencatatan dan pelaporan hasil pemeriksaan isik kesehatan masyarakat lanjut usia. Di kelurahan Cimuning baru terbentuk 8 Posyandu Lansia dari 26 RW yang ada, sehingga perlu dibentuk lagi posyandu lansia pada RW yang belum memiliki posyandu lansia. Dengan demikian Program Kerja Sama Mitra (PKM) dalam pengabdian masyarakat menawarkan solusi antara lain dengan pelatihan dan pendampingan kader posyandu lansia. Kegiatannya antara lain: Sosialisasi pentingnya posyandu lansia melalui Forum Kelurahan/RW, rekrutmen dan pelatihan kader posyandu lansia, layanan posyandu lansia, penyuluhan kesehatan, PMT, penimbangan, vitamin dan permainan-permainan yg menyenagkan dan menyehatkan, peningkatan kesehatan, komunikasi interpersonal yang bekerjasama dengan masyarakat sekitar. </em><em>Kesimpulan</em><em> bahwa </em><em>pelatihan dan pendampingan kader posyandu lansia kelurahan Cimuning sangat bermanfaat dalam meningkatkan status kesehatan dan kualitas hidup lansia pelayanan kesehatan lansia di posyandu.</em></p><p><strong>Kata kunci :<em> Lansia, Pengabdian, Posyandu</em></strong></p><p> </p><p align="center"><strong>Abstract</strong></p><p><em>Community service titled Training and Assistance for Elderly Posyandu Cadres in Cimuning Village Cimuning Health Center Work Area aims to build public awareness about health in old age. The method of implementing this community service activity is a persuasive approach with stages of implementation, namely (1) carrying out a persuasive approach to the community as a posyandu cadre, (2) health education / interactive stories, group discussions, questions and answers, and simulations, (3) physical examinations ( 4) as well as recording and reporting the results of health examinations for the elderly. The elderly posyandu services emphasize promotive and preventive services without ignoring curative and rehabilitative efforts. In Cimuning Village, only 8 Elderly Integrated Healthcare Center was formed from 26 existing RWs, so it is necessary to re-establish elderly Integrated Healthcare Center for RWs that do not yet have elderly Integrated Healthcare Center. Therefore the Partnership Cooperation Program in community service offers solutions including, among others, training and mentoring for elderly Integrated Healthcare Center cadres. The activities socialization of the importance of Integrated Healthcare Center for the elderly through the Village Office Forum, recruitment and training of elderly Integrated Healthcare Center cadres, elderly Integrated Healthcare Center services, health counseling, supplementary feeding, weighing, vitamins and games that are fun and healthy, improving health, interpersonal communication in collaboration with surrounding communities. The Conclusion that the training and assistance of elderly Integrated Healthcare Center cadres in Cimuning Village are very useful in improving the health status and quality of life of elderly health services in the Integrated Healthcare Center.</em></p><p><strong>Keywords:<em> Integrated Healthcare Center, Elderly, Devotion</em></strong></p>

Developing an effective entrepreneurial ecosystem is viewed as a regional economic development approach that focuses on developing supportive circumstances that encourage the startup’s success. This study aims to investigate the impact of the entrepreneurial ecosystem on startups’ success and the variables that could play a mediating role in the relationship between entrepreneurial ecosystem and startups’ success. The research is based on face-to-face and online semi-structured interviews (the interview guide consisted of 9 open-ended questions) from second quarter of 2023 until the end of the third quarter of 2023 (the data collection phase was closed after meeting the criteria of data saturation). The participants were selected via purposeful sampling technique (20 owners or managers of startup companies including IT, customer service, food, transportation, etc. in Egypt). Thematic and content analysis is done by using NVivo software. From the analysis of the interviews, four themes are developed, and each theme consists of several codes. The first theme is the entrepreneurial ecosystem, with codes: competence development, education and training, enterprising culture and leadership, financial support, government policies and regulations, market openness, and intermediary services. The second theme is entrepreneurial characteristics, with codes: self-efficacy, entrepreneurial attitude, entrepreneurial intention, and entrepreneurial innovation. The third theme is entrepreneurial challenges, with codes: fierce competition, failure to plan and unrealistic expectations, knowledge and skills gaps, and ineffective marketing. The fourth theme is startup success, with codes: productivity, financial performance, and competitive advantage. This study found, that some elements are unimportant for startup’s ecosystem: government programs and support, commercial and professional infrastructure for entrepreneurs, and access to physical infrastructure for entrepreneurship. At the same time, the study confirmed that education and training, enterprising culture and leadership, financial support, government policies and regulations, and market openness are unimportant for startup’s ecosystem. Moreover, it is found that such elements as competence development and intermediate services should be additionally included in the ecosystem. From this study, the model that investigates the relationship between the entrepreneurial ecosystem and startup success was developed. Finally, some recommendations provided to decision-makers and current and future research.

Heads: A medical student completes their Bachelor of Medicine and Bachelor of Surgery (MBBS) degree after five years of mentally exhausting and back-breaking toil. They then go on to complete one demanding year of internship in a hospital. Now they want to start their clinical practice. The regulatory body of physicians has some other ideas though. It wants them to give yet another exam, covering the same subjects they have cleared during MBBS. When they think they have the right to be practicing independently, they have to study hard and undertake an exam again. Tails: A regulatory body of physicians in the country knows the quality of medical teaching in the country is not uniform. The standard of training during internship also varies greatly. Yet, after attaining MBBS degree and completing internship, every medical doctor is deemed qualified enough to manage the patients without any supervision. The regulatory body, therefore, introduces a uniform licensing exam that every doctor needs to pass before starting independent clinical practice. It believes that only those who had attained a minimum acceptable level of competence will eventually be capable enough to pass the exam and thus be qualified to treat people. Medical licensing examinations are considered a tool to gauge a doctor’s competence for unsupervised clinical practice. The National Licensing Examination (NLE) was announced on 24th September 2020 in Section 20 of the Pakistan Medical Commission (PMC) Act 2020.1 The idea was inspired by similar exams in many other countries.2 Fast forward more than one year, this exam still faces stiff resistance from many medical students and Pakistan Medical Association (PMA).3,4 Broadly, there are two main objections: The nature of the exam itself, and its applicability. The medical students deem it unfair to be asked to appear in another exam after obtaining their MBBS degree. Another point of contention is in including all current medical students. It is argued that only those students should be asked to undertake the exam that began their MBBS education after the PMC Act 2020. A petition filed in Lahore High Court to this effect was dismissed by the adjudicating judge, making it mandatory for all current and future medical students to pass the NLE.5 Is this exam really so flawed that it should be abandoned altogether? Is PMC justified in taking this exam? Are the concerns of the protesting students valid? Is there a middle ground in this conflict? Let us analyze the current format of the NLE and compare it with the two most coveted medical licensing exams in the world. The NLE is designed as a two-step examination. The first step is the multiple-choice questions (MCQ) based theory component containing 70% MCQs from clinical sciences and 30% MCQs from basic sciences. A student has to pass this first step in order to qualify for the second Clinical Skills Examination (CSE). The CSE aims to evaluate essential clinical skills required by a general medical practitioner through a structured clinical examination. The students can appear in the first theory component only after acquiring their MBBS qualification. Both steps need to be passed in order to attain permanent medical license from PMC.6 The United States Medical Licensing Exam (USMLE) is the most well-known medical licensing exam in the world. It is a three-step exam comprising of Step 1, Step 2 Clinical Knowledge (CK), and Step 3. Step 1, an MCQ exam, is attempted by the local students at the end of 2nd year of medical education. It is designed to test the examinee’s aptitude to apply basic and integral science concepts to clinical scenarios. Step 2 CK is an MCQ exam that assesses the examinee’s grasp on the medical knowledge and understanding of clinical sciences that are considered essential for patient care under supervision. Local students appear in this exam in the 4th year of their medical education; passing this exam is essential to receive medical graduation. Step 3 is again an MCQ exam that assesses the candidate’s caliber to apply medical knowledge for unsupervised practice of medicine. This exam is attempted after obtaining medical graduation and passing the exam is necessary to practice independently in the US. After the decision to abandon the Step 2 Clinical Skills (CS) examination in February 2021, there is currently no clinical examination in the USMLE. International Medical Graduates (IMGs) need to clear Step 1 and Step 2 CK (not necessarily in order and at no fixed time) to become eligible for Step 3.7 The Professional and Linguistic Assessments Board test (PLAB) is a two-part exam taken by General Medical Council (GMC) of the United Kingdom (UK).PLAB 1 is an MCQ based exam that tests the examinee’s ability to apply the acquired medical knowledge to answer clinical-scenario based questions. PLAB 2 is a clinical exam that tests the candidate’s clinical and communication skills on standardized patients.8 Currently, only IMGs need to appear in the exam in order to practice medicine independently in UK. This is set to change from 2024; GMC has announced Medical Licensing Assessment (MLA) that both UK locals and IMGs will need to pass from 2024 onwards in order to attain the medical registration.9 It is clear from the above discussion that regulatory bodies in many countries including the US test their local students with standardized exam in addition to their medical college graduation. The UK has also announced a similar system for their local students from 2024. Therefore, concept of the NLE is a sound one, based on the international practices. The problem may lie in the format and timing of the exam. MBBS curriculum is broadly divided into two categories: Basic sciences and clinical sciences. Basic sciences, as the name suggests, contain core subjects that are essential to understand the basics of human body. These include subjects like anatomy, physiology, biochemistry, pharmacology etc. These are typically focused more during the first three years of MBBS. Clinical sciences deal with more practical subjects like medicine, surgery, paediatrics, gynaecology etc. These subjects are given more emphasis during the final two years of MBBS. The key to the deadlock may lie in the timing and curriculum of NLE. Currently, a student is asked to study all the subjects again after obtaining MBBS degree for the MCQ based theoretical exam.6 This means studying the basic sciences again, the portions of which they may have studied years ago. The exam may be divided into three separate portions comprising of a) MCQ exam of basic sciences, b) MCQ exam of clinical sciences, and c) a clinical skills exam. The idea is to take the exam when the students are actually studying the examined subjects, rather than taking it all together in the end. Table 1 demonstrates the proposed format and timing of the NLE. TABLE I: PROPOSED FORMAT AND TIMING OF THE NATIONAL LICENSING EXAMINATION Exam Subjects/Skills Format Minimum Qualification NLE Step 1 Basic Sciences MCQ 2nd Year MBBS NLE Step 2 Clinical Sciences MCQ 4th Year MBBS NLE Step 3 Clinical and Communication Skills Structured Clinical Examination 5th Year MBBS NLE=National Licensing Examination; MCQ=Multiple-choice questions; MBBS=Bachelor of Medicine and Bachelor of Surgery Splitting the exam into the three proposed steps will be advantageous for all concerned, i.e. PMC, medical students, and the public. PMC will achieve the desired objective of assessing a physician’s competence before offering registration. Students will be appearing in NLE steps that will be covering subjects in accordance with their current/recent MBBS curriculum. This will reduce the burden for the students and make the exam more agreeable for them. The public will receive healthcare only from those doctors who would have proved their competence. Heads or tails? We win both ways!

Background:Patient education (PE), with the aim of supporting patients to self-manage their disease is important in the treatment and care of patients with rheumatoid arthritis (RA) (1). Today, there is a shift in the organization of healthcare systems due to a demographic change towards ageing populations and an increasing use of technology. Advancements in web-technology can offer alternative ways to provide PE – e.g. through an e-learning platform. However,E-Learning development must be based on the needs of the learners and on existing evidence on both education and content.Objectives:To develop an e-learning platform targeting newly diagnosed patients with RA.Methods:Focus group interviews with patients, rheumatologists and nurses, with the aim of exploring informational and educational needs related to RA and how this may be communicated in an e-learning program, were conducted. We used a short interview guide to ensure the focus of the interviews, however, strived for a less structured start of the interview to promote a free discussion and later a more structured discussion of specific questions. Pictures, illustrating possible topics in PE within RA and ways to communicate, were also applied. The transcribed interviews were analyzed using thematic analysis (2).The theoretical framework in the development and design drew on the cognitive theory of multimedia learning (3) and entertainment education (4).Results:Four themes, covering experiences and needs emerged in the analysis of the focus-group interviews;‘Knowledge of RA, the disease course and prognosis’, ‘Medical treatment’, ‘A new life situation’and‘Daily living with RA’.Subsequently, the program was developed through an iterative process between the project group, patient representatives, a communication consultant, graphic designers and an e-learning company.The program was divided into three learning modules covering knowledge of RA, complications, medical treatment, examinations and daily living with RA, e.g. coping with emotions, pain, fatigue, work, education, physical activity etc. It offers a combination of e.g. animations, videos with personal patient stories, podcasts, written text, spoken words and interactive quizzes.Conclusion:The e-learning program is developed and ready for feasibility testing. Subsequently, the effectiveness of the program will be tested in a RCT study among approximately 250 patients.References:[1]Zangi HA, Ndosi M, Adams J, et al. EULAR recommendations for patient education for people with inflammatory arthritis. Ann Rheum Dis. 2015; 0:1-9.[2]Braun V, Clarke V. Using thematic analysis in psychology.Qualitative research in psychology. 2006; 3 (2): 77-101.[3]Mayer R. The Cambridge handbook of multimedia learning. 2005. New York.[4]Singhal A, Cody MJ, Rogers EM, Sabido M (editors). Entertainment-education and social change – History, research and practice. Taylor and Francis; 2003.Acknowledgments:We thank the participants in focus groups who shared their experiences. We also express our gratitude to the Novo Nordisk Foundation for supporting the study. Furthermore, we are grateful for the collaboration with the communication consultants, graphic designers and the e-learning company, who have contributed to the development of the e-learning platform.Disclosure of Interests:Line Raunsbæk Knudsen Consultant of: Phizer (Not relevant for the present study)., Speakers bureau: Phizer (Not relevant for the present study).Lily (Not relevant for the present study).Roche (Not relevant for the present study)., Kirsten Lomborg: None declared, Annette de Thurah Grant/research support from: Novartis (not relevant for the present study)., Speakers bureau: Lily (not relevant for the present study).

One of the newest principles of modern pedagogy is the humanization of education – the focus on personal development. The construction of personality-oriented methodological systems requires appropriate changes in the content of physical education and its methodological support. Today the high school functions as a profile. During distance learning, each student must gain some social experience, gaining in the process of achieving a common result by interacting with other members of the student body, develops communication skills. A huge advantage of this type of educational activity is the involvement of absolutely all students in the class. The main purpose of school education is the holistic development of the student's personality. The means of personal development that reveals its potential inner abilities is independent cognitive and mental activity. Thus, the teacher's task is to provide such activities, which are facilitated by modern interactive technologies. In this case, the student himself opens the way to knowledge. and the acquisition of knowledge is the result of his activities. To achieve maximum results, it is necessary to use methods that enhance the activities of students. Interactive teaching of physics allows to form their active-cognitive position, which meets the current educational needs of the modern educational process. Scientific and social progress is rapidly, radically changing the working conditions and content of the teacher. In this regard, there is a need to create such methodological systems that would meet not only the general goals and objectives of teaching physics, but would also have reasonable means to achieve the end results of learning and general physical education by students. Тhe peculiarity of the seminar is that it orients students to the manifestation of high cognitive activity in educational activities. The teacher at the seminar only manages the collective activities of students. Seminar training differs from the traditional one, which is characterized as a «teacher-student» interaction, it should involve mainly the «student-student» interaction (student both teaches and learns). It is very important that the seminars are not monotonous, that students are interested not only in the issues under consideration, but also the forms of their discussion, methods of work in the classroom, making them interesting and dynamic. This can be achieved by using in practice various types of seminars and increasing the level of active cognitive activity of students. The techniques that promote the development of active independent actions of the student in the classroom include the creation of such situations in which he must be able to: defend their opinion, provide arguments, evidence, using their knowledge and life experience; ask questions to teachers and peers, find out the unclear; review answers; help classmates with complications, explain to them the incomprehensible; independently perform tasks designed for reading literature, observation, etc.; find not one but several independent solutions; practice free choice of tasks, mainly exploratory and creative; be interested in collective activities and promote the creative search for peers.

AbstractBackgroundDespite landmine-risk education programs and extensive demining activities on the Western border of Iran, landmines and unexploded ordnance (UXOs) still cause civilian and child casualties three decades after the Iraq-Iran war (1980-1988). The objective of this study was to understand the epidemiological patterns and risk factors of injury in child casualties of landmines and UXOs in Western and Southwestern Iran.MethodsChildren who were 18 years old or younger at the time of study and who sustained injuries from landmines and UXOs were identified through a search at the Iranian National Veterans Registry. These children participated in a 5-day gathering. The information on socioeconomic status, health-related issues, quality of life, health care utilization, and clinical profiles concerning the landmine and UXO injuries were collected. The method of data collection consisted of three component surveys: health interview, social survey, and medical examinations. Social surveys and health interviews were conducted in a face-to-face method by utilizing a questionnaire consisting of 39 questions addressing household and individual components, including information on time and type of injuries, physical activity, mental health, and quality of life. A comprehensive team of physicians in different subspecialties evaluated and examined children to assess the current medical and psychiatric conditions and physical activity, and recommended and arranged further medical, rehabilitation, or surgical planning.ResultsSeventy-eight child casualties were identified and participated in the study. The mean age of the participants at the time of study was 16.11 years old (SD=2 years). The mean age of victims at the time of injury was 8.2 years (SD=3.12 years; ranged from 2 to 15 years old). Sixty-seven (85.9%) of the children were male. Provinces of Kurdistan and Kermanshah had the highest number of casualties, with a total number of 54 children (68.3%). Eighty percent of the injuries were caused by landmines, and UXO explosions were reported in 20% of the cases. Overall, 24 children (30%) had received some landmine-risk education before or after the events. Sixty percent of the explosions had happened in the morning between 9:00amand 12:00pm. Playing and grazing livestock were the most prevalent activities/reasons at the time of injury, which were reported in 77% of the subjects. Sixty-three percent of incidents had multiple casualties and in only 13 explosions were the children the only victims of the explosion. The most prevalent injuries were amputations in 41 subjects (52.56%), followed by hearing loss in 23 subjects (29.5%). Amputations were more common in upper extremities (62%) than in lower extremities (38%).ConclusionLandmines and UXOs comprise a significant safety hazard to the children living in the Western border of Iran decades after the Iraq-Iran War. The large number of injuries and lack of risk training among victims suggest that landmine cleanings and landmine-risk education should be age-specifically targeted and expanded substantially.MousaviB,SoroushMR,MasoumiM,KhateriS,ModirianE,ShokoohiH,FatemiMJ,HemattiMA,SoroushM,Ghassemi-BroumandM,RassafianiM,AllamiM,NouriF,YavariA,GanjparvarZ,KamyabM,MirsadeghiSA,Epidemiological study of child casualties of landmines and unexploded ordnances: a national study from Iran.Prehosp Disaster Med.2015;30(5):472–477.

Abstract: "Commercial sex workers" refers to those who engage in prostitution, and have been used in the literature on the subject over a period of time. The term has been adopted, which is free of the complex, derogatory and sexist connotations, which are often linked with the concept of a "slut". Sex work includes a wide variety of activities, including the exchange of foreign currency (or an equivalent) for the purchase of sex, and sexual services. Sex work has been attributed to several psychiatric issues, including physical violence as a child, sexual assault as a child, adult domestic discrimination, substance abuse, trauma etc. Commercial sex work, according to Medrano, and Gilchrist, is often correlated with the socio-demographic disadvantage such as ethnic minority, low-income, food and nutrition, and a lack of education and training. Sex workers may be exposed to the stigma of the action, and, therefore, have a high risk for psychiatric morbidity. There is indeed a scarcity of literature into how sex workers deal with mental health and stigma. The stigma of the sex industry would have a direct impact on the mental health of sex workers. The need to control, and the risk of selective disclosure of the sex work is the usual on-the-job. The objective of this review is to examine the current literature on sex workers, with a focus on health as well as other forms of social isolation such as disability, homelessness, and drug abuse. There aren't many articles dedicated to mental health, social isolation, or sex work. The paper is divided into three sections based on three major themes. The very first theme looks at the causes that lead to insecurity, social isolation, and sex work participation. The second topic examines how exclusionary mechanisms impact sex workers' mental health and the most common mental illnesses in the sex worker population. Finally, the third topic considers how exclusionary mechanisms impact the lives of sex workers, as well as the various degrees of social exclusion faced by different classes of sex workers. Sex workers, especially on-the-street, off-the-street, transient, and trafficked sex workers, face potential threats and sickness. Several of these impediments are connected to wider questions of social exclusion that go far beyond sex work. Keywords: Sex worker, psychiatric morbidity, social exclusion, sex work stigma, factors affecting entrance into sex workers.

In the developing knowledge-based society information technologies play a particularly significant role. However, even the most advanced technologies will not give a necessary effect, if their usage (application) in the educational system is not adequate to the current development of technologies and increased educational needs. In the author’s opinion, our epoch is marked with global environmental crisis and the advent of information age. Extensive implementation of a range of information technologies into high and higher school curricula and the emphasis on environmental issues in education are two leading trends in contemporary education. We maintain that it would be optimal if the computer (especially using the Internet) is a natural teaching / learning aids like books and other sources of information. On the other hand, it is necessary to create conditions for teachers to raise qualification. This is emphasized by numerous researchers. It has to be stated that the Internet possibilities in the teaching process are insufficiently used. On the other hand, in principal there are no reliable studies, which would reveal the actual situation in this field. Therefore, the object of our study is the usage of the Internet for teaching physics. The main aim of the study is to analyse the situation of the usage of the Internet for teaching physics and highlight the hindering/encouraging factors of its usage in the teaching process. The most important study tasks have been formulated: • To analyse the situation of the usage of the Internet for teaching physics; • To identify the hindering/stimulating factors of Internet usage for teaching physics; • To highlight the experts’ opinion about the expected development perspectives of Internet usage for teaching physics in the nearest five years period. The study employed expert inquiry. The type of expert inquiry – “Delphi study”, containing several experts’ inquiries (stages). The data of every round are generalised and repeatedly submitted to the experts. Such procedure is repeated several times, most often 3-4 times. The study was carried out in September – December 2005. In the first stage of the study the experts replied to 5 essential questions. In the opinion of the majority of experts (62%) the usage of the Internet during the nearest five years will increase only insignificantly. 31% of experts maintain that the usage of the Internet will increase significantly and 7% think that it will not change at all. Having studied and generalised the first stage results, the new questionnaire for the second stage of the study was prepared. It was identified that the most important factors, hindering the Internet usage were as follows: poor computerisation of physics rooms and the shortage of the Internet access, poor school technical possibilities and poor funding, shortage of specialized Internet websites and of websites applied for teaching physics, poor knowledge of foreign languages, etc. The most important stimulating factors: the wish to interest pupils and search for more diverse teaching forms, the possibility to present the phenomena to the pupils that they find difficult to imagine, the diversification of the demonstration and laboratory teaching aids, etc. In the third stage of the study the experts had to assess the generalised second stage results. In many cases the experts approved the generalised assessment of the current situation; however, they noted that the situation in town schools and village schools differed. The experts clearly expressed their concern regarding the immoderate ICT usage in the teaching process and emphasized that the computer will never replace the teacher’s explanation and natural experiments with real physical bodies in the real environment. Some conclusions were indicated: • The Internet possibilities for teaching physics are not being fully used both for objective and subjective reasons. • It is expected that during the nearest five years the Internet usage will increase only insignificantly. • Higher effectiveness of ICT application for teaching physics can be achieved in the presence of continuous monitoring (how the situation changes, what influences it, etc.), on the other hand, the physics teachers need continuous methodical assistance, independent of their formal qualification. Effective ICT application for teaching physics is one of the composite parts of the competence of physics teachers. • Continuous studies and in-service training institutions should allocate more attention raising the qualification of physics teachers in this field. Key words: teaching physics, Internet usage, expert inquiry

Historically, dependability services originated within design units of companies. A design engineer had his/her own ideas about the quality control of released products. As the initial application field of the dependability theory was the aerospace industry, he/she understood that the presence of errors and omissions within a product could cause catastrophic consequences [1]. Along with the dependability unit the quality and technical supervision service was developing, and that was primarily tasked with organizing and conducting acceptance testing, receiving inspection and prevention of a product’s non-compliance with technical documentation. At one point, a conflict arouse between the two branches, which lead to a general misunderstanding of responsibilities and disorganization of the product dependability control. As a result, in some companies the dependability service is integrated with the quality service, in others it is subordinated to the design bureau. Additionally, operational dependability evaluation requires an uninterruptible source of reliable information on the reliability and maintainability of the equipment. The quality of this information depends on the interaction between the dependability service and the maintenance service. The latter is to compare the repair reports that specify the recovery time and operation time of the product and promptly submit that data for dependability calculation. Thus, the following questions arise: which activities are to be performed by the dependability service, who is to be subordinated to whom, who is the owner of the processes associated with the estimation of dependability parameters? It is important to understand the purpose of establishing a dependability unit in a company, what authority its employees possess, what results the management expects to obtain. The formalization of the research findings presents a problem. As of today, there is no single approach to formalized calculations, preparation of dependability analysis reports. The research findings are to be sent to all the involved business units, therefore a convenient form of information representation must be developed. A special attention must be given to personnel training in terms of technical system dependability. Industrial products become more and more complex, new technologies are developed, and old approaches to dependability calculation and analysis do not always ensure acceptable results. That is not surprising, as the significance of the use of reliable and substantiated methods of dependability estimation is very understated. That is due to the fact, that many believe that the dependability theory is based on the research of the physical, design-specific causes of failure, physicochemical processes, etc., meaning that a dependability engineer is first and foremost a design or process engineer. However, it should not be forgotten that the general dependability theory is subdivided into the mathematical (mathematical methods of the probability theory), statistical (method of mathematical statistics) and physical (research of materials properties variations). Subsequently, a dependability service is to conduct analysis based on competent application of mathematics alongside activities associated with products design research. Proposals regarding future developments in this area, including the education system, will be welcome.Aim. To propose an approach to the organization of the dependability service in a modern machine-building company taking into account advanced methods and concepts of dependability analysis at all lifecycle stages of a product.Conclusions. The paper suggests an organizational structure of a dependability unit for a transport machine building company. The interactions between the dependability service and other business units is examined. A number of factors affecting the efficient operation of the dependability service are identified.

Field-based research programs offer students a singular opportunity to understand that today there are no simple scientific, economic or socio-political answers to the complex questions facing governments, communities, and local organizations. Through their research, students can gain a first-hand appreciation that decision making in the real world is a mix of all these disciplines, and that they have a vital role to play in participating in this process. According to the most recent Open Doors report (2006), issued by the Institute of International Education, about 206,000 US students studied abroad in 2004/5. While about 55% studied in Europe, an increasing number studied in other host countries around the world. Social science and physical science students comprised about 30% of all US study abroad students in this period. While study abroad programs encompassing a field research component are still in the minority, an increasing number of home institutions and field-based providers are supporting and conducting these types of programs. As the student papers in this Special Issue of Frontiers demonstrate, there is high quality work being produced by undergraduates in settings as diverse as France, Thailand, Kenya, South Africa and Mali. For these students this opportunity was likely a new experience, involving living and studying in international settings; dealing with language and culture differences; matriculating in programs operated by host country universities, independent program providers, or their home institution’s international program; and learning how to conduct research that meets professional standards. Much has been written and discussed regarding pre-departure orientation of US students studying abroad, along with studies and evaluations of the study abroad experience. Less discussion and research has focused on the experiences of the on-site faculty and staff who host students and incorporate field-based research into their courses and programs. These courses and programs involving student research include the following types: • International university-based research, in which the student conducts research on a topic as part of a course or term paper; • Independent field-based research, in which the student identifies a topic, organizes the project, and conducts the field work, analysis, write-up, etc. for an overall grade; • Collective field-based research, in which students, working under the guidance of a professor (either US or international), conduct a research project as part of a US-based course, or complementary to the professor’s research focus; • Client-focused, directed, field-based research in which the research conducted is in response to, or in collaboration with, a specific client ranging from an NGO, to a corporation, to an indigenous community, or a governmental agency. The purpose of this article is to describe some of the issues and challenges that on-site faculty and staff encounter in preparing and supporting US undergraduate students to conduct formal research projects in international settings in order to maximize their success and the quality of their research. The perspectives described below have been gathered through informal surveys with a range of international program faculty and staff; discussions with program managers and faculty; and through our own experience at The School for Field Studies (SFS), with its formal directed research model. The survey sought responses in the following areas, among others: preparing students to conduct successfully their field-based research in a different socio-cultural environment; the skill building needs of students; patterns of personal, cultural, and/or technical challenges that must be addressed to complete the process successfully; and, misconceptions that students have about field-based research. Student Preparation Students work either individually or in groups to conduct their research, depending on the program. In either case on-site faculty and staff focus immediately on training students on issues ranging from personal safety and risk management, to cultural understanding, language training, and appropriate behavior. In programs involving group work, faculty and staff have learned that good teamwork dynamics cannot be taken for granted. They work actively with students in helping them understand the ebb and flow of groups, the mutual respect which must be extended, and the active participation that each member must contribute. As one on-site director indicates, “Students make their experience what it is through their behavior. We talk a lot about respecting each other as individuals and working together to make the project a great experience.” Cultural and sensitivity training are a major part of these field-based programs. It is critical that students learn and appreciate the social and cultural context in which they will conduct their research. As another on-site director states, “It is most important that the students understand the context in which the research is happening. They need to know the values and basic cultural aspects around the project they will be working on. It is not simply doing ‘good science.’ It requires understanding the context so the science research reaches its goal.” On-site faculty and staff also stress the importance of not only understanding cultural dynamics, but also acting appropriately and sensitively relative to community norms and expectations. Language training is also a component of many of these programs. As a faculty member comments, “Students usually need help negotiating a different culture and a new language. We try to help the students understand that they need to identify appropriate solutions for the culture they are in, and that can be very difficult at times.” Skill Building Training students on the technical aspects of conducting field-based research is the largest challenge facing most on-site faculty and staff, who are often struck by the following: • A high percentage of students come to these programs with a lack of knowledge of statistics and methods. They’ve either had very little training in statistics, or they find that real world conditions complicate their data. According to one faculty member, “Statistics are a big struggle for most students. Some have done a class, but when they come to work with real data it is seldom as black and white as a text book example and that leads to interpretation issues and lack of confidence in their data. They learn that ecology (for example) is often not clear, but that is OK.” • Both physical and social science students need basic training in scientific methodology in order to undertake their projects. Even among science majors there is a significant lack of knowledge of how to design, manage and conduct a research project. As a program director states, “Many students begin by thinking that field research is comprised only of data collection. We intensively train students to understand that good research is a process that begins with conceptualization of issues, moves into review of relevant literature, structures a research hypothesis, determines indicators and measurements, creates the research design, collects data, undertakes analysis and inference. This is followed by write-up in standard scientific format for peer review and input. This leads to refining earlier hypotheses, raising new questions and initiating further research to address new questions.” Consistently, on-site faculty have indicated that helping students understand and appreciate this cycle is a major teaching challenge, but one that is critical to their education and the success of their various field research projects. • The uncertainty and ambiguity that are often present in field research creates challenges for many students who are used to seeking ‘the answer in the book.’ On-site faculty help students understand that science is a process in which field-based research is often non-linear and prone to interruption by natural and political events. It is a strong lesson for students when research subjects, be they animal or human, don’t cooperate by failing to appear on time, or at all, and when they do appear they may have their own agendas. Finally, when working with human communities, student researchers need to understand that their research results and recommendations are not likely to result in immediate action. Program faculty help them to understand that the real world includes politics, conflicting attitudes, regulatory issues, funding issues, and other community priorities. • Both physical and social science students demonstrate a consistent lack of skill in technical and evidence-based writing. For many this type of writing is completely new and is a definite learning experience. As a faculty member states, “Some students find the report writing process very challenging. We want them to do well, but we don’t want to effectively write their paper for them.” Challenges The preceding points address some of the technical work that on-site faculty conduct with students. Faculty also witness and experience the ‘emotional’ side of field-based research being conducted by their students. This includes what one faculty member calls “a research-oriented motivation” — the need for students to develop a strong, energized commitment to overcome all the challenges necessary to get the project done. As another professor indicates, “At the front end the students don’t realize how much effort they will have to expend because they usually have no experience with this sort of work before they do their project.” Related to this is the need for students to learn that flexibility in the research process does not justify a sloppy or casual approach. It does mean a recognition that human, political, and meteorological factors may intervene, requiring the ability to adapt to changed conditions. The goal is to get the research done. The exact mechanics for doing so will emerge as the project goes on. “Frustration tolerance” is critical in conducting this type of work. Students have the opportunity to learn that certain projects need to incorporate a substantial window of time while a lengthy ethics approval and permit review system is conducted by various governmental agencies. Students learn that bureaucracies move at their own pace, and for reasons that may not be obvious. Finally, personal challenges to students may include being uncomfortable in the field (wet, hot, covered in scrub itch) or feeling over-tired. As a faculty member states, “Many have difficulty adjusting to the early mornings my projects usually involve.” These issues represent a range of challenges that field-based research faculty and staff encounter in working with undergraduate students in designing and conducting their research projects around the world. In my own experience with SFS field-based staff, and in discussions with a wide variety of others who work and teach on-site, I am consistently impressed by the dedication, energy and commitment of these men and women to train, support and mentor students to succeed. As an on-site director summarizes, essentially speaking for all, “Fortunately, most of the students attending our program are very enthusiastic learners, take their limitations positively, and hence put tremendous effort into acquiring the required skills to conduct quality research.” Summary/Conclusions Those international program faculty and staff who have had years of experience in dealing with and teaching US undergraduates are surprised that the US educational system has not better prepared students on subjects including statistics, scientific report formatting and composition, and research methodologies. They find that they need to address these topics on an intensive basis in order for a substantial number of students to then conduct their research work successfully. Having said this, on-site faculty and staff are generally impressed by the energy and commitment that most students put into learning the technical requirements of a research project and carrying it out to the best of their abilities. Having students conduct real field-based research, and grading these efforts, is a very concrete method of determining the seriousness with which a student has participated in their study abroad program. Encouraging field-based research is good for students and good for study abroad because it has the potential of producing measurable products based on very tangible efforts. In a number of instances students have utilized their field research as the basis for developing their senior thesis or honors project back on their home campus. Successful field research has also formed the basis of Fulbright or Watson proposals, in addition to other fellowships and graduate study projects. An increasing number of students are also utilizing their field research, often in collaboration with their on-site program faculty, to create professional conference presentations and posters. Some of these field-based research models also produce benefits for incountry clients, including NGOs, corporations and community stakeholders. In addition to providing the data, analyses, technical information, and recommendations that these groups might not otherwise be able to afford, it is a concrete mechanism for the student and her/his study abroad program faculty and staff to ‘give back’ to local stakeholders and clients. It changes the dynamic from the student solely asking questions, interviewing respondents, observing communities, to more of a mutually beneficial relationship. This is very important to students who are sensitive to this dynamic. It is also important to their program faculty and staff, and in most cases, genuinely appreciated by the local stakeholders. In essence, community identified and responsive research is an excellent mechanism for giving to a community — not just taking from it. An increasing interest in conducting field-based research on the part of US universities and their students may have the effect of expanding the international destinations to which US students travel. A student’s sociological, anthropological, or environmental interest and their desire to conduct field research in that academic discipline, for example, may help stretch the parameters of the student’s comfort level to study in more exotic (non-traditional) locales. Skill building in preparing for and conducting field-based research is an invaluable experience for the student’s future academic and professional career. It is a fairly common experience for these students to indicate that with all the classroom learning they have done, their study abroad experience wherein they got their hands dirty, their comfort level stretched, their assumptions tested, and their work ethic challenged, provided them with an invaluable and life changing experience. Conducting field-based research in an international setting provides real world experience, as the student papers in this edition of Frontiers attest. It also brings what may have only been academic subjects, like statistics, and research design and methodology, to life in a real-conditions context. On a related note, conducting real field-based work includes the requirement to endure field conditions, remote locations, bad weather, personal discomforts, technological and mechanical breakdowns, and sometimes dangerous situations. Field research is hard work if it is done rigorously. In addition, field work often includes non-cooperating subjects that defy prediction, and may confound a neat research hypothesis. For a student considering a profession which requires a serious commitment to social or physical science field work this study abroad experience is invaluable. It clarifies for the student what is really involved, and it is helpful to the student in assessing their future career focus, as they ask the critical question — would I really want to do this as a fulltime career? US education needs to bridge better the gap between the physical and social sciences. Students are done a disservice with the silo-type education that has been so prevalent in US education. In the real world there are no strictly scientific, economic, or sociological solutions to complex, vexing problems facing the global community. Going forward there needs to be interdisciplinary approaches to these issues by decision makers at all levels. We need to train our students to comprehend that while they may not be an ecologist, or an economist, or a sociologist, they need to understand and appreciate that all these perspectives are important and must be considered in effective decision-making processes. In conclusion, education abroad programs involving serious field-based research are not a distraction or diversion from the prescribed course of study at US home institutions; rather, they are, if done well, capable of providing real, tangible skills and experience that students lack, in spite of their years of schooling. This is the reward that is most meaningful to the international program faculty and staff who teach, mentor and support US students in conducting their field-based research activities. As an Australian on-site program director stated, “there are relatively few students who are adequately skilled in these (field research) areas when they come to our program. Most need a lot of instruction and assistance to complete their research projects, but that of course is part of what we’re all about — helping students acquire or improve these critical skills.” This is the real service that these programs and on-site faculty and staff offer to US undergraduates. Paul Houlihan, President The School for Field Studies

Background. Each new generation of students brings with them its own themes and subjects, and the continuous flow of life opens up new artistic horizons. In addition, each team of teachers and students is unique, and the necessity to look repeatedly for ways to uncover the individualities of future actors arises. Therefore, the work on the etudes, being aimed at the development of the creative abilities of the young actors, occupies almost the main place in the learning process. For a student, an etude is a means to build up self-own effective scenic behavior in the conditions of zones of silence. Etude has its own principles of construction and embodiment. The concept of the etude, its themes and components are the subjects of research in this article. The etude method of the actor’s work on the role was rather thoroughly and deeply examined by such authors as M. O. Knebel [4], S. V. Gippius [2], N. M. Gorchakov [3]. K. S. Stanislavsky [6, 7] reveals the versatile properties of the elements of scenic well-being, the laws of creativity and psycho-techniques with exhaustive completeness. E. B. Vakhtangov considered theatrical training not only from the point of view of mastering acting prowess, but mainly as formation the artist’s worldview: the up-brining of desire to serve high ideals and devote his art to them, an acute sense of modernity, the ability to see life creatively, guess its requirements [1]. The purpose of this study is to describe the practical exercises used in the work on etudes with first-year students. We offer our-own methodical developments, give the examples of exercises and etudes for the development of memory of physical actions, fantasy and imagination, the ability to build a truthful line of stage behavior in specific proposed circumstances, according to the system of K. S. Stanislavsky [6, 7]. The main material of the research. Scenic etude is the initial and basic component in the organization of stage action, an exercise with a certain psychological load. This is acting training in a variety of scenic situations and proposed external circumstances. Each of the students, called on the scene for the first time, experiences excitement, which appears in one or another form. Therefore, we warn the students that they do not need “to play” anything, but to behave as in life, in a word, we try in every way to do everything so that the transition to the stage does not disrupt normal human well-being. For a group of students, we suggest listening to and remembering the sounds that were heard in the room from the moment the exercise began to its end. In fact, those students who are on the stage and those who look to them in the auditorium, participate in this exercise. Then all the students take turns talking about the sounds, which they heard, complementing their comrades. This exercise helps to instill in students an understanding that the mental work and the activity of the sense organs on the stage are the same as in real life. The attention of the student is focused on some subject, sound, thought or action of the partner. Such an object, action, thought, sound is perceived particularly clearly and is called the “object of attention”. These exercises make it possible: 1) to focus your attention on a given object; 2) to keep this attention for some time, that is, to make the proposed action exciting, important for yourself. After these exercises, we introduce students to the “circles of attention”. “Small circle of attention” – it is when attention is directed to the inner world, to my sensations and experiences; the “medium circle” – to all that surrounds me within this room, where I am at the moment (things, sounds, smells, etc.); the “big circle of attention” – to all that surrounds me outside the room (hall), where I am at the moment. The focused attention distracts the student from the auditorium, hence the action that he performs in his etude on stage become the most important for him. It is very important for us, the teachers who works with the first-year students, to attain that the student concentrates on the stage action. It is also important that the students at the initial period of their training during the performance of etudes would not experience muscle strain, which, for the most part, arises from their efforts to appear in public better and smarter, more nimble and graceful than they usually are. K. S. Stanislavsky found a way to get rid of the tightness and education of muscle freedom by the way of creating a “muscular controller” – the ability to quickly find out in which muscle group the tension and remove it, leading oneself to a state of muscle freedom. Exercises for relax of muscles we begin with the fourth or fifth lessons and apply in parallel with the exercises on attention, combining them in the future. Then we give students to touch some subjects and tell about the chain of associations they cause. These exercises, freeing the thought, lead students to the beginning of work on the development of imagination. The next cycle of exercises we devote to the development of the imagination to create “proposed circumstances” (“magic if”, following K. Stanislavsky). “Proposed circumstances” arise when we ask the students questions: “Who?”, “When?”, “Where?”, “Why?”, “How?”, which excite their imagination, enticing them to substantiate their actions in a logical and consistent manner. We offer the students also etudes developing the memory about physical actions: having no objects in their hands, feeling them only with the help of their imagination, the students do certain physical actions. It is very important to instill in the first year students a feeling of proper physical well-being in the exercises; it is that need in future work on a role. The next stage of the work is the etudes, in which there is already a plot. Etudes are structured in such a way that an event or a surprise takes place in them that changes the course of life in the etude and makes it necessary to evaluate a new state of affairs. The next stage in the work with first-year students is the plot etudes. They are built in such a way that an event takes place in them or a surprise happens, which changes the course of a character’s life and makes it necessary to evaluate a new state of affairs. The construction of an etude contains a small introduction, exposure, the event itself and the outcome. We try to choice the plot based on events that could happen in reality with students and that correlate with the area of their life experience. We remind of the need for action from myself: what would I do in real life if it happened to me? The next section is the relationship to the partners in the etude. When two or more students act on the stage, interaction and mutual interest between them occurs. We act on our partner with the power of our “I”, not only with words and appearance, but with our whole being. This influence of my “I” on the “I” of my partner and contrary is the essence of the process of “communication”. We cultivate in a student the ability to concern seriously his course mate, same as his brother, sister, bride and so on, depending on their relationship in the etude. Conclusions. In a result of the beginning exercises and etudes, the students of the first year of study should come to an understanding of what the “inner well-being” status constitutes in practice. That is, to find a natural state in the context of scenic playing on public; to master the stage attention that is, being on the stage learn to concentrate on any one impression. This state should be connected with the activity of the senses (hearing, sight, smell, touch, taste), but, at the same time, the student should not lose the ability to think and act. In the process of working on etudes, students should answer the questions: wherefore are we going to play this etude, what shall we say to those who will watch us in this etude? Answers to these questions help us, the teachers, to lead students to a clear comprehension of the tasks of their stage work and understanding the role of the collective as a creative unit, nurturing in them a feeling of partnership, “a feeling of elbow”, camaraderie, the ability to perceive criticism and self-criticism correctly, since the theater is the collective art; to develop the artistic taste of students; ultimately – to cultivate in them the love of their future profession.

The article deals with certain medico-legal aspects of trauma in the salon of bus as one of the types of road traffic accidents with a large number of dead and injured. Are shown the typical causes of such incidents and the nature of the victims injury. Was developed and proposed a modern approach to optimization of expert research in case of appearance a large number of victims in the bus. Circumstances of injury in case of personal injury people in the bus are very diverse:− rollover of the bus when transporting a large number of people while driving;− bus falling from height;− a massive collision with a fixed roadside objects; − collision with other vehicles; among the latter is the most fatal bus collision with a moving train.Naturally, in these cases, the massive injuries have affected depends on the intensity of injury to passengers in the bus, and the mechanism of damage is determined by the specific form of an accident involving a bus. In such cases, the experts faced, usually with mechanical trauma inside the cabin, and mixed types of injuries passengers (e.g. in case of fire). For in-car trauma characterized by formation damage from the following mechanisms:− shock bodies on the inner part of the interior (interior);− injuries from the shards of broken glass.Basically, the nature of injury is determined by the structural features of the bus, the presence of foreign objects, the location of the victims. If the vehicle rolls over, the occupants people are numerous additional impact. Formed characteristic for the driver damage to the hands, fractures of the sternum fractures of the hips, legs and feet. For passengers is characteristic fractures of the lower limbs, bruised head wounds, fractures and dislocations of the cervical spine when using the seat belts − stripe-like bruises and abrasions ofthe chest and abdomen, broken ribs, collarbone, sternum, in the projection of the belts. Shards of broken glass caused by the multiple linear abrasions and (or) surface or deep cut wounds mainly in the face and upper extremities. In the case of deformation of the bus body can be compression of the bodies are formed by damage to several areas, primarily the chest, abdomen, extremities, accompanied by multiple bilateral rib fractures, ruptures of internal organs. If in the future there is a fire or explosion of the vehicle, the nature of thedamage detected on the bodies will correspond to the combined injury.In cases of injuries in the bus to work with the bodies of the victims begins at the scene. Thus, the Protocol of inspection of the scene and of the corpse in the first place should reflect the data about the mutual position of bodies and (or) their fragments relative to the vehicle and other parts, the distance between them; the condition of clothing, odors from it, the presence of different overlays, damage; contamination of the skin; localization and nature of the injuries on the bodies, the presence of deformations of its individualparts; the presence of traces of biological origin on the vehicle in comparison with the nature of the deformation (damage) of the body.Be sure to note the results of the inspection of the road where there was a traffic accident, a bus traces of blood, and fragments of various things, etc. Despite the small percentage of bus injured in world General statistics of fatal injuries, it presents certain difficulties in planning, organization, execution and coordination of forensic work on multi-step liquidation of medical consequences of the accident, usually associated with a large number of victims, gross impact of factors affecting on the bodies of the victims, the need to quickly address some specific issues: establishing at autopsy pathological symptoms that indicate the status of the health of drivers in the period priorto the tragic event; the existence of facts pointing to the use of intoxicating and medicinal substances that depress the nervous system and many others), early identification of all victims. According to the results of the analysis made it impossible to offer modern, optimal, evidence-informed, and until only itremains to be reliable in practice the system approach to the organizational model of forensic activities, while ensuring the interests of the investigation of an accident involving a bus and a large number of victims:1. The preliminary stage of organization expert services. It can conditionally enough be divided into 2 phases:− advance (pre-) phase;− the immediate phase.To the basic questions of the early phases include: early development, coordination and approval of the optimal legislative and other regulatory framework; preliminary methodological, administrative and organizational, theoretical-practical, logistical, software and applied training; exercise reasonable estimates of projected short and long term needs and costs with regard to the peculiarities specified by the tragic events; creation, storage, use and replenishment of the trust reserves, logistical and financial resources areinviolable, is intended solely for use in such emergencies. It also includes the creation, maintenance and continuous improvement of a Single centralized situation center on a temporary or permanent basis, with a good system of departmental and interdepartmental cooperation, primarily containing a - operational information-Supervisory and analytical center for the collection, processing, storage, information exchange and joint action with the threat, occurrence and prevention of emergencies with a large number of victims.Immediately with the receipt of the news of the accident involving a bus and a large number of victims for forensic services begin immediate phase, the main elements of which include:− prompt notification and collection of employees and expert institutions;− an emergency conference call to discuss the organizational, theoretical and practical questions and short specialized trainingon occupational safety, including use of personal protective equipment depending on the nature of the accident and actions are potentially dangerous to health and life of employees and expert institutions factors.All plans of measures are necessarily coordinated and agreed with appropriate representatives of structures of fast reaction, especially when conducting urgent investigative actions in the emergency areas, primarily the inspection of the scene. 2. The inspection of the crime scene it is advisable to start with a preliminary review («intelligence»), which finally determined the necessity of application of those or other technical means, and the number of specialists who will participate in the inspection.The static phase of scene examination with the participation of forensic doctors is accompanied by clear mapping; mapping, photo - and video fixing of vehicle, various objects; it is noted the exact relative positions of the bus (its parts) and discovered the corpses, fragments of human remains and other biological material. During dynamic examination of the scene produce a detailed external examination of the human remains, their fragments, biological material, perform primary medical sorting, their careful packaging,clear detailed marking. Then performed the proper loading, transportation and unloading. In case of need in a temporary Deposit of biological material, can be used in railway wagons refrigerators, refrigerated trailers, mobile camera with a refrigeration unit, and in the absence or lack of volume for the total number of remains and the biomaterial deploys heat-resistant boxes, fit the space with the use of outdoor mobile air conditioning systems, large amounts of ice obtained from specialized industrial ice makers, etc., which is especially important for braking processes of rotting corpses, their fragments and biomaterial in the warm season.3. After the initial registration and a secondary sort examine corpses, their fragments and biological material collection for postmortem identification of significant information, determine the cause of death, nature, mechanism and prescription of formation damage and address other special issues. At this stage also produce the identification of fragmented body parts and (or) tissues that or another body. In expert identification work on the fragments of human remains or biological material, preference is given to genetic research providing highly accurate results. Depending on the extent of influence of damaging factors on the bodies of the victims and their degree of preservation, only after the completion of the necessary is judicial-medical research with a full range of fence material for additional research, producing restoration of the exterior, embalming, sanitary and cosmetic processing of human remains and give them to relatives (relatives, authorized representatives, etc.) for burial. 4. Issued the final results of examinations; establishes data that may be useful for later investigative and judicial actions aimed at gathering and verification of evidence in a criminal case.5. The penultimate stage consists of conducting sanitary-and-hygienic, treatment-and-prophylactic, rehabilitation (including a full psychological) of interventions for physical and mental health of employees and expert institutions involved in this work.6. After the conclusion of the criminal proceedings in general, with the official opening of data access, it is advisable to analyze the material, and publish the relevant data in the scientific literature, with the goal of widespread study and use of gained experience.CONCLUSIONS.1. Research platform forensic activities in cases of accidents involving buses and a large number of victims to date have not been developed.2. The effectiveness of forensic medical groups in this situation is in direct proportion to the degree of readiness for quick response and timely quality completion of tasks.3. Based on this, very urgent is the development of modern optimal evidence-based systemic approach to the organizational model of forensic activities in the presence of a large number of injured persons in the bus; the solution to this problem and sent the above recommendations.4. The recommendations, in principle, can be applied not only in cases of injuries in the bus, but also to similar situations in which there is a massive injury and loss of life.5. It is necessary to continue scientific and practical research aimed at improving this algorithm works experts.

Introduction Such symptoms as hard, complex, bodily or mental feelings, that turn our everyday life into a hell, at first, lead us to a doctor, and then - to a psychotherapist. A sick man is keen to get rid of a symptom. A doctor prescribes medication, that is ought to eliminate a symptom. A psychotherapist searches for a reason of the problem that needs to be removed. There is such an idea that a neurotic symptom, in particular, an anxiety - is a pathological (spare or extra) response of a body. It is generally believed that such anxiety doesn’t have some real, objective reasons and that it is the result of a nervous system disorder, or some disruption of a cognitive sphere etc. Meanwhile, it is known that in the majority of cases, medical examinations of anxious people show that they don’t have any organic damages, including nervous system. It often happens that patients even wish doctors have found at least any pathology and have begun its treatment. And yet - there is no pathology. All examinations indicate a high level of functionality of a body and great performance of the brain's work. Doctors throw their hands up, as they can't cure healthy people. One of my clients told me her story of such medical examinations (which I’ll tell you with her permission). She said that it was more than 10 years ago. So, when she told her doctor all of her symptoms - he seemed very interested in it. He placed a helmet with electrodes on her head and wore some special glasses, when, according to her words, he created some kind of stressful situation for her brain, as she was seeing some flashings of bright pictures in her eyes. She said that he had been bothered with her for quite a long time, and at the end of it he had told her that her brain had been performing the best results in all respects. He noted that he’d rarely got patients with such great health indicators. My client asked the doctor how rare that was. And he answered: “one client in two or three months.” At that moment my client didn’t know whether to be relieved, flattered or sad. But since then, when someone told her that anxiety was a certain sign of mental problems, or problems with the nervous system, or with a body in general, she answered that people who had anxiety usually had already got all the required medical examinations sufficiently, and gave them the advice to go through medical screening by themselves before saying something like that. Therefore, we see a paradoxical situation, when some experts point to a neurotic anxiety as if it is a kind of pathology, in other words - some result of a nervous system disorder. Other specialists in the same situation talk about cognitive impairments. And some, after all the examinations, are ready to send such patients into space Main text I don’t agree with the statement that any neurotic anxiety that happens is excessive and unfounded. It often happens that there is objective, specific and real causes for appearance of anxiety conditions. And these causes require solutions. And it’s not about some organic damages of the brain or nervous system. The precondition that may give a rise to anxiety disorder is the development of such a life story that at some stage becomes too toxic - when, on the one hand, a person interacts with the outside world in a way that destroys his or her personality, and, on the other hand, this person uses repression and accepts such situation as common and normal. Repression - is an essential condition for the development of a neurotic symptom. Sigmund Freud was the first who pointed this out. Repression is such a defense mechanism that helps people separate themselves from some unpleasant feelings of discomfort (pain) while having (external or internal) irritations. It is the situation when, despite the presence of irritations and painful feelings, a person, however, doesn't feel any of it and is not aware of them in his or her conscious mind. Repression creates the situation of so-called emotional anesthesia. As a result, a displacement takes place, so a body starts to signal about the existing toxic life situation via a symptom. Anxiety disorder is usually an appropriate response (symptom) of a healthy body to an unhealthy life situation, which is seen by a person as normal. And it’s common when such a person is surrounded by others (close people), who tend to benefit from such situation, and so they actively maintain this state of affairs, whether it is conscious for them or not. At the beginning of a psychotherapy almost all clients insist that everything is good in their lives, even great, as it is like in everyone else’s life. They say that they have only one problem, which is that goddamn symptom. So they focus all of their attention on that symptom. They are not interested in all the other aspects of their life, and they show their irritation when it comes to talking about it. People want to get rid of it, whatever it takes, but they often tend to keep their lives the way that it was. In such cases a psychotherapist is dealing with the resistance of clients, trying to turn their attention from a symptom to their everyday situation that includes their way of thinking, interactions with themselves and with others and with the external world in order to have the opportunity to see the real problem, to live it through, to rethink and to change the story of their lives. For better understanding about how it works I want to tell you three allegorical tales. The name of the first tale is “A frog in boiling water”. There is one scientific anecdote and an assumption (however, it is noted that such experiments were held in 19 century), that if we put a frog in a pot with warm water and start to slowly heat the water, then this frog get used to the temperature rise and stays in a hot water, the frog doesn’t fight the situation, slowly begins to lose its energy and at the last moment it couldn’t find enough strength and energy to get out of that pot. But if we throw a frog abruptly in hot water - it jumps out very quickly. It is likely that a frog, that is seating in boiling water, will have some responses of the body (symptoms). For example, the temperature of its body will rise, the same as the color of it, etc., that is an absolutely normal body response to the existing situation. But let us keep fantasizing further. Imagine a cartoon where such a frog is the magical cartoon hero, that comes to some magical cartoon doctor, shows its skin, that has changed the color, to the doctor, and asks to change the situation by removing this unpleasant symptom. So the doctor prescribes some medication to return the natural green color of the frog’s skin back. The frog gets back in its hot water. For some period of time this medication helps. But then, after a while, the frog’s body gets over the situation, and the redness of the frog's skin gets back. And the magical cartoon doctor states that the resistance of the body to this medication has increased, and each time prescribes some more and more strong drugs. In this example with the frog it is perfectly clear that the true solution of the problem requires the reduction of the water temperature in that pot. We could propose that magical cartoon frog to think and try to realize that: 1) the water in that pot is hot, and that is the reason why the skin is red; 2) the frog got used to this situation and that is why it is so unnoticeably for this frog; 3) if the temperature of the water in the pot still stay so hot, without any temperature drop, then all the medication works only temporarily; 4) if we lower the temperature in that pot - the redness disappears on its own, automatically and without any medication. Also this cartoon frog, that will go after the doctor to some cartoon physiotherapist, will face the necessity to give itself some answers for such questions as: 1) What is going on? Who has put this frog in that pot? Who is raising the temperature progressively? Who needs it? And what is the purpose or benefit for this person in that? Who benefits? 2) Why did the frog get into the pot? What are the benefits in it for the frog? Or why did the frog agree to that? 3) What does the frog lose when it gets out of this pot? What are the consequences of it for the frog? What does the frog have to face? What are the possible difficulties on the way? Who would be against the changes? With whom the frog may confront? 4) Is the frog ready to take control over its own pot in its own hands and start to regulate the temperature of the water by itself, so to make this temperature comfortable for itself? Is this frog ready to influence by itself on its own living space, to take the responsibility for it to itself? The example “A frog in boiling water” is often used as a metaphorical portrayal of the inability of people to respond (or fight back) to significant changes that slowly happen in their lives. Also this tale shows that a body, while trying to adjust to unfavorable living conditions, will react with a symptom. And it is very important to understand this symptom. Symptom - is the response of a body, it’s a way a body adjusts to some unfriendly environment. Symptom, on the one hand, informs about the existence of a problem, and from the other hand - tries to regulate this problem, at least in some way (like, to remove or reduce), at the level on which it can do it. The process is similar to those when, for example, in a body, while it suffers from some infectious disease, the temperature rises. Thus, on the one hand, the temperature informs about the existence of some infection. On the other hand, the temperature increase creates in a body the situation that is damaging for the infection. So, it would be good to think about in what way does an anxiety symptom help a body that is surrounded by some toxic life situation. And this is a good topic for another article. Here I want to emphasize that all the attempts to remove a symptom without a removal of a problem, without changing the everyday life story, may lead to strengthening of the symptom in the body. Even though the removal of a symptom without elimination of its cause has shown success, it only means that the situation was changed into the condition of asymptomatic existence of a problem. And it is, in its essence, a worse situation. For example, it can cause an occurrence of cancer. The tale “A frog in boiling water” is about the tendency of people to treat a symptom, instead of seeing their real problems, as its cause, and trying to solve it. People don’t want to see their problems, but it doesn’t mean that the problem doesn’t exist. The problem does exist and it continues to destroy a person, unnoticeably for him or her. A person with panic disorder could show us anxiety that is out of control (fear, panic), which, by its essence, seems to exist without any logical reason. Meanwhile the body of such a person could be in such processes that are similar to those that occur in the conditions of some real dangers, when the instinct for self-preservation is triggered and an automatic response of a body to fight or flight implements for its full potential. We can see or feel signs of this response, for example, in cases when some person tries to avoid some real or imaginary danger via attempts to escape (the feeling of fear), or tries to handle the situation by some attempts to fight (the feeling of anger). As I mentioned before, many doctors believe that such fear is pathological, as there is no real reason for such intense anxiety. They may see the cause of the problem in worrisome temper, so they try to remove specifically anxiety rather than help such patients to understand specific reason of their anxiety, they use special psychotherapeutic methods that are designed to help clients to develop logical thinking, so it must help them to realize the groundlessness of their anxiety. In my point of view, such anxiety often has specific, real reasons, when this response of a body, fight or flight, is absolutely appropriate, but not excessive or pathological. Inadequacy, in fact, is in the unconsciousness, but not in the reactions of a body. For a better understanding of the role of anxiety in some toxic environment, that isn’t realized, I want to tell you another allegorical tale called “The wolf and the hare”. Let us imagine that two cages were brought together in one room. The wolf was inside one cage and the hare was in another. The cages were divided by some kind of curtain that makes it impossible for them to see each other. At this point a question arises whether the animals react to each other in some way in such a situation, or not? I think that yes, they will. Since there are a lot of other receptors that participate in the receiving and processing of the sensory information. As well as sight and hearing, we have of course a range of other senses. For example, animals have a strong sense of smell. It is well known that people, along with verbal methods of communicating information, like language and speaking, also have other means of transmitting information - non-verbal, such as tone of voice, intonation, look, gestures, body language, facial expressions etc., that gives us the opportunity to receive additional information from each other. The lie detector works by using this principle: due to detecting non-verbal signals, it distinguishes the level of the accuracy of information that is transmitted. It is assumed, that about 30% of information, that we receive from the environment, comes through words, vision, hearing, touches etc. This is the information that we are aware of in our consciousness, so we could consciously (logically) use it to be guided by. And approximately 70% of everyday information about the reality around us we receive non-verbally, and this information in the majority of cases could remain in us without any recognition. It is the situation when we’ve already known something, and we even have already started to respond to it via our body, but we still don’t know logically and consciously that we know it. We can observe the responses of our own body without understanding what are the reasons for such responses. We can recognize this unconscious information through certain pictures, associations, dreams, or with the help of psychoanalysis. Psychoanalysis is a great tool that can help to recognize the information from the unconscious mind, so that it can be logically processed further on, in other words, a person then receives the opportunity to indicate the real problems and to make right decisions. But let us return to the tale where the hare and the wolf stay in one room and don’t see each other, and, maybe, don’t hear, though - feel. These feelings (in other words - non-verbal information that the hare receives) activate a certain response in the hare’s body. And it reacts properly and adequately to the situation, for instance, the body starts to produce adrenaline and runs the response “fight or flight”. So the hare starts to behave accordingly and we could see the following symptoms: the hare is running around his cage, fussing, having some tremor and an increased heart rate, etc.. And now let us imagine this tale in some cartoon. The hare stays in its house, and the wolf wanders about this house. But the hare doesn’t see the wolf. Though the body of the hare gives some appropriate responses. And then that cartoon hare goes to a cartoon doctor and asks that doctor to give it some pill from its tremor and the increased heart rate. And in general asks to treat in some way this incomprehensible, confusing, totally unreasonable severe anxiety. If we try to replace the situation from this fairy-tale to a life story, we could see that it fits well to the script of interdependent relationships, where there are a couple “a victim and an aggressor”, and where such common for our traditional families’ occurrences as a domestic family violence, psychological and physical abuse take place. Only in 2019 a law was passed that follows the European norms and gives a legislative definition of such concepts as psychological domestic abuse, sexual abuse, physical abuse, bullying, that criminalizes all of these occurrences, establishes the punishment and directly points to people that could be a potential abuser. Among them are: a husband towards his wife, parents towards their children, a wife towards her husband, a superior towards a subordinate, a teacher towards his or her students, children towards each other etc.. When it comes to recognition of something as unacceptable, it seems more easy to put to that category such occurrences as physical and sexual abuse, as we could see here some obvious events. For example, beating or sexual harassment. Our society is ready to respond to these incidents in more or less adequate way, and to recognize them as a crime. But it is harder to deal with the recognition of psychological abuse as an offence. Psychological abuse in our families is common. Psychological abuse occurs through such situations, when one person, while using different psychological manipulations, such as violation of psychological borders, imposition of feeling of guilty or shame, etc., force another person to give up his or her needs and desires, and so in such a way make this person live another’s life. Such actions have an extremely negative effect on the mental health of these people, just as much as physical abuse. It can destroy a person from the inside, ruin self-esteem and a feeling of self-worth, create the situation of absolute dependence such victim from an abuser, including financial dependence etc.. It often happens that psychological abuse takes place against the backdrop of demonstrations of care and love. So you've got this story about the wolf and the hare, that are right next to each other, and the shield between two of them is a repression - a psychological defense mechanism, when a person turns a blind eye to such offences, that take place in his or her own life and towards him or her. And this person considers this as normal, doesn't realize, doesn't have a resource to realize, that it is a crime. Most importantly - doesn’t feel anything, as a repression takes place. But a body responds in a right way - from a certain point of the existence of such a toxic situation the response “fight or flight” is launched in a body at full, in other words - the fear and anxiety with the associated symptoms. The third allegorical tale I called “Defective suit”, which I read in the book of Clarissa Pinkola Estés with the name “Running With the Wolves". “Once one man came to a tailor and started to try on a suit. When he was standing in front of a mirror, he saw that the costume had uneven edges. - Don’t worry, - said the tailor. - If you hold the short edge of the suit by your left hand - nobody notices it. But then the man saw that a lapel of a jacket folded up a little bit. - It's nothing. You only need to turn your head and to nail it by your chin. The customer obeyed, but when he put on trousers, he saw that they were pulling. - All right, so just hold your trousers like this by your right hand - and everything will be fine, - the tailor comforts him. The client agreed with him and took the suit. The next day he put on his new suit and went for a walk, while doing everything exactly in the way that the tailor told him to. He waddled in a park, while holding the lapel by his chin, and holding the short edge of the suit by his left hand, and holding his trousers by his right hand. Two old men, who were playing checkers, left the game and started to watch him. - Oh, God! - said one of them. - Look at that poor cripple. - Oh, yes - the limp - is a disaster. But I'm wondering, where did he get such a nice suit?” Clarissa wrote: “The commentary of the second old man reflects the common response of the society to a woman, who built a great reputation for herself, but turned into a cripple, while trying to save it. “Yes, she is a cripple, but look how great her life is and how lovely she looks.” When the “skin” that we put on ourselves towards society is small, we become cripples, but try to hide it. While fading away, we try to waddle perky, so everyone could see that we are doing really well, everything is great, everything is fine”. As for me, this tale is also about the process of forming a symptom in a situation when one person tries very hard to match to another one, whether it is a husband, a wife or parents. It’s about a situation when such a person always tries to support the other one, while giving up his or her own needs and causing oneself harm in such a way by feeling a tension every day, that becomes an inner normality. And so this person doesn’t give oneself a possibility to relax, to be herself (or himself), to be spontaneous, free. As a result, in this situation the person, who was supported, looks perfect from the outside, but those who tried to match, arises some visible defect, like a limp - a symptom. And so this person lives like a cripple, under everyday stress and tension, trying to handle it, while sacrificing herself (or himself) and trying to maintain this situation, so not to lose the general picture of a beautiful family and to avoid shame. The tailor, who made this defective suit and tells how to wear the suit properly, in order to keep things going as they are going, often is a mother who raised a problematic child and then tells another person how to deal with her child in the right way. It is the situation when a mother-in-law tells her daughter-in-law how to treat her son properly. In other words, how to support him, when to keep silent, to handle, how to fit in, so that her problematic son and this relationship in general looks perfect. Or vice versa, when a mother-in-law tells her son-in-law how to support her problematic daughter, how to fit in etc.. When, for example, a woman acts like this in her marriage and with her husband, with these excessive efforts to fit in - then after a while everybody will talk like: “Look at this lovely man: he lives with his sick wife, and their family seems perfect!”. But when such a woman becomes brave enough to relax and to just let the whole thing go, everybody will see that the relationship in her marriage isn’t perfect, and it is the other one who has problems. Each time when someone tries excessively to match up to another one, while turning oneself in some kind of a cripple, - he or she, on the one hand, supports the comfort of that person, to whom he or she tries to match up, and on the other hand - such a situation always arises in that person such conditions as a continuous tension, anxiety, fear to act spontaneously. A symptom - is like a visible defect, that shows itself through the body (and may look like some kind of injury). It is the result of a hidden inner prison. As a result of evolution, a pain tells us about a problem that is needed to be solved. When we repress our pain we can’t see our needs and our problems at full. And then a body starts to talk to us via a symptom. Psychotherapy aims for providing a movement from a symptom to a resumption of sensitivity to feelings, a resumption of the ability to feel your psychological pain, so you can realize your own toxic story. In this perspective another fairy-tale looks interesting to analyze - it is Andersen's fairytale “Princess and the Pea”. In the tale a prince wanted to find a princess to marry. There was one requirement for women candidates, so the prince could select her among commoner - high level of sensitivity, as the real princess would feel a pea through the mountain of mattresses, and so she could have the ability to feel discomfort, to be in a good contact with her body, to tell about her discomfort without such feeling as shame and guilt, and to refuse that discomfort, so to have the readiness to solve her problems and to demand from others the respect for her needs. It is common for our culture that the expression “a princess on a pea” very often uses for a negative meaning. So people who are in good contact with their body and who can demand comfort for themselves are often called capricious. At the same time the heroes who are ready to suffer and to tolerate their pain, who are able to repress (stop to feel) their pain represents a good example to be followed in our society. So, we may see the next algorithm in cases of various anxiety disorders: the existence of some toxic situation that brings some danger to a person. And we need not to be confused: a danger exists not for a body, but for a personality. A toxic live situation as well as having a panic attack is not a threat for the health of a body (that is what medical examinations show), and vice versa - it’s like every day intensive sport training, that could be good for your health only to some degree. A toxic situation destroys a person as a personality, who longs for one self’s expression; the existence of such a defense mechanism as repression - it’s a life with closed eyes, in pink glasses, when there is inability (or the absence of the desire) to see its own toxic story; 3.the presence of a symptom - a healthy response of a body “fight or flight” to some toxic situation; displacement - it’s replacement of the attention from the situation to a symptom, when a person starts to see and search for the problem in some other place, not where it really is. A symptom takes as some spare, pathological reaction that we need to get rid of. The readiness to fight the symptom arises, and that is the goal of such methods of therapy as pharmacological therapy, CBT and many others; the absence of adequate actions that are directed towards the change of a toxic situation itself. The absence of the readiness to show aggression when it comes to protect its space. All of it is a mechanism of formation of primary anxiety and preparation for launch of secondary anxiety. A complete anxiety disorder is the interaction between a primary and a secondary anxiety.

Background and Objective: Suicide attempts are 10-20X more common than completed suicide and an important risk factor for death by suicide, yet most people who attempt suicide do not die by suicide. The process of recovering after a suicide attempt has not been well studied. The Reasons to go on Living (RTGOL) Project, a narrative web-based study, focuses on experiences of people who have attempted suicide and made the decision to go on living, a process not well studied. Narrative research is ideally suited to understanding personal experiences critical to recovery following a suicide attempt, including the transition to a state of hopefulness. Voices from people with lived experience can help us plan and conceptualize this work. This paper reports on a secondary research question of the larger study: what stories do participants tell of the positive role/impact of the mental health system. Material and Methods: A website created for The RTGOL Project (www.thereasons.ca) enabled participants to anonymously submit a story about their suicide attempt and recovery, a process which enabled participation from a large and diverse group of participants. The only direction given was “if you have made a suicide attempt or seriously considered suicide and now want to go on living, we want to hear from you.” The unstructured narrative format allowed participants to describe their experiences in their own words, to include and emphasize what they considered important. Over 5 years, data analysis occurred in several phases over the course of the study, resulting in the identification of data that were inputted into an Excel file. This analysis used stories where participants described positive involvement with the mental health system (50 stories). Results: Several participants reflected on experiences many years previous, providing the privilege of learning how their life unfolded, what made a difference. Over a five-year period, 50 of 226 stories identified positive experiences with mental health care with sufficient details to allow analysis, and are the focus of this paper. There were a range of suicidal behaviours in these 50 stories, from suicidal ideation only to medically severe suicide attempts. Most described one or more suicide attempts. Three themes identified included: 1) trust and relationship with a health care professional, 2) the role of friends and family and friends, and 3) a wide range of services. Conclusion: Stories open a window into the experiences of the period after a suicide attempt. This study allowed for an understanding of how mental health professionals might help individuals who have attempted suicide write a different story, a life-affirming story. The stories that participants shared offer some understanding of “how” to provide support at a most-needed critical juncture for people as they interact with health care providers, including immediately after a suicide attempt. Results of this study reinforce that just one caring professional can make a tremendous difference to a person who has survived a suicide attempt. Key Words: web-based; suicide; suicide attempt; mental health system; narrative research Word Count: 478 Introduction My Third (or fourth) Suicide AttemptI laid in the back of the ambulance, the snow of too many doses of ativan dissolving on my tongue.They hadn't even cared enough about meto put someone in the back with me,and so, frustrated,I'd swallowed all the pills I had with me— not enough to do what I wanted it to right then,but more than enough to knock me out for a good 14 hours.I remember very little after that;benzodiazepines like ativan commonly cause pre- and post-amnesia, says Google helpfullyI wake up in a locked rooma woman manically drawing on the windows with crayonsthe colors of light through the glassdiffused into rainbows of joy scattered about the roomas if she were coloring on us all,all of the tattered remnants of humanity in a psych wardmade into a brittle mosaic, a quilt of many hues, a Technicolor dreamcoatand I thoughtI am so glad to be able to see this. (Story 187)The nurse opening that door will have a lasting impact on how this story unfolds and on this person’s life. Each year, almost one million people die from suicide, approximately one death every 40 seconds. Suicide attempts are much more frequent, with up to an estimated 20 attempts for every death by suicide.1 Suicide-related behaviours range from suicidal ideation and self-injury to death by suicide. We are unable to directly study those who die by suicide, but effective intervention after a suicide attempt could reduce the risk of subsequent death by suicide. Near-fatal suicide attempts have been used to explore the boundary with completed suicides. Findings indicated that violent suicide attempters and serious attempters (seriousness of the medical consequences to define near-fatal attempts) were more likely to make repeated, and higher lethality suicide attempts.2 In a case-control study, the medically severe suicide attempts group (78 participants), epidemiologically very similar to those who complete suicide, had significantly higher communication difficulties; the risk for death by suicide multiplied if accompanied by feelings of isolation and alienation.3 Most research in suicidology has been quantitative, focusing almost exclusively on identifying factors that may be predictive of suicidal behaviours, and on explanation rather than understanding.4 Qualitative research, focusing on the lived experiences of individuals who have attempted suicide, may provide a better understanding of how to respond in empathic and helpful ways to prevent future attempts and death by suicide.4,5 Fitzpatrick6 advocates for narrative research as a valuable qualitative method in suicide research, enabling people to construct and make sense of the experiences and their world, and imbue it with meaning. A review of qualitative studies examining the experiences of recovering from or living with suicidal ideation identified 5 interconnected themes: suffering, struggle, connection, turning points, and coping.7 Several additional qualitative studies about attempted suicide have been reported in the literature. Participants have included patients hospitalized for attempting suicide8, and/or suicidal ideation,9 out-patients following a suicide attempt and their caregivers,10 veterans with serious mental illness and at least one hospitalization for a suicide attempt or imminent suicide plan.11 Relationships were a consistent theme in these studies. Interpersonal relationships and an empathic environment were perceived as therapeutic and protective, enabling the expression of thoughts and self-understanding.8 Given the connection to relationship issues, the authors suggested it may be helpful to provide support for the relatives of patients who have attempted suicide. A sheltered, friendly environment and support systems, which included caring by family and friends, and treatment by mental health professionals, helped the suicidal healing process.10 Receiving empathic care led to positive changes and an increased level of insight; just one caring professional could make a tremendous difference.11 Kraft and colleagues9 concluded with the importance of hearing directly from those who are suicidal in order to help them, that only when we understand, “why suicide”, can we help with an alternative, “why life?” In a grounded theory study about help-seeking for self-injury, Long and colleagues12 identified that self-injury was not the problem for their participants, but a panacea, even if temporary, to painful life experiences. Participant narratives reflected a complex journey for those who self-injured: their wish when help-seeking was identified by the theme “to be treated like a person”. There has also been a focus on the role and potential impact of psychiatric/mental health nursing. Through interviews with experienced in-patient nurses, Carlen and Bengtsson13 identified the need to see suicidal patients as subjective human beings with unique experiences. This mirrors research with patients, which concluded that the interaction with personnel who are devoted, hope-mediating and committed may be crucial to a patient’s desire to continue living.14 Interviews with individuals who received mental health care for a suicidal crisis following a serious attempt led to the development of a theory for psychiatric nurses with the central variable, reconnecting the person with humanity across 3 phases: reflecting an image of humanity, guiding the individual back to humanity, and learning to live.15 Other research has identified important roles for nurses working with patients who have attempted suicide by enabling the expression of thoughts and developing self-understanding8, helping to see things differently and reconnecting with others,10 assisting the person in finding meaning from their experience to turn their lives around, and maintain/and develop positive connections with others.16 However, one literature review identified that negative attitudes toward self-harm were common among nurses, with more positive attitudes among mental health nurses than general nurses. The authors concluded that education, both reflective and interactive, could have a positive impact.17 This paper is one part of a larger web-based narrative study, the Reasons to go on Living Project (RTGOL), that seeks to understand the transition from making a suicide attempt to choosing life. When invited to tell their stories anonymously online, what information would people share about their suicide attempts? This paper reports on a secondary research question of the larger study: what stories do participants tell of the positive role/impact of the mental health system. The focus on the positive impact reflects an appreciative inquiry approach which can promote better practice.18 Methods Design and Sample A website created for The RTGOL Project (www.thereasons.ca) enabled participants to anonymously submit a story about their suicide attempt and recovery. Participants were required to read and agree with a consent form before being able to submit their story through a text box or by uploading a file. No demographic information was requested. Text submissions were embedded into an email and sent to an account created for the Project without collecting information about the IP address or other identifying information. The content of the website was reviewed by legal counsel before posting, and the study was approved by the local Research Ethics Board. Stories were collected for 5 years (July 2008-June 2013). The RTGOL Project enabled participation by a large, diverse audience, at their own convenience of time and location, providing they had computer access. The unstructured narrative format allowed participants to describe their experiences in their own words, to include and emphasize what they considered important. Of the 226 submissions to the website, 112 described involvement at some level with the mental health system, and 50 provided sufficient detail about positive experiences with mental health care to permit analysis. There were a range of suicidal behaviours in these 50 stories: 8 described suicidal ideation only; 9 met the criteria of medically severe suicide attempts3; 33 described one or more suicide attempts. For most participants, the last attempt had been some years in the past, even decades, prior to writing. Results Stories of positive experiences with mental health care described the idea of a door opening, a turning point, or helping the person to see their situation differently. Themes identified were: (1) relationship and trust with a Health Care Professional (HCP), (2) the role of family and friends (limited to in-hospital experiences), and (3) the opportunity to access a range of services. The many reflective submissions of experiences told many years after the suicide attempt(s) speaks to the lasting impact of the experience for that individual. Trust and Relationship with a Health Care Professional A trusting relationship with a health professional helped participants to see things in a different way, a more hopeful way and over time. “In that time of crisis, she never talked down to me, kept her promises, didn't panic, didn't give up, and she kept believing in me. I guess I essentially borrowed the hope that she had for me until I found hope for myself.” (Story# 35) My doctor has worked extensively with me. I now realize that this is what will keep me alive. To be able to feel in my heart that my doctor does care about me and truly wants to see me get better.” (Story 34). The writer in Story 150 was a nurse, an honours graduate. The 20 years following graduation included depression, hospitalizations and many suicide attempts. “One day after supper I took an entire bottle of prescription pills, then rode away on my bike. They found me late that night unconscious in a downtown park. My heart threatened to stop in the ICU.” Then later, “I finally found a person who was able to connect with me and help me climb out of the pit I was in. I asked her if anyone as sick as me could get better, and she said, “Yes”, she had seen it happen. Those were the words I had been waiting to hear! I quickly became very motivated to get better. I felt heard and like I had just found a big sister, a guide to help me figure out how to live in the world. This person was a nurse who worked as a trauma therapist.” At the time when the story was submitted, the writer was applying to a graduate program. Role of Family and Friends Several participants described being affected by their family’s response to their suicide attempt. Realizing the impact on their family and friends was, for some, a turning point. The writer in Story 20 told of experiences more than 30 years prior to the writing. She described her family of origin as “truly dysfunctional,” and she suffered from episodes of depression and hospitalization during her teen years. Following the birth of her second child, and many family difficulties, “It was at this point that I became suicidal.” She made a decision to kill herself by jumping off the balcony (6 stories). “At the very last second as I hung onto the railing of the balcony. I did not want to die but it was too late. I landed on the parking lot pavement.” She wrote that the pain was indescribable, due to many broken bones. “The physical pain can be unbearable. Then you get to see the pain and horror in the eyes of someone you love and who loves you. Many people suggested to my husband that he should leave me in the hospital, go on with life and forget about me. During the process of recovery in the hospital, my husband was with me every day…With the help of psychiatrists and a later hospitalization, I was actually diagnosed as bipolar…Since 1983, I have been taking lithium and have never had a recurrence of suicidal thoughts or for that matter any kind of depression.” The writer in Story 62 suffered childhood sexual abuse. When she came forward with it, she felt she was not heard. Self-harm on a regular basis was followed by “numerous overdoses trying to end my life.” Overdoses led to psychiatric hospitalizations that were unhelpful because she was unable to trust staff. “My way of thinking was that ending my life was the only answer. There had been numerous attempts, too many to count. My thoughts were that if I wasn’t alive I wouldn’t have to deal with my problems.” In her final attempt, she plunged over the side of a mountain, dropping 80 feet, resulting in several serious injuries. “I was so angry that I was still alive.” However, “During my hospitalization I began to realize that my family and friends were there by my side continuously, I began to realize that I wasn't only hurting myself. I was hurting all the important people in my life. It was then that I told myself I am going to do whatever it takes.” A turning point is not to say that the difficulties did not continue. The writer of Story 171 tells of a suicide attempt 7 years previous, and the ongoing anguish. She had been depressed for years and had thoughts of suicide on a daily basis. After a serious overdose, she woke up the next day in a hospital bed, her husband and 2 daughters at her bed. “Honestly, I was disappointed to wake up. But, then I saw how scared and hurt they were. Then I was sorry for what I had done to them. Since then I have thought of suicide but know that it is tragic for the family and is a hurt that can never be undone. Today I live with the thought that I am here for a reason and when it is God's time to take me then I will go. I do believe living is harder than dying. I do believe I was born for a purpose and when that is accomplished I will be released. …Until then I try to remind myself of how I am blessed and try to appreciate the wonders of the world and the people in it.” Range of Services The important role of mental health and recovery services was frequently mentioned, including dialectical behavioural therapy (DBT)/cognitive-behavioural therapy (CBT), recovery group, group therapy, Alcoholics Anonymous, accurate diagnosis, and medications. The writer in Story 30 was 83 years old when she submitted her story, reflecting on a life with both good and bad times. She first attempted suicide at age 10 or 12. A serious post-partum depression followed the birth of her second child, and over the years, she experienced periods of suicidal intent: “Consequently, a few years passed and I got to feeling suicidal again. I had pills in one pocket and a clipping for “The Recovery Group” in the other pocket. As I rode on the bus trying to make up my mind, I decided to go to the Recovery Group first. I could always take the pills later. I found the Recovery Group and yoga helpful; going to meetings sometimes twice a day until I got thinking more clearly and learned how to deal with my problems.” Several participants described the value of CBT or DBT in learning to challenge perceptions. “I have tools now to differentiate myself from the illness. I learned I'm not a bad person but bad things did happen to me and I survived.”(Story 3) “The fact is that we have thoughts that are helpful and thoughts that are destructive….. I knew it was up to me if I was to get better once and for all.” (Story 32): “In the hospital I was introduced to DBT. I saw a nurse (Tanya) every day and attended a group session twice a week, learning the techniques. I worked with the people who wanted to work with me this time. Tanya said the same thing my counselor did “there is no study that can prove whether or not suicide solves problems” and I felt as though I understood it then. If I am dead, then all the people that I kept pushing away and refusing their help would be devastated. If I killed myself with my own hand, my family would be so upset. DBT taught me how to ‘ride my emotional wave’. ……….. DBT has changed my life…….. My life is getting back in order now, thanks to DBT, and I have lots of reasons to go on living.”(Story 19) The writer of Story 67 described the importance of group therapy. “Group therapy was the most helpful for me. It gave me something besides myself to focus on. Empathy is such a powerful emotion and a pathway to love. And it was a huge relief to hear others felt the same and had developed tools of their own that I could try for myself! I think I needed to learn to communicate and recognize when I was piling everything up to build my despair. I don’t think I have found the best ways yet, but I am lifetimes away from that teenage girl.” (Story 67) The author of story 212 reflected on suicidal ideation beginning over 20 years earlier, at age 13. Her first attempt was at 28. “I thought everyone would be better off without me, especially my children, I felt like the worst mum ever, I felt like a burden to my family and I felt like I was a failure at life in general.” She had more suicide attempts, experienced the death of her father by suicide, and then finally found her doctor. “Now I’m on meds for a mood disorder and depression, my family watch me closely, and I see my doctor regularly. For the first time in 20 years, I love being a mum, a sister, a daughter, a friend, a cousin etc.” Discussion The 50 stories that describe positive experiences in the health care system constitute a larger group than most other similar studies, and most participants had made one or more suicide attempts. Several writers reflected back many years, telling stories of long ago, as with the 83-year old participant (Story 30) whose story provided the privilege of learning how the author’s life unfolded. In clinical practice, we often do not know – how did the story turn out? The stories that describe receiving health care speak to the impact of the experience, and the importance of the issues identified in the mental health system. We identified 3 themes, but it was often the combination that participants described in their stories that was powerful, as demonstrated in Story 20, the young new mother who had fallen from a balcony 30 years earlier. Voices from people with lived experience can help us plan and conceptualize our clinical work. Results are consistent with, and add to, the previous work on the importance of therapeutic relationships.8,10,11,14–16 It is from the stories in this study that we come to understand the powerful experience of seeing a family members’ reaction following a participant’s suicide attempt, and how that can be a potent turning point as identified by Lakeman and Fitzgerald.7 Ghio and colleagues8 and Lakeman16 identified the important role for staff/nurses in supporting families due to the connection to relationship issues. This research also calls for support for families to recognize the important role they have in helping the person understand how much they mean to them, and to promote the potential impact of a turning point. The importance of the range of services reflect Lakeman and Fitzgerald’s7 theme of coping, associating positive change by increasing the repertoire of coping strategies. These findings have implications for practice, research and education. Working with individuals who are suicidal can help them develop and tell a different story, help them move from a death-oriented to life-oriented position,15 from “why suicide” to “why life.”9 Hospitalization provides a person with the opportunity to reflect, to take time away from “the real world” to consider oneself, the suicide attempt, connections with family and friends and life goals, and to recover physically and emotionally. Hospitalization is also an opening to involve the family in the recovery process. The intensity of the immediate period following a suicide attempt provides a unique opportunity for nurses to support and coach families, to help both patients and family begin to see things differently and begin to create that different story. In this way, family and friends can be both a support to the person who has attempted suicide, and receive help in their own struggles with this experience. It is also important to recognize that this short period of opportunity is not specific to the nurses in psychiatric units, as the nurses caring for a person after a medically severe suicide attempt will frequently be the nurses in the ICU or Emergency departments. Education, both reflective and interactive, could have a positive impact.17 Helping staff develop the attitudes, skills and approach necessary to be helpful to a person post-suicide attempt is beginning to be reported in the literature.21 Further implications relate to nursing curriculum. Given the extent of suicidal ideation, suicide attempts and deaths by suicide, this merits an important focus. This could include specific scenarios, readings by people affected by suicide, both patients themselves and their families or survivors, and discussions with individuals who have made an attempt(s) and made a decision to go on living. All of this is, of course, not specific to nursing. All members of the interprofessional health care team can support the transition to recovery of a person after a suicide attempt using the strategies suggested in this paper, in addition to other evidence-based interventions and treatments. Findings from this study need to be considered in light of some specific limitations. First, the focus was on those who have made a decision to go on living, and we have only the information the participants included in their stories. No follow-up questions were possible. The nature of the research design meant that participants required access to a computer with Internet and the ability to communicate in English. This study does not provide a comprehensive view of in-patient care. However, it offers important inputs to enhance other aspects of care, such as assessing safety as a critical foundation to care. We consider these limitations were more than balanced by the richness of the many stories that a totally anonymous process allowed. Conclusion Stories open a window into the experiences of a person during the period after a suicide attempt. The RTGOL Project allowed for an understanding of how we might help suicidal individuals change the script, write a different story. The stories that participants shared give us some understanding of “how” to provide support at a most-needed critical juncture for people as they interact with health care providers immediately after a suicide attempt. While we cannot know the experiences of those who did not survive a suicide attempt, results of this study reinforce that just one caring professional can make a crucial difference to a person who has survived a suicide attempt. We end with where we began. Who will open the door? References 1. World Health Organization. Suicide prevention and special programmes. http://www.who.int/mental_health/prevention/suicide/suicideprevent/en/index.html Geneva: Author; 2013.2. Giner L, Jaussent I, Olie E, et al. Violent and serious suicide attempters: One step closer to suicide? J Clin Psychiatry 2014:73(3):3191–197.3. Levi-Belz Y, Gvion Y, Horesh N, et al. Mental pain, communication difficulties, and medically serious suicide attempts: A case-control study. Arch Suicide Res 2014:18:74–87.4. Hjelmeland H and Knizek BL. Why we need qualitative research in suicidology? Suicide Life Threat Behav 2010:40(1):74–80.5. Gunnell D. A population health perspective on suicide research and prevention: What we know, what we need to know, and policy priorities. Crisis 2015:36(3):155–60.6. Fitzpatrick S. Looking beyond the qualitative and quantitative divide: Narrative, ethics and representation in suicidology. Suicidol Online 2011:2:29–37.7. Lakeman R and FitzGerald M. How people live with or get over being suicidal: A review of qualitative studies. J Adv Nurs 2008:64(2):114–26.8. Ghio L, Zanelli E, Gotelli S, et al. Involving patients who attempt suicide in suicide prevention: A focus group study. J Psychiatr Ment Health Nurs 2011:18:510–18.9. Kraft TL, Jobes DA, Lineberry TW., Conrad, A., & Kung, S. Brief report: Why suicide? Perceptions of suicidal inpatients and reflections of clinical researchers. Arch Suicide Res 2010:14(4):375-382.10. Sun F, Long A, Tsao L, et al. The healing process following a suicide attempt: Context and intervening conditions. Arch Psychiatr Nurs 2014:28:66–61.11. Montross Thomas L, Palinkas L, et al. Yearning to be heard: What veterans teach us about suicide risk and effective interventions. Crisis 2014:35(3):161–67.12. Long M, Manktelow R, and Tracey A. The healing journey: Help seeking for self-injury among a community population. Qual Health Res 2015:25(7):932–44.13. Carlen P and Bengtsson A. Suicidal patients as experienced by psychiatric nurses in inpatient care. Int J Ment Health Nurs 2007:16:257–65.14. Samuelsson M, Wiklander M, Asberg M, et al. Psychiatric care as seen by the attempted suicide patient. J Adv Nurs 2000:32(3):635–43.15. Cutcliffe JR, Stevenson C, Jackson S, et al. A modified grounded theory study of how psychiatric nurses work with suicidal people. Int J Nurs Studies 2006:43(7):791–802.16. Lakeman, R. What can qualitative research tell us about helping a person who is suicidal? Nurs Times 2010:106(33):23–26.17. Karman P, Kool N, Poslawsky I, et al. Nurses’ attitudes toward self-harm: a literature review. J Psychiatr Ment Health Nurs 2015:22:65–75.18. Carter B. ‘One expertise among many’ – working appreciatively to make miracles instead of finding problems: Using appreciative inquiry as a way of reframing research. J Res Nurs 2006:11(1): 48–63.19. Lieblich A, Tuval-Mashiach R, Zilber T. Narrative research: Reading, analysis, and interpretation. Sage Publications; 1998.20. Braun V and Clarke V. Using thematic analysis in psychology. Qual Res Psychol 2006:3(2):77–101.21. Kishi Y, Otsuka K, Akiyama K, et al. Effects of a training workshop on suicide prevention among emergency room nurses. Crisis 2014:35(5):357–61.

Education is a process on which the future of a nation depends. In addition, a quality educational process is a necessary condition for higher education, without which education will not be competitive. Teachers, educational technologies, methods, tools (visual aids, textbooks, technical devices, etc.), educational management are involved in the process. Education provides general cultural and professionally oriented training of a graduate of the degree of junior specialist, determines the amount of special knowledge, skills and abilities sufficient to solve typical tasks of the specialist in the respective position, including the ability to use theoretical knowledge and practical skills, to perform the technological stages of manufacturing orthopedic prostheses, to provide medical care in emergencies, to assess the impact of dangerous factors on the development of occupational diseases. Education provides the activities of a nurse, which includes organizational functions, determining the needs of patients, the ability to prepare patients for complex laboratory tests and instrumental methods of examination, special care and care for patients, participation in treatment and prevention, conduct an educational work in accordance with the principles of nursing ethics and deontology, constant improvement of professional level, practice of practical skills in the departments of hospitals, hospices and family medicine clinics. Education provides students with the ability to form a worldview, understanding the principles of society, the ability to think abstractly, analyze and synthesize on the basis of logical arguments and verified facts, consider social phenomena in development and specific historical conditions, lead a discussion, use appropriate terminology and thoughts expression in oral and written forms in the native language. Students are taught to use knowledge in the field of socio-economic training, communicate in a foreign language, be ready to work in a foreign language environment using information technology, search for processing and analysis of information from various sources, communicate professionally, provide harmonious and constructive relationships in the performance of professional tasks. At IFNMU Medical College, students learn the ability to interpret and use theoretical knowledge and practical skills on diseases questions, methods of organizing the safety of human life, their protection from the possible consequences of accidents and disasters. At the same time, education, and hence its quality, is not limited to learning outcomes. It is also the physical, intellectual and spiritual development of the individual, the level of his upbringing. That is why well-known scientists do not have a single opinion on the concept of quality education. The quality of education depends on many factors: teaching staff, the level of their skills; resource provision of the educational process; management of the educational process; curricula of educational content and educational and methodological support; effective educational technologies; psychological support of the educational process, as well as from the subjects of education, concerted actions with parents, etc. Of course, education will be of good quality if all components interact effectively. The article highlights the features of providing quality professional before higher education, its interrelation with efficiency of preparation of experts in higher educational institutions is defined.

AbstractEntrustable professional activity (EPA) is a tool for comprehensively evaluating the level of confidence in resident performances across various competencies in medicine. The application of and attitudes towards EPAs in radiology across the European Society of Radiology (ESR) national institutional member societies is still to be determined. An online survey was conducted among ESR national institutional member societies to assess the current use of EPAs and other resident assessment forms among different countries.Although the primary focus was on the use of EPAs, additional questions also addressed the adherence of training programs to the European Training Curriculum (ETC), other methods of continuous assessment, and examinations. A total of 65 responses were received from 38 countries (81% response rate among national institutional member societies). EPAs were being used in radiology in 21% of countries and planned to be used in 26%. Most responders considered EPAs suitable for radiology and, regarding the future, preferred European-level guidelines on EPAs over national or institutional levels. The majority (63%) of national training programs were reported to be similar to or following the content of the ETC, and the majority (95%) of countries rated the requirements of the European Training Curriculum (ETC) to be adequate. In conclusion, EPAs are beginning to be used in radiology resident training programs across Europe, and their use is expected to increase. There seems to be a positive attitude toward using EPAs in radiology and toward a common European framework.Critical relevance statement As a result of this survey, we found positive attitudes towards using entrustable professional activities (EPA) in radiology among the institutional member societies of the European Society of Radiology (ESR).Key points• Twenty-one percent of national member societies use entrustable professional activities (EPA) in radiology.• There is a positive attitude toward using EPAs in radiology.• Majority of respondents preferred a common European framework for EPAs.• Majority of radiology training curricula adhere to the European Training Curriculum (ETC). Graphical Abstract

The aim of the study was to provide an understanding of current practices and perceptions of strength and conditioning (S&C) training in female touring professionals. A cross-sectional, explorative survey was undertaken and contained 30 questions separated into four sections: (i) general participant information, (ii) S&C practices, (iii) Likert scale questions on S&C for golf performance, and (iv) knowledge and awareness of S&C. A total of 102 players completed the survey with a combination of multiple-choice questions (MCQs), open-ended questions, and Likert scale style questions utilised throughout. Results showed that ≥94% of players believed that strength and power in both the lower and upper body, in addition to flexibility, were the most important physical characteristics to complement golf shot metrics (e.g. clubhead speed [CHS], ball speed, carry distance, etc.). However, 26% of players conducted S&C training only in the off-season, with 21% suggesting that they had a fear of injury from S&C training. When considering the barriers to undertaking S&C training, the most common reasons included time constraints (20%) and players wanting to prioritise golf practice (15%). Finally, 58% of players believed that training in the weight room should replicate the golf swing. Although it is positive to see that the main physical characteristics for golf are well-understood by professional players, it is also evident that further education and knowledge translation is required relating to the application of S&C training for performance enhancement and injury risk mitigation purposes.

Aims and method We conducted a cross-sectional survey to examine how undergraduate psychiatry is taught and assessed across medical schools in the UK that have at least one cohort of graduated students. Results In total, 27 medical schools completed the survey. Curriculum coverage of common mental disorders, assessment skills and mental health law was broadly consistent, although exposure to psychiatric subspecialties varied. Significant variation existed regarding the duration of psychiatry placements and availability of enrichment activities. Small-group teaching, lectures and e-learning were the most frequent teaching modalities and various professionals and lived experience educators (patient and/or carers) contributed to teaching. Objective structured clinical examinations and multiple-choice questions dominated assessments. Clinical implications Medical schools should consider increasing students’ exposure to different psychiatric subspecialties and integrating physical and mental health training to address comorbidity and promote holistic care. Future research should explore whether specific undergraduate experiences promote greater career interest and skills in psychiatry.

Abstract HyFlex termed as hybrid-flexibility is a teaching approach where teachers and students have the alternative to participate in planned courses either remotely or face-to-face. This study examines the effectiveness of the HyFlex pedagogical method to teach highly interactive digital and face-to-face cyber security training in Nigeria amidst the pandemic. Data was collected using a survey questionnaire from 113 participants to evaluate student’s perception towards the effectiveness of the Hyflex method using physical and Zoom teleconferencing which allow students to participate remotely in the cyber security training. The developed questionnaire comprising both open-ended and Likert-style questions was administered to purposely sampled participants. Findings from this study presents implementation details on how the HyFlex teaching model was implemented from a developing country context. Besides, findings present challenges and opportunities experienced with adopting the HyFlex pedagogical model, and also offers recommendations to other instructors for employing this teaching model. Findings also reveal that although there were challenges experienced by the students who attended via online such as connectivity issues, competency in using some features in Zoom-conferencing, etc. The students did appreciate the flexibility HyFlex teaching afforded, indicating that HyFlex is a promising teaching approach for fostering engagement of students especially in large-group cyber security courses.

Objectives: Professional athletes have a high prevalence of dental pathology, a low rate of routine dental visits, and a poor understanding of how these factors can affect athletic performance. The purpose of this study is to assess perceptions and behaviors of professional baseball players, specifically minor league professional baseball players (MLPB), in taking care of their oral health. Methods: Spring Training physicals were performed for MLPB players; a dental screening examination component was included. Following the dental screening, each MLPB player was asked to complete a 9-question survey anonymously and voluntarily. These questions included: (1) demographics, (2) attitude/history regarding dental exams and cleanings, and (3) the player’s perception of the dental screening program. An oral health prevention component was also incorporated, in which MLPB players were given plaque disclosing tablets, educated verbally and provided a written explanation on their purpose and usage. Data were analyzed using descriptive statistics and Chi-square tests. Results: A total of 80 MLPB players received dental screening examinations and 42 completed the survey. Players completing the survey were equally represented between Hispanic and non-Hispanic. A significant relationship existed between whether the spring training physical was the main dentist visit and the length of time since last dental exam. Whether the spring training physical was the main dentist visit was also significantly associated with the length of time since last dental cleaning. A significant relationship existed between Hispanic players and Non-Hispanic players as to a belief that preventive education was a beneficial part of the pre-participation dental screening examination. Additionally, a significant relationship was found between Hispanic players and Non-Hispanic players as to having received dental disclosing tablets for take home use (a preventive measure) following a pre-participation dental screening examination. Conclusion: The results of this study suggest that oral health professionals and professional baseball organizations should consider implementing practices whereby they can modify perceptions and activities that contribute to good oral health, especially among Hispanic minor league professional baseball players. One sentence summary: Oral disease prevention education is important for professional athletes, especially among Hispanic minor league professional baseball players.

AbstractBackgroundAlzheimer’s disease is a universal medical and public health challenge. A timely identification of this ailment can enhance both the standard of care and the patient’s quality of life. Alzheimer’s diagnosis includes a critical component called cognitive assessment. These examinations have been carried out by neurologists, manually and digitally since the development of clinical neurological tests. But it’s obvious that integrating AI technologies into such assessments has many advantages. This research paper describes the implementation of a 3‐Dimensional Embodied Conversational Agent to support Neurologists in conducting cognitive assessments in Alzheimer patients.MethodTwenty‐two questions are included in the assessment. The assessment checks different mental abilities of patients such as time orientation, place orientation, ability to recall things, concentration skills, language skills, ability to follow written and oral instructions, visual interpretation skills, etc. A score is given for each correct answer. A normal score must be higher than 24. A score of 24 or less is typically seen as abnormal and indicative of possible cognitive impairment further subject to detailed analysis of a neurologist as the result may occasionally be impacted by certain physical impairments, language or speech barriers, education level, or cultural differences.The 3D agent was created using software such as Blender, iclone7, Adobe Photoshop, JavaScript, and MIT App Inventor. Text‐to‐speech synthesis algorithms were used to convert the questions to speech. The answers given by the user will be recognized using Natural Language Processing (NLP) algorithms. Correspondingly, a score will be awarded. TinyDB is used for local storage and CloudDB for web storage.ResultThe 3D agent receives the speech input, analyzes the input, and provides a vocal response. As per the total score, it will suggest suitable recommendations vocally. Also, an assessment report with the AI impression is generated.ConclusionThe implementation of a 3‐D Embodied Conversational Agent to support Neurologists in conducting cognitive assessment is portrayed in this research. Instead of trying to replace clinicians, Artificial Intelligence aims to help them and make their tasks simpler.

<p>Early childhood center is concerned as the first environment of children second to their home, in which they socialize and come into contact with organized learning. Their holistic development and well-being are directly linked to preschool structures that implement high-quality education programs. The role of early childhood education and care educators is crucial in determining the quality provided (Foti &amp; Sidiropoulou, 2019). <br />The purpose is to clarify the frame of the professional habitus and to enrich its understanding. Also, to further investigate if new questions will raise with regards to early childhood education and care educators, extending to students, studies and fellow workers as well as babies, toddlers and their families. All the information collected could be used for decision-making on redefining the aims of the early childhood education sector as well as the early year educators training organizations babies. The followed method was a quantitative approach, using the methodology of questionnaires. The analysis will be descriptive and will include basic descriptive measures (e.g., mean, standard deviation, mode, etc.), as well as frequency tables. Furthermore, we will compare the mean scores by analyzing their variance using One-Way ANOVA. In total, the analyzed questionnaires were 248. From these questionnaires, it appears that early childhood education and care educators select the title that suits their profession depending on the school they graduated. The pedagogical part of their profession is influenced by their studies and the interaction among colleagues. The importance of the pedagogical team and cooperation is recognized. Cooperation with parents is sought. Specialized help to manage children with physical issues is required. They stand in favor of all forms of future training. Compared to the past, the educational level is evaluated as higher. They are more interested in the essence of their educational work and not so much for appearances through events. To conclude, early childhood education and care educators love their profession and fully understand the importance of their work. They keep evolving in terms of their educational level and understand the necessity of their professional development. They desire to be educated in various ways. The results of this research are important to be further used by employment agencies and universities. Given that lectures, seminars, workshops and conferences are often held, it is important to emphasize in-service training and interventions within the actual field of action of the early childhood education and care educators, i.e. the early childhood center.</p><p> </p><p><strong> Article visualizations:</strong></p><p><img src="/-counters-/soc/0091/a.php" alt="Hit counter" /></p>

BackgroundAdvances in artificial intelligence (AI) technologies, together with the availability of big data in society, creates uncertainties about how these developments will affect healthcare systems worldwide. Compassion is essential for high-quality healthcare and research shows how prosocial caring behaviors benefit human health and societies. However, the possible association between AI technologies and compassion is under conceptualized and underexplored.ObjectivesThe aim of this scoping review is to provide a comprehensive depth and a balanced perspective of the emerging topic of AI technologies and compassion, to inform future research and practice. The review questions were: How is compassion discussed in relation to AI technologies in healthcare? How are AI technologies being used to enhance compassion in healthcare? What are the gaps in current knowledge and unexplored potential? What are the key areas where AI technologies could support compassion in healthcare?Materials and methodsA systematic scoping review following five steps of Joanna Briggs Institute methodology. Presentation of the scoping review conforms with PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews). Eligibility criteria were defined according to 3 concept constructs (AI technologies, compassion, healthcare) developed from the literature and informed by medical subject headings (MeSH) and key words for the electronic searches. Sources of evidence were Web of Science and PubMed databases, articles published in English language 2011–2022. Articles were screened by title/abstract using inclusion/exclusion criteria. Data extracted (author, date of publication, type of article, aim/context of healthcare, key relevant findings, country) was charted using data tables. Thematic analysis used an inductive-deductive approach to generate code categories from the review questions and the data. A multidisciplinary team assessed themes for resonance and relevance to research and practice.ResultsSearches identified 3,124 articles. A total of 197 were included after screening. The number of articles has increased over 10 years (2011, n = 1 to 2021, n = 47 and from Jan–Aug 2022 n = 35 articles). Overarching themes related to the review questions were: (1) Developments and debates (7 themes) Concerns about AI ethics, healthcare jobs, and loss of empathy; Human-centered design of AI technologies for healthcare; Optimistic speculation AI technologies will address care gaps; Interrogation of what it means to be human and to care; Recognition of future potential for patient monitoring, virtual proximity, and access to healthcare; Calls for curricula development and healthcare professional education; Implementation of AI applications to enhance health and wellbeing of the healthcare workforce. (2) How AI technologies enhance compassion (10 themes) Empathetic awareness; Empathetic response and relational behavior; Communication skills; Health coaching; Therapeutic interventions; Moral development learning; Clinical knowledge and clinical assessment; Healthcare quality assessment; Therapeutic bond and therapeutic alliance; Providing health information and advice. (3) Gaps in knowledge (4 themes) Educational effectiveness of AI-assisted learning; Patient diversity and AI technologies; Implementation of AI technologies in education and practice settings; Safety and clinical effectiveness of AI technologies. (4) Key areas for development (3 themes) Enriching education, learning and clinical practice; Extending healing spaces; Enhancing healing relationships.ConclusionThere is an association between AI technologies and compassion in healthcare and interest in this association has grown internationally over the last decade. In a range of healthcare contexts, AI technologies are being used to enhance empathetic awareness; empathetic response and relational behavior; communication skills; health coaching; therapeutic interventions; moral development learning; clinical knowledge and clinical assessment; healthcare quality assessment; therapeutic bond and therapeutic alliance; and to provide health information and advice. The findings inform a reconceptualization of compassion as a human-AI system of intelligent caring comprising six elements: (1) Awareness of suffering (e.g., pain, distress, risk, disadvantage); (2) Understanding the suffering (significance, context, rights, responsibilities etc.); (3) Connecting with the suffering (e.g., verbal, physical, signs and symbols); (4) Making a judgment about the suffering (the need to act); (5) Responding with an intention to alleviate the suffering; (6) Attention to the effect and outcomes of the response. These elements can operate at an individual (human or machine) and collective systems level (healthcare organizations or systems) as a cyclical system to alleviate different types of suffering. New and novel approaches to human-AI intelligent caring could enrich education, learning, and clinical practice; extend healing spaces; and enhance healing relationships.ImplicationsIn a complex adaptive system such as healthcare, human-AI intelligent caring will need to be implemented, not as an ideology, but through strategic choices, incentives, regulation, professional education, and training, as well as through joined up thinking about human-AI intelligent caring. Research funders can encourage research and development into the topic of AI technologies and compassion as a system of human-AI intelligent caring. Educators, technologists, and health professionals can inform themselves about the system of human-AI intelligent caring.

In recent years ecological thinking has been applied to a range of social, cultural, and aesthetic systems, including performing arts as a living system of policy makers, producers, organisations, artists, and audiences. Ecological thinking is systems-based thinking which allows us to see the performing arts as a complex and protean ecosystem; to explain how elements in this system act and interact; and to evaluate its effects on Australia’s social fabric over time. According to Gallasch, ecological thinking is “what we desperately need for the arts.” It enables us to “defeat the fragmentary and utilitarian view of the arts that dominates, to make connections, to establish overviews of the arts that can be shared and debated” (Gallasch NP). The ecological metaphor has featured in debates about the performing arts in Brisbane, Australia, in the last two or three years. A growing state capital on Australia’s eastern seaboard, Brisbane is proud of its performing arts culture. Its main theatre organisations include the state flagship Queensland Theatre Company; the second major presenter of adapted and new text-based performances La Boite Theatre Company; venues which support local and touring performances such as the Judith Wright Centre for Contemporary Arts and the Brisbane Powerhouse; emerging talent incubator Metro Arts; indigenous companies like Kooemba Jdarra; independent physical theatre and circus companies such as Zen Zen Zo and Circa; and contemporary play-producing company 23rd Productions (cf. Baylis 3). Brisbane aspires to be a cultural capital in Australia, Australasia, and the Asia Pacific (Gill). Compared to Australia’s southern capitals Sydney and Melbourne, however, Brisbane does have a relatively low level of performing arts activity across traditional and contemporary theatre, contemporary performance, musicals, circus, and other genres of performance. It has at times been cast as a piecemeal, potentially unsustainable arts centre prone to losing talent to other states. In 2009, John Baylis took up these issues in Mapping Queensland Theatre, an Arts Queensland-funded survey designed to map practices in Brisbane and in Queensland more broadly, and to provide a platform to support future policy-making. This report excited debate amongst artists who, whilst accepting the tenor of Baylis’s criticisms, also lamented the lack of nuanced detail and contextualised relationships its map of Queensland theatre provided. In this paper we propose a new approach to mapping Brisbane’s and Queensland’s theatre that extends Baylis’s “value chain” into a “value ecology” that provides a more textured picture of players, patterns, relationships, and activity levels. A “value chain” approach emphasises linear relationships and gaps between production, distribution, and consumption in a specific sector of the economy. A “value ecology” approach goes further by examining a complex range of rhizomatic relationships between production, distribution, and consumption infrastructure and how they influence each other within a sector of the economy such as the performing arts. Our approach uses a “value ecology” model adapted from Hearn et al. and Cherbo et al. to map and interpret information from the AusStage performing arts database, the Australian Bureau of Statistics, and other sources such as previews, reviews, and an ongoing local blogosphere debate. Building upon Baylis’s work, our approach produces literal and conceptual maps of Queensland’s performing arts as they change over time, with analysis of support, infrastructure, and relationships amongst government, arts organisations, artists, and audiences. As debate on Mapping Queensland Theatre gives way to more considered reflection, and as Baylis develops a follow-up report, our approach captures snapshots of Queensland’s performing arts before, during, and after such policy interventions. It supports debate about how Queensland artists might manage their own sustainability, their own ability to balance artistic, cultural, and economic factors that influence their work in a way that allows them to survive long term, and allows policy makers, producers, and other players to better understand, articulate, assess, and address criticisms. The Ecological Metaphor In recent years a number of commentators have understood the performing arts as an “ecology,” a system characterised by interacting elements, engagements, flows, blockages, breaks, and breakthroughs whose “health” (synonymous in this context with sustainability) depends on relationships between players within and without the system. Traditionally, performing arts policies in Australia have concentrated on singular elements in a system. They have, as Hunt and Shaw argue, “concentrate[d] on individual companies or an individual artist’s practice rather than the sector as a whole” (5, cf. 43). The focus has been on how to structure, support, and measure the success—the aesthetic and social benefits—of individual training institutions, artists, administrators, and arts organisations. The “health” of singular elements has been taken as a sign of the “health” of the system. An ecologies approach, by contrast, concentrates on engagements, energies, and flows as signs of health, and thus sustainability, in a system. Ecological thinking enables policy makers, practitioners, and scholars to go beyond debate about the presence of activity, the volume of activity, and the fate of individual agents as signs of the health or non-health of a system. In an ecologies context, level of activity is not the only indicator of health, and low activity does not necessarily equate with instability or unsustainability. An ecological approach is critical in Brisbane, and in Queensland more broadly, where attempts to replicate the nature or level of activity in southern capitals are not necessarily the best way to shore up the “health” of our performing arts system in our own unique environment. As the locus of our study Queensland is unique. While Queensland has 20% of Australia’s population (OESR; ABS ‘ Population Projections’), and is regularly recognised as a rapidly growing “lifestyle superstate” which values innovation, creativity, and cultural infrastructure (Cunningham), it is still home to significantly less than 20% of Australia’s performing arts producers, and many talented people continue to migrate to the south to pursue career opportunities (Baylis 4, 28). An ecologies approach can break into oft-cited anxieties about artist, activity, and audience levels in Brisbane, and in Queensland, and create new ideas about what a “healthy” local performing arts sector might look like. This might start to infuse some of the social media commentary that currently tends to emphasise the gaps in the sector. Ecologies are complex systems. So, as Costanza says, when we consider ecosystem health, we must consider the overall performance of the system, including its ability to deal with “external stress” (240) from macro-level political, legal, social, cultural, economic, or technological currents that change the broader society this particular sector or ecosystem sits within. In Brisbane, there is a growing population and a desire to pursue a cultural capital tag, but the distinctive geographic, demographic, and behavioural characteristics of Brisbane’s population—and the associated ‘stresses’, conditions, or constraints—mean that striving to replicate patterns of activity seen in Sydney or Melbourne may not be the straightest path to a “healthy” or “sustainable” sector here. The attitudes of the players and the pressures influencing the system are different, so this may be like comparing rainforests with deserts (Costanza), and forgetting that different elements and engagements are in fact “healthy” in different ecosystems. From an ecologies point of view, policy makers and practitioners in Brisbane and in Queensland more broadly might be well advised to stop trying to match Sydney or Melbourne, and to instead acknowledge that a “healthy” ecosystem here may look different, and so generate policy, subsidy, and production systems to support this. An ecological approach can help determine how much activity is in fact necessary to ensure a healthy and sustainable local performing arts sector. It can, in other words, provide a fresh approach that inspires new ideas and strategies for sector sustainability. Brisbane, Baylis and the Blogosphere Debate The ecological metaphor has clearly captured the interest of policy makers as they consider how to make Queensland’s performing arts more sustainable and successful. For Arts Queensland: The view of the sector as a complex and interdependent ‘ecosystem’ is forging new thinking, new practices and new business models. Individual practitioners and organisations are rethinking where they sit within the broader ecology, and what they contribute to the health and vitality of the sector, and how they might address the gaps in services and skills (12). This view informed the commissioning of Mapping Queensland Theatre, an assessment of Queensland’s theatre sector which offers a framework for allocation of resources under the Queensland Arts & Cultural Sector Plan 2010-2013. It also offers a framework for negotiation with funded organisations to ensure “their activities and focus support a harmonious ecology” (Baylis 3) in which all types and levels of practice (emerging, established, touring, and so on) are functioning well and are well represented within the overall mix of activities. Utilising primary and secondary survey sources, Mapping Queensland Theatre seeks: to map individuals, institutions, and organisations who have a stake in developing Queensland’s professional theatre sector; and to apply a “value chain” model of production from supply (training, creation, presentation, and distribution) to demand (audiences) to identify problems and gaps in Queensland’s professional theatre sector and recommend actions to address them. The report is critical of the sector. Baylis argues that “the context for great theatre is not yet in place in Queensland … therefore works of outstandingly high quality will be rare” (28).Whilst acknowledging a lack of ready answers about how much activity is required in a vibrant theatre culture, Baylis argues that “comparisons are possible” (27) and he uses various data sets to compare numbers of new Australian productions in different states. He finds that “despite having 20% of the Australian population, [Queensland] generates a dramatically lower amount of theatre activity” (4, cf. 28). The reason, according to Baylis (20, 23, 25, 29, 32, 40-41, 44), is that there are gaps in the “value chain” of Queensland theatre, specifically in: Support for the current wave of emerging and independent artistsSpace for experimentation Connections between artists, companies, venues and festivals, between and within regional centres, and between Queensland companies and their (inter)national peers Professional development for producers to address the issue of market distributionAudience development “Queensland lacks a critical mass of theatre activity to develop a sustainable theatre culture” (48), and the main gap is in pathways for independent artists. Quality new work does not emerge, energy dissipates, and artists move on. The solution, for Baylis, is to increase support for independent companies (especially via co-productions with mainstage companies), to improve (inter)national touring, and to encourage investment in audience development. Naturally, Queensland’s theatre makers responded to this report. Responses were given, for example, in inaugural speeches by new Queensland Theatre Company director Wesley Enoch and new La Boite Theatre Company director David Berthold, in the media, and in blogosphere commentary on a range of articles on Brisbane performing arts in 2010. The blogosphere debate in particular raged for months and warrants more detailed analysis elsewhere. For the purposes of this paper, though, it is sufficient to note that blogosphere debate about the health of Queensland theatre culture acknowledged many of the deficits Baylis identified and called for: More leadershipMore government supportMore venuesMore diversityMore audience, especially for risky work, and better audience engagementMore jobs and retention of artists Whilst these responses endorse Baylis’s findings and companies have since conceived programs that address Baylis’s criticisms (QTC’s introduction of a Studio Season and La Boite’s introduction of an Indie program in 2010 for example) a sense of frustration also emerged. Some, like former QTC Chair Kate Foy, felt that “what’s really needed in the theatre is a discussion that breaks out from the old themes and encourages fresh ideas—approaches to solving whatever problems are perceived to exist in ‘the system’.” For commentators like Foy the blogosphere debate enacted a kind of ritual rehearsal of an all-too-familiar set of concerns: inadequate and ill-deployed funding, insufficient venues, talent drain, and an impoverished local culture of theatre going. “Value Chains” versus “Value Ecologies” Why did responses to this report demand more artists, more arts organisations, more venues, and more activities? Why did they repeat demands for more government-subsidised venues, platforms, and support rather than drive toward new seed- or non- subsidised initiatives? At one level, this is to do with the report’s claims: it is natural for artists who have been told quality work is “rare” amongst them to point to lack of support to achieve success. At another level, though, this is because—as useful as it has been for local theatre makers—Baylis’s map is premised on a linear chain from training, to first productions, to further developed productions (involving established writers, directors, designers and performers), to opportunities to tour (inter)nationally, etc. It provides a linear image of a local performing arts sector in which there are individuals and institutions with potential, but specific gaps in the production-distribution-consumption chain that make it difficult to deliver work to target markets. It emphasises gaps in the linear pathway towards “stability” of financial, venue, and audience support and thus “sustainability” over a whole career for independent artists and the audiences they attract. Accordingly, asking government to plug the gaps through elements added to the system (venues, co-production platforms, producer hubs, subsidy, and entrepreneurial endeavours) seems like a logical solution. Whilst this is true, it does not tell the whole story. To generate a wider story, we need to consider: What the expected elements in a “healthy” ecosystem would be (e.g. more versus alternative activity);What other aesthetic, cultural, or economic pressures affect the “health” of an ecosystem;Why practices might need to cycle, ebb, and flow over time in a “healthy” ecosystem. A look at the way La Boite works before, during, and after Baylis’s analysis of Brisbane theatre illustrates why attention to these elements is necessary. A long-running company which has made the transition from amateur to professional to being a primary developer of new Australian work in its distinctive in-the-round space, La Boite has recently shifted its strategic position. A focus on text-based Australian plays has given way to adapted, contemporary, and new work in a range of genres; regular co-productions with companies in Brisbane and beyond; and an “Indie” program that offers other companies a venue. This could be read as a response to Baylis’s recommendation: the production-distribution-consumption chain gap for Brisbane’s independents is plugged, the problem is solved, the recommendation has led to the desired result. Such a reading might, though, overlook the range of pressures beyond Brisbane, beyond Queensland, and beyond the Baylis report that drive—and thus help, hinder, or otherwise effect—the shift in La Boite’s program strategies. The fact that La Boite recently lost its Australia Council funding, or that La Boite like all theatre companies needs co-productions to keep its venue running as costs increase, or that La Boite has rebranded to appeal to younger audiences interested in postdramatic, do-it-your-self or junkyard style aesthetics. These factors all influence what La Boite might do to sustain itself, and more importantly, what its long-term impact on Brisbane’s theatre ecology will be. To grasp what is happening here, and get beyond repetitive responses to anxieties about Brisbane’s theatre ecology, detail is required not simply on whether programs like La Boite’s “plugged the gap” for independent artists, but on how they had both predicted and unpredicted effects, and how other factors influenced the effects. What is needed is to extend mapping from a “value chain” to a full ”value ecology”? This is something Hearn et al. have called for. A value chain suggests a “single linear process with one stage leading to the next” (5). It ignores the environment and other external enablers and disregards a product’s relationship to other systems or products. In response they prefer a “value creating ecology” in which the “constellation of firms are [sic] dynamic and value flow is multi-directional and works through clusters of networks” (6). Whilst Hearn et al. emphasise “firms” or companies in their value creating ecology, a range of elements—government, arts organisations, artists, audiences, and the media as well as the aesthetic, social, and economic forces that influence them—needs to be mapped in the value creating ecology of the performing arts. Cherbo et al. provide a system of elements or components which, adapted for a local context like Brisbane or Queensland, can better form the basis of a value ecology approach to the way a specific performing arts community works, adapts, changes, breaks down, or breaks through over time. Figure 1 – Performing Arts Sector Map (adapted from Cherbo et. al. 14) Here, the performing arts sector is understood in terms of core artistic workers, companies, a constellation of generic and sector specific support systems, and wider social contexts (Cherbo et al. 15). Together, the shift from “value chain” to “value ecology” that Hearn et al. advocate, and the constellation of ecology elements that Cherbo et al. emphasise, bring a more detailed, dynamic range of relations into play. These include “upstream” production infrastructure (education, suppliers, sponsors), “downstream” distribution infrastructure (venues, outlets, agents), and overall public infrastructure. As a framework for mapping “value ecology” this model offers a more nuanced perspective on production, distribution, and consumption elements in an ecology. It allows for analysis of impact of interventions in dozens of different areas, from dozens of perspectives, and thus provides a more detailed picture of players, relationships, and results to support both practice and policy making around practice. An Aus-e-Stage Value Ecology To provide the more detailed, dynamic image of local theatre culture that a value ecology approach demands—to show players, relations between players, and context in all their complexity—we use the Aus-e-Stage Mapping Service, an online application that maps data about artists, arts organisations, and audiences across cityscapes/landscapes. We use Aus-e-Stage with data drawn from three sources: the AusStage database of over 50,000 entries on Australian performing arts venues, productions, artists, and reviews; the Australian Bureau of Statistics (ABS) data on population; and the Local Government Area (LGA) maps the ABS uses to cluster populations. Figure 2 – Using AusStage Interface Figure 3 – AusStage data on theatre venues laid over ABS Local Government Area Map Figure 4 – Using Aus-e-Stage / AusStage to zoom in on Australia, Queensland, Brisbane and La Boite Theatre Company, and generate a list of productions, dates and details Aus-e-Stage produces not just single maps, but a sequential series of snapshots of production ecologies, which visually track who does what when, where, with whom, and for whom. Its sequences can show: The way artists, companies, venues, and audiences relate to each other;The way artists’ relationship to companies, venues, and audiences changes over time;The way “external stressors” changes such as policy, industrial, or population changes affect the elements, roles, and relationships in the ecology from that point forward. Though it can be used in combination with other data sources such as interviews, the advantage of AusStage data is that maps of moving ecologies of practice are based not on descriptions coloured by memory but clear, accurate program, preview, and review data. This allows it to show how factors in the environment—population, policy, infrastructure, or program shifts—effect the ecology, effect players in the ecology, and prompt players to adapt their type, level, or intensity of practice. It extends Baylis’s value chain into a full value ecology that shows the detail on how an ecology works, going beyond demands that government plug perceived gaps and moving towards data- and history- based decisions, ideas and innovation based on what works in Brisbane’s performing arts ecology. Our Aus-e-Stage mapping shows this approach can do a number of useful things. It can create sequences showing breaks, blockages, and absences in an individual or company’s effort to move from emerging to established (e.g. in a sudden burst of activity followed by nothing). It can create sequences showing an individual or company’s moves to other parts of Australia (e.g. to tour or to pursue more permanent work). It can show surprising spaces, relations, and sources of support artists use to further their career (e.g. use of an amateur theatre outside the city such as Brisbane Arts Theatre). It can capture data about venues, programs, or co-production networks that are more or less effective in opening up new opportunities for artists (e.g. moving small-scale experiments in Metro Arts’ “Independents” program to full scale independent productions in La Boite’s “Indie” program, its mainstage program, other mainstage programs, and beyond). It can link to program information, documentation, or commentary to compare anticipated and actual effects. It can lay the map dates and movements across significant policy, infrastructure, or production climate shifts. In the example below, for instance, Aus-e-Stage represents the tour of La Boite’s popular production of a new Australian work Zig Zag Street, based on the Brisbane-focused novel by Nick Earls about a single, twentysomething man’s struggles with life, love, and work. Figure 5 – Zig Zag Street Tour Map In the example below, Aus-e-Stage represents the movements not of a play but of a performer—in this case Christopher Sommers—who has been able to balance employment with new work incubator Metro Arts, mainstage and indie producer La Boite, and stage theatre company QTC with his role with independent theatre company 23rd Productions to create something more protean, more portfolio-based or boundary-less than a traditional linear career trajectory. Figure 6 – Christopher Sommers Network Map and Travel Map This value of this approach, and this technology, is clear. Which independents participate in La Boite Indie (or QTC’s “Studio” or “Greenroom” new work programs, or Metro’s emerging work programs, or others)? What benefits does it bring for artists, for independent companies, or for mainstage companies like La Boite? Is this a launching pad leading to ongoing, sustainable production practices? What do artists, audiences or others say about these launching pads in previews, programs, or reviews? Using Aus-e-Stage as part of a value ecology approach answers these questions. It provides a more detailed picture of what happens, what effect it has on local theatre ecology, and exactly which influences enabled this effect: precisely the data needed to generate informed debate, ideas, and decision making. Conclusion Our ecological approach provides images of a local performing arts ecology in action, drawing out filtered data on different players, relationships, and influencing factors, and thus extending examination of Brisbane’s and Queensland’s performing arts sector into useful new areas. It offers three main advances—first, it adopts a value ecology approach (Hearn et al.), second, it adapts this value ecology approach to include not just companies by all up- and down- stream players, supporters and infrastructure (Cherbo et. al.), and, thirdly, it uses the wealth of data available via Aus-e-Stage maps to fill out and filter images of local theatre ecology. It allows us to develop detailed, meaningful data to support discussion, debate, and development of ideas that is less likely to get bogged down in old, outdated, or inaccurate assumptions about how the sector works. Indeed, our data lends itself to additional analysis in a number of ways, from economic analysis of how shifts in policy influence productivity to sociological analysis of the way practitioners or practices acquire status and cultural capital (Bourdieu) in the field. Whilst descriptions offered here demonstrate the potential of this approach, this is by no means a finished exercise. Indeed, because this approach is about analysing how elements, roles, and relationships in an ecology shift over time, it is an ever-unfinished exercise. As Fortin and Dale argue, ecological studies of this sort are necessarily iterative, with each iteration providing new insights and raising further questions into processes and patterns (3). Given the number of local performing arts producers who have changed their practices significantly since Baylis’s Mapping Queensland Theatre report, and the fact that Baylis is producing a follow-up report, the next step will be to use this approach and the Aus-e-Stage technology that supports it to trace how ongoing shifts impact on Brisbane’s ambitions to become a cultural capital. This process is underway, and promises to open still more new perspectives by understanding anxieties about local theatre culture in terms of ecologies and exploring them cartographically. References Arts Queensland. Queensland Arts & Cultural Sector Plan 2010-2013. Brisbane: Arts Queensland, 2010. Australian Bureau of Statistics. “Population Projections, Australia, 2006 to 2101.” Canberra: ABS (2008). 20 June 2011 ‹http://www.abs.gov.au/AUSSTATS/abs@.nsf/Lookup/3222.0Main+Features12006%20to%202101?OpenDocument›. ——-. “Regional Population Growth, Australia, 2008-2009: Queensland.” Canberra: ABS (2010). 20 June 2011 ‹http://www.abs.gov.au/ausstats/abs@.nsf/Latestproducts/3218.0Main%20Features62008-09?opendocument&tabname=Summary&prodno=3218.0&issue=2008-09&num=&view=›. Baylis, John. Mapping Queensland Theatre. Brisbane: Arts Queensland, 2009. Bourdieu, Pierre. “The Forms of Capital.” Handbook of Theory and Research for the Sociology of Education. Ed. John G. Richardson. New York: Greenwood, 1986.241-58. Cherbo, Joni M., Harold Vogel, and Margaret Jane Wyszomirski. “Towards an Arts and Creative Sector.” Understanding the Arts and Creative Sector in the United States. Ed. Joni M. Cherbo, Ruth A. Stewart and Margaret J. Wyszomirski. New Brunswick: Rutgers University Press, 2008. 32-60. Costanza, Robert. “Toward an Operational Definition of Ecosystem Health”. Ecosystem Health: New Goals for Environmental Management. Eds. Robert Costanza, Bryan G. Norton and Benjamin D. Haskell. Washington: Island Press, 1992. 239-56. Cunningham, Stuart. “Keeping Artistic Tempers Balanced.” The Courier Mail, 4 August (2010). 20 June 2012 ‹http://www.couriermail.com.au/news/opinion/keeping-artistic-tempers-balanced/story-e6frerc6-1225901295328›. Gallasch, Keith. “The ABC and the Arts: The Arts Ecologically.” RealTime 61 (2004). 20 June 2011 ‹http://www.realtimearts.net/article/61/7436›. Gill, Raymond. “Is Brisbane Australia’s New Cultural Capital?” Sydney Morning Herald, 16 October (2010). 20 June 2011 ‹http://www.smh.com.au/entertainment/art-and-design/is-brisbane-australias-new-cultural-capital-20101015-16np5.html›. Fortin, Marie-Josée and Dale, Mark R.T. Spatial Analysis: A Guide for Ecologists. Cambridge: Cambridge University Press, 2005. Foy, Kate. “Is There Anything Right with the Theatre?” Groundling. 10 January (2010). 20 June 2011 ‹http://katefoy.com/2010/01/is-there-anything-right-with-the-theatre/›. Hearn, Gregory N., Simon C. Roodhouse, and Julie M. Blakey. ‘From Value Chain to Value Creating Ecology: Implications for Creative Industries Development Policy.’ International Journal of Cultural Policy 13 (2007). 20 June 2011 ‹http://eprints.qut.edu.au/15026/›. Hunt, Cathy and Phyllida Shaw. A Sustainable Arts Sector: What Will It Take? Strawberry Hills: Currency House, 2007. Knell, John. Theatre’s New Rules of Evolution. Available from Intelligence Agency, 2008. Office of Economic and Statistical Research. “Information Brief: Australian Demographic Statistics June Quarter 2009.” Canberra: OESR (2010). 20 June 2012 ‹http://www.oesr.qld.gov.au/queensland-by-theme/demography/briefs/aust-demographic-stats/aust-demographic-stats-200906.pdf›.

Introduction: Bubbles and Sport The ephemeral materiality of bubbles – beautiful, spectacular, and distracting but ultimately fragile – when applied to protect or conserve in the interests of sport-media profit, creates conditions that exacerbate existing inequalities in sport and society. Bubbles are usually something to watch, admire, and chase after in their brief yet shiny lives. There is supposed to be, technically, nothing inside them other than one or more gasses, and yet we constantly refer to people and objects being inside bubbles. The metaphor of the bubble has been used to describe the life of celebrities, politicians in purpose-built capital cities like Canberra, and even leftist, environmentally activist urban dwellers. The metaphorical and material qualities of bubbles are aligned—they cannot be easily captured and are liable to change at any time. In this article we address the metaphorical sporting bubble, which is often evoked in describing life in professional sport. This is a vernacular term used to capture and condemn the conditions of life of elite sportspeople (usually men), most commonly after there has been a sport-related scandal, especially of a sexual nature (Rowe). It is frequently paired with connotatively loaded adjectives like pampered and indulged. The sporting bubble is rarely interrogated in academic literature, the concept largely being left to the media and moral entrepreneurs. It is represented as involving a highly privileged but also pressurised life for those who live inside it. A sporting bubble is a world constructed for its most prized inhabitants that enables them to be protected from insurgents and to set the terms of their encounters with others, especially sport fans and disciplinary agents of the state. The Covid-19 pandemic both reinforced and reconfigured the operational concept of the bubble, re-arranging tensions between safety (protecting athletes) and fragility (short careers, risks of injury, etc.) for those within, while safeguarding those without from bubble contagion. Privilege and Precarity Bubble-induced social isolation, critics argue, encourages a loss of perspective among those under its protection, an entitled disconnection from the usual rules and responsibilities of everyday life. For this reason, the denizens of the sporting bubble are seen as being at risk to themselves and, more troublingly, to those allowed temporarily to penetrate it, especially young women who are first exploited by and then ejected from it (Benedict). There are many well-documented cases of professional male athletes “behaving badly” and trying to rely on institutional status and various versions of the sporting bubble for shelter (Flood and Dyson; Reel and Crouch; Wade). In the age of mobile and social media, it is increasingly difficult to keep misbehaviour in-house, resulting in a slew of media stories about, for example, drunkenness and sexual misconduct, such as when then-Sydney Roosters co-captain Mitchell Pearce was suspended and fined in 2016 after being filmed trying to force an unwanted kiss on a woman and then simulating a lewd act with her dog while drunk. There is contestation between those who condemn such behaviour as aberrant and those who regard it as the conventional expression of youthful masculinity as part of the familiar “boys will be boys” dictum. The latter naturalise an inequitable gender order, frequently treating sportsmen as victims of predatory women, and ignoring asymmetries of power between men and women, especially in homosocial environments (Toffoletti). For those in the sporting bubble (predominantly elite sportsmen and highly paid executives, also mostly men, with an array of service staff of both sexes moving in and out of it), life is reflected for those being protected via an array of screens (small screens in homes and indoor places of entertainment, and even smaller screens on theirs and others’ phones, as well as huge screens at sport events). These male sport stars are paid handsomely to use their skill and strength to perform for the sporting codes, their every facial expression and bodily action watched by the media and relayed to audiences. This is often a precarious existence, the usually brief career of an athlete worker being dependent on health, luck, age, successful competition with rivals, networks, and club and coach preferences. There is a large, aspirational reserve army of athletes vying to play at the elite level, despite risks of injury and invasive, life-changing medical interventions. Responsibility for avoiding performance and image enhancing drugs (PIEDs) also weighs heavily on their shoulders (Connor). Professional sportspeople, in their more reflective moments, know that their time in the limelight will soon be up, meaning that getting a ticket to the sporting bubble, even for a short time, can make all the difference to their post-sport lives and those of their families. The most vulnerable of the small minority of participants in sport who make a good, short-term living from it are those for whom, in the absence of quality education and prior social status, it is their sole likely means of upward social mobility (Spaaij). Elite sport performers are surrounded by minders, doctors, fitness instructors, therapists, coaches, advisors and other service personnel, all supporting athletes to stay focussed on and maximise performance quality to satisfy co-present crowds, broadcasters, sponsors, sports bodies and mass media audiences. The shield offered by the sporting bubble supports the teleological win-at-all-costs mentality of professional sport. The stakes are high, with athlete and executive salaries, sponsorships and broadcasting deals entangled in a complex web of investments in keeping the “talent” pivotal to the “attention economy” (Davenport and Beck)—the players that provide the content for sale—in top form. Yet, the bubble cannot be entirely secured and poor behaviour or performance can have devastating effects, including permanent injury or disability, mental illness and loss of reputation (Rowe, “Scandals and Sport”). Given this fragile materiality of the sporting bubble, it is striking that, in response to the sudden shutdown following the economic and health crisis caused by the 2020 global pandemic, the leaders of professional sport decided to create more of them and seek to seal the metaphorical and material space with unprecedented efficiency. The outcome was a multi-sided tale of mobility, confinement, capital, labour, and the gendering of sport and society. The Covid-19 Gilded Cage Sociologists such as Zygmunt Bauman and John Urry have analysed the socio-politics of mobilities, whereby some people in the world, such as tourists, can traverse the globe at their leisure, while others remain fixed in geographical space because they lack the means to be mobile or, in contrast, are involuntarily displaced by war, so-called “ethnic cleansing”, famine, poverty or environmental degradation. The Covid-19 global pandemic re-framed these matters of mobilities (Rowe, “Subjecting Pandemic Sport”), with conventional moving around—between houses, businesses, cities, regions and countries—suddenly subjected to the imperative to be static and, in perniciously unreflective technocratic discourse, “socially distanced” (when what was actually meant was to be “physically distanced”). The late-twentieth century analysis of the “risk society” by Ulrich Beck, in which the mysterious consequences of humans’ predation on their environment are visited upon them with terrifying force, was dramatically realised with the coming of Covid-19. In another iteration of the metaphor, it burst the bubble of twenty-first century global sport. What we today call sport was formed through the process of sportisation (Maguire), whereby hyper-local, folk physical play was reconfigured as multi-spatial industrialised sport in modernity, becoming increasingly reliant on individual athletes and teams travelling across the landscape and well over the horizon. Co-present crowds were, in turn, overshadowed in the sport economy when sport events were taken to much larger, dispersed audiences via the media, especially in broadcast mode (Nicholson, Kerr, and Sherwood). This lucrative mediation of professional sport, though, came with an unforgiving obligation to generate an uninterrupted supply of spectacular live sport content. The pandemic closed down most sports events and those that did take place lacked the crucial participation of the co-present crowd to provide the requisite event atmosphere demanded by those viewers accustomed to a sense of occasion. Instead, they received a strange spectacle of sport performers operating in empty “cathedrals”, often with a “faked” crowd presence. The mediated sport spectacle under the pandemic involved cardboard cut-out and sex doll spectators, Zoom images of fans on large screens, and sampled sounds of the crowd recycled from sport video games. Confected co-presence produced simulacra of the “real” as Baudrillardian visions came to life. The sporting bubble had become even more remote. For elite sportspeople routinely isolated from the “common people”, the live sport encounter offered some sensory experience of the social – the sounds, sights and even smells of the crowd. Now the sporting bubble closed in on an already insulated and insular existence. It exposed the irony of the bubble as a sign of both privileged mobility and incarcerated athlete work, both refuge and prison. Its logic of contagion also turned a structure intended to protect those inside from those outside into, as already observed, a mechanism to manage the threat of insiders to outsiders. In Australia, as in many other countries, the populace was enjoined by governments and health authorities to help prevent the spread of Covid-19 through isolation and immobility. There were various exceptions, principally those classified as essential workers, a heterogeneous cohort ranging from supermarket shelf stackers to pharmacists. People in the cultural, leisure and sports industries, including musicians, actors, and athletes, were not counted among this crucial labour force. Indeed, the performing arts (including dance, theatre and music) were put on ice with quite devastating effects on the livelihoods and wellbeing of those involved. So, with all major sports shut down (the exception being horse racing, which received the benefit both of government subsidies and expanding online gambling revenue), sport organisations began to represent themselves as essential services that could help sustain collective mental and even spiritual wellbeing. This case was made most aggressively by Australian Rugby League Commission Chairman, Peter V’landys, in contending that “an Australia without rugby league is not Australia”. In similar vein, prominent sport and media figure Phil Gould insisted, when describing rugby league fans in Western Sydney’s Penrith, “they’re lost, because the football’s not on … . It holds their families together. People don’t understand that … . Their life begins in the second week of March, and it ends in October”. Despite misgivings about public safety and equality before the pandemic regime, sporting bubbles were allowed to form, re-form and circulate. The indefinite shutdown of the National Rugby League (NRL) on 23 March 2020 was followed after negotiation between multiple entities by its reopening on 28 May 2020. The competition included a team from another nation-state (the Warriors from Aotearoa/New Zealand) in creating an international sporting bubble on the Central Coast of New South Wales, separating them from their families and friends across the Tasman Sea. Appeals to the mental health of fans and the importance of the NRL to myths of “Australianness” notwithstanding, the league had not prudently maintained a financial reserve and so could not afford to shut down for long. Significant gambling revenue for leagues like the NRL and Australian Football League (AFL) also influenced the push to return to sport business as usual. Sport contests were needed in order to exploit the gambling opportunities – especially online and mobile – stimulated by home “confinement”. During the coronavirus lockdowns, Australians’ weekly spending on gambling went up by 142 per cent, and the NRL earned significantly more than usual from gambling revenue—potentially $10 million above forecasts for 2020. Despite the clear financial imperative at play, including heavy reliance on gambling, sporting bubble-making involved special licence. The state of Queensland, which had pursued a hard-line approach by closing its borders for most of those wishing to cross them for biographical landmark events like family funerals and even for medical treatment in border communities, became “the nation's sporting hub”. Queensland became the home of most teams of the men’s AFL (notably the women’s AFLW season having been cancelled) following a large Covid-19 second wave in Melbourne. The women’s National Netball League was based exclusively in Queensland. This state, which for the first time hosted the AFL Grand Final, deployed sport as a tool in both national sports tourism marketing and internal pre-election politics, sponsoring a documentary, The Sporting Bubble 2020, via its Tourism and Events arm. While Queensland became the larger bubble incorporating many other sporting bubbles, both the AFL and the NRL had versions of the “fly in, fly out” labour rhythms conventionally associated with the mining industry in remote and regional areas. In this instance, though, the bubble experience did not involve long stays in miners’ camps or even the one-night hotel stopovers familiar to the popular music and sport industries. Here, the bubble moved, usually by plane, to fulfil the requirements of a live sport “gig”, whereupon it was immediately returned to its more solid bubble hub or to domestic self-isolation. In the space created between disciplined expectation and deplored non-compliance, the sporting bubble inevitably became the scrutinised object and subject of scandal. Sporting Bubble Scandals While people with a very low risk of spreading Covid-19 (coming from areas with no active cases) were denied entry to Queensland for even the most serious of reasons (for example, the death of a child), images of AFL players and their families socialising and enjoying swimming at the Royal Pines Resort sporting bubble crossed our screens. Yet, despite their (players’, officials’ and families’) relative privilege and freedom of movement under the AFL Covid-Safe Plan, some players and others inside the bubble were involved in “scandals”. Most notable was the case of a drunken brawl outside a Gold Coast strip club which led to two Richmond players being “banished”, suspended for 10 matches, and the club fined $100,000. But it was not only players who breached Covid-19 bubble protocols: Collingwood coaches Nathan Buckley and Brenton Sanderson paid the $50,000 fine imposed on the club for playing tennis in Perth outside their bubble, while Richmond was fined $45,000 after Brooke Cotchin, wife of team captain Trent, posted an image to Instagram of a Gold Coast day spa that she had visited outside the “hub” (the institutionally preferred term for bubble). She was subsequently distressed after being trolled. Also of concern was the lack of physical distancing, and the range of people allowed into the sporting bubble, including babysitters, grandparents, and swimming coaches (for children). There were other cases of players being caught leaving the bubble to attend parties and sharing videos of their “antics” on social media. Biosecurity breaches of bubbles by players occurred relatively frequently, with stern words from both the AFL and NRL leaders (and their clubs) and fines accumulating in the thousands of dollars. Some people were also caught sneaking into bubbles, with Lekahni Pearce, the girlfriend of Swans player Elijah Taylor, stating that it was easy in Perth, “no security, I didn’t see a security guard” (in Barron, Stevens, and Zaczek) (a month later, outside the bubble, they had broken up and he pled guilty to unlawfully assaulting her; Ramsey). Flouting the rules, despite stern threats from government, did not lead to any bubble being popped. The sport-media machine powering sporting bubbles continued to run, the attendant emotional or health risks accepted in the name of national cultural therapy, while sponsorship, advertising and gambling revenue continued to accumulate mostly for the benefit of men. Gendering Sporting Bubbles Designed as biosecurity structures to maintain the supply of media-sport content, keep players and other vital cogs of the machine running smoothly, and to exclude Covid-19, sporting bubbles were, in their most advanced form, exclusive luxury camps that illuminated the elevated socio-cultural status of sportsmen. The ongoing inequalities between men’s and women’s sport in Australia and around the world were clearly in evidence, as well as the politics of gender whereby women are obliged to “care” and men are enabled to be “careless” – or at least to manage carefully their “duty of care”. In Australia, the only sport for women that continued during the height of the Covid-19 lockdown was netball, which operated in a bubble that was one of sacrifice rather than privilege. With minimum salaries of only $30,000 – significantly less than the lowest-paid “rookies” in the AFL – and some being mothers of small children and/or with professional jobs juggled alongside their netball careers, these elite sportswomen wanted to continue to play despite the personal inconvenience or cost (Pavlidis). Not one breach of the netballers out of the bubble was reported, indicating that they took their responsibilities with appropriate seriousness and, perhaps, were subjected to less scrutiny than the sportsmen accustomed to attracting front-page headlines. National Netball League (also known after its Queensland-based naming rights sponsor as Suncorp Super Netball) players could be regarded as fortunate to have the opportunity to be in a bubble and to participate in their competition. The NRL Women’s (NRLW) Premiership season was also completed, but only involved four teams subject to fly in, fly out and bubble arrangements, and being played in so-called curtain-raiser games for the NRL. As noted earlier, the AFLW season was truncated, despite all the prior training and sacrifice required of its players. Similarly, because of their resource advantages, the UK men’s and boy’s top six tiers of association football were allowed to continue during lockdown, compared to only two for women and girls. In the United States, inequalities between men’s and women’s sports were clearly demonstrated by the conditions afforded to those elite sportswomen inside the Women’s National Basketball Association (WNBA) sport bubble in the IMG Academy in Florida. Players shared photos of rodent traps in their rooms, insect traps under their mattresses, inedible food and blocked plumbing in their bubble accommodation. These conditions were a far cry from the luxury usually afforded elite sportsmen, including in Florida’s Walt Disney World for the men’s NBA, and is just one of the many instances of how gendered inequality was both reproduced and exacerbated by Covid-19. Bursting the Bubble As we have seen, governments and corporate leaders in sport were able to create material and metaphorical bubbles during the Covid-19 lockdown in order to transmit stadium sport contests into home spaces. The rationale was the importance of sport to national identity, belonging and the routines and rhythms of life. But for whom? Many women, who still carry the major responsibilities of “care”, found that Covid-19 intensified the affective relations and gendered inequities of “home” as a leisure site (Fullagar and Pavlidis). Rates of domestic violence surged, and many women experienced significant anxiety and depression related to the stress of home confinement and home schooling. During the pandemic, women were also more likely to experience the stress and trauma of being first responders, witnessing virus-related sickness and death as the majority of nurses and care workers. They also bore the brunt of much of the economic and employment loss during this time. Also, as noted above, livelihoods in the arts and cultural sector did not receive the benefits of the “bubble”, despite having a comparable claim to sport in contributing significantly to societal wellbeing. This sector’s workforce is substantially female, although men dominate its senior roles. Despite these inequalities, after the late March to May hiatus, many elite male sportsmen – and some sportswomen - operated in a bubble. Moving in and out of them was not easy. Life inside could be mentally stressful (especially in long stays of up to 150 days in sports like cricket), and tabloid and social media troll punishment awaited those who were caught going “over the fence”. But, life in the sporting bubble was generally preferable to the daily realities of those afflicted by the trauma arising from forced home confinement, and for whom watching moving sports images was scant compensation for compulsory immobility. The ethical foundation of the sparkly, ephemeral fantasy of the sporting bubble is questionable when it is placed in the service of a voracious “media sports cultural complex” (Rowe, Global Media Sport) that consumes sport labour power and rolls back progress in gender relations as a default response to a global pandemic. Covid-19 dramatically highlighted social inequalities in many areas of life, including medical care, work, and sport. For the small minority of people involved in sport who are elite professionals, the only thing worse than being in a sporting bubble during the pandemic was not being in one, as being outside precluded their participation. Being inside the bubble was a privilege, albeit a dubious one. But, as in wider society, not all sporting bubbles are created equal. Some are more opulent than others, and the experiences of the supporting and the supported can be very different. The surface of the sporting bubble may be impermanent, but when its interior is opened up to scrutiny, it reveals some very durable structures of inequality. Bubbles are made to burst. They are, by nature, temporary, translucent structures created as spectacles. As a form of luminosity, bubbles “allow a thing or object to exist only as a flash, sparkle or shimmer” (Deleuze, 52). In echoing Deleuze, Angela McRobbie (54) argues that luminosity “softens and disguises the regulative dynamics of neoliberal society”. The sporting bubble was designed to discharge that function for those millions rendered immobile by home confinement legislation in Australia and around the world, who were having to deal with the associated trauma, risk and disadvantage. Hence, the gender and class inequalities exacerbated by Covid-19, and the precarious and pressured lives of elite athletes, were obscured. We contend that, in the final analysis, the sporting bubble mainly serves those inside, floating tantalisingly out of reach of most of those outside who try to grasp its elusive power. Yet, it is a small group beyond who wield that power, having created bubbles as armoured vehicles to salvage any available profit in the midst of a global pandemic. References AAP. “NRL Makes Desperate Plea to Government as It Announces Season Will Go Ahead.” 7News.com.au 15 Mar. 2020. 8 Mar. 2021 <https://7news.com.au/sport/rugby-league/nrl-makes-desperate-plea-to-government-as-it-announces-season-will-go-ahead-c-745711>. Al Jazeera English. “Sports TV: Faking Spectators and Spectacles.” The Listening Post 26 Sep. 2020 <https://www.youtube.com/watch?v=0AlD63s26sQ&feature=youtu.be&t=827>. Barron, Jackson, Kylie Stevens, and Zoe Zaczek. “WAG Who Broke into COVID-19 Bubble for an Eight-Hour Rendezvous with Her AFL Star Boyfriend Opens Up on ‘How Easy It Was’—and Apologises for ‘Really Big Mistake’ That Cost Club $50,000.” The Daily Mail 19 Aug. 2020. 8 Mar. 2021 <https://www.dailymail.co.uk/news/article-8638959/WAG-AFL-star-sacked-season-coronavirus-breach-reveals-easy-sneak-in.html>. Bauman, Zygmunt. Liquid Modernity. Cambridge: Polity Press, 2000. Beck, Ulrich. Risk Society: Towards a New Modernity. London: Sage, 1992. Benedict, Jeff. Public Heroes, Private Felons: Athletes and Crimes against Women. Boston: Northeastern Uni. Press, 1999. Benfante, Agata, Marialaura di Tella, Annunziata Romeo, and Lorys Castelli. “Traumatic Stress in Healthcare Workers during COVID-19 Pandemic: A Review of the Immediate Impact.” Frontiers in Psychology 11 (23 Oct. 2020). Blaine, Lech. “The Art of Class War.” The Monthly. 17 Aug. 2020. 8 Mar. 2021 <https://www.themonthly.com.au/issue/2020/august/1596204000/lech-blaine/art-class-war#mtr>. Brooks, Samantha K., Rebecca K. Webster, Louise E. Smith, Lisa Woodland, Simon Wessely, Neil Greenberg, and Gideon J. Rubin. “The Psychological Impact of Quarantine and How to Reduce It: Rapid Review of the Evidence.” The Lancet 26 Feb. 2020. 8 Mar. 2021 <https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30460-8/fulltext>. Caust, Jo. “Coronavirus: 3 in 4 Australians Employed in the Creative and Performing Arts Could Lose Their Jobs.” The Conversation 20 Apr. 2020. 8 Mar. 2021 <https://theconversation.com/coronavirus-3-in-4-australians-employed-in-the-creative-and-performing-arts-could-lose-their-jobs-136505>. Connor, James. “The Athlete as Widget: How Exploitation Explains Elite Sport.” Sport in Society 12.10 (2009): 1369–77. Courage, Cara. “Women in the Arts: Some Questions.” The Guardian 5 Mar. 2012. 8 Mar. 2021 <https://www.theguardian.com/culture-professionals-network/culture-professionals-blog/2012/mar/05/women-in-the-arts-introduction>. Davenport, Thomas H., and John C. Beck. The Attention Economy: Understanding the New Currency of Business. Cambridge, MA: Harvard Business Review Press, 2001. Deleuze, Gilles. Foucault. Trans. and ed. S. Hand. Minneapolis: University of Minnesota Press, 1986. Dennien, Matt, and Lydia Lynch. “Footage Shows Relaxed Scenes from AFL Hub amid Calls for Exception Overhaul.” Brisbane Times 3 Sep. 2020. 8 Mar. 2021 <https://www.brisbanetimes.com.au/national/queensland/footage-shows-relaxed-scenes-from-afl-hub-amid-calls-for-exemption-overhaul-20200903-p55s74.html>. Dobeson, Shanee. “Bailey Defends Qld Border Rules after Grieving Mother Denied Entry to Bury Son.” MyGC.com.au 12 Sep. 2020. 8 Mar. 2021 <https://www.mygc.com.au/bailey-defends-qld-border-rules-after-grieving-mother-denied-exemption-to-bury-son>. Dunn, Amelia. “Who Is Deemed an ‘Essential’ Worker under Australia’s COVID-19 Rules?” SBS News 26 Mar. 2020. 8 Mar. 2021 <https://www.youtube.com/watch?v=0AlD63s26sQ&feature=youtu.be&t=827>. Emiko. “Women’s Unpaid Care Work in Australia.” YWCA n.d. 8 Mar. 2021 <https://www.ywca.org.au/opinion/womens-unpaid-care-work-in-australia>. Fullagar, Simone, and Adele Pavlidis. “Thinking through the Disruptive Effects and Affects of the Coronavirus with Feminist New Materialism.” Leisure Sciences (2020). 8 Mar. 2021 <https://www.tandfonline.com/doi/abs/10.1080/01490400.2020.1773996?journalCode=ulsc20>. Flood, Michael, and Sue Dyson. “Sport, Athletes, and Violence against Women.” NTV Journal 4.3 (2007): 37–46. Goodwin, Sam. “AFL Boss Left Fuming over ‘Out of Control’ Quarantine Party.” Yahoo! Sport 8 Sep. 2020. 8 Mar. 2021 <https://au.sports.yahoo.com/afl-2020-uproar-out-of-control-quarantine-party-224251554.html>. Griffith News. “New Research Shows Why Musicians among the Hardest Hit by COVID-19.” 18 June 2020. 8 Mar. 2021 <https://news.griffith.edu.au/2020/06/18/new-research-shows-why-musicians-among-the-hardest-hit-by-COVID-19>. Hart, Chloe. “‘This Is the Hardest It’s Going to Get’: NZ Warriors Open Up about Relocating to Australia for NRL.” ABC News 8 Aug. 2020. 8 Mar. 2021 <https://www.abc.net.au/news/2020-08-08/nz-warriors-open-up-about-relocation-to-australia-for-nrl/12531074>. Hooper, James. “10 Broncos Hit with Fines as Club Cops Huge Sanction over Pub Bubble Breach.” Fox Sports 18 Aug. 2020. 8 Mar. 2021 <https://www.foxsports.com.au/nrl/nrl-premiership/teams/broncos/nrl-2020-brisbane-broncos-pub-covid19-bubble-breach-fine-sanctions-who-was-at-the-pub/news-story/d3bd3c559289a8b83bc3fccbceaffe78>. Hytner, Mike. “AFL Suspends Season and Cancels AFLW amid Coronavirus Crisis.” The Guardian 22 Mar. 2020. 8 Mar. 2021 <https://www.theguardian.com/sport/2020/mar/22/afl-nrl-and-a-league-press-on-despite-restrictions>. Jones, Wayne. “Ray of Hope for Medical Care across Border.” Echo Netdaily 14 Aug. 2020. 8 Mar. 2021 <https://www.echo.net.au/2020/08/ray-of-hope-for-medical-care-across-border>. Jouavel, Levi. “Women’s Football Shutdowns: ‘It’s Unfair Boys’ Academies Can Still Play’.” BBC News 10 Nov. 2020. 8 Mar. 2021 <https://www.bbc.com/news/newsbeat-54876198>. Keh, Andrew. “We Hope Your Cheers for This Article Are for Real.” The New York Times 16 June 2020. 8 Mar. 2021 <https://www.nytimes.com/2020/06/16/sports/coronavirus-stadium-fans-crowd-noise.html>. Kennedy, Else. “‘The Worst Year’: Domestic Violence Soars in Australia during COVID-19.” The Guardian 1 Dec. 2020. 8 Mar. 2021 <https://www.theguardian.com/society/2020/dec/01/the-worst-year-domestic-violence-soars-in-australia-during-COVID-19>. Keoghan, Sarah. “‘Everyone’s Concerned’: Players Cop 70% Pay Cut.” Sydney Morning Herald 28 Mar. 2020. 8 Mar. 2021 <https://www.smh.com.au/sport/netball/everyone-s-concerned-players-cop-70-per-cent-pay-cut-20200328-p54esz.html>. Knox, Malcolm. “Gambling’s Share of NRL Revenue Could Well Double: That Brings Power.” Sydney Morning Herald. 15 May 2020. 8 Mar. 2021 <https://www.smh.com.au/sport/gambling-s-share-of-nrl-revenue-could-well-double-that-brings-power-20200515-p54tbg.html>. McGrath, Pat. “Racing Victoria Got $16.6 Million in Emergency COVID Funding: Then Online Horse Racing Gambling Revenue Skyrocketed.” ABC News 3 Nov. 2020. 8 Mar. 2021 <https://www.abc.net.au/news/2020-11-03/racing-victoria-emergency-coronavirus-COVID-funding/12838012>. McRobbie, Angela. The Aftermath of Feminism: Gender, Culture and Social Change. Thousand Oaks, CA: Sage, 2009. Madden, Helena. “Lebron James’s Suite in the NBA Bubble Is Fit for a King.” Robb Report 16 Sep. 2020. 8 Mar. 2021 <https://robbreport.com/travel/hotels/lebron-james-nba-bubble-suite-1234569303>. Maguire, Joseph. “Sportization.” The Blackwell Encyclopedia of Sociology. Ed. George Ritzer. Oxford: Blackwell, 2007. 4710–11. Mathieson, Craig. “Michael Jordan Pierces the Bubble of Elite Sport in Juicy ESPN Doco.” Sydney Morning Herald. 13 May 2020. 8 Mar. 2021 <https://www.smh.com.au/culture/tv-and-radio/michael-jordan-pierces-the-bubble-of-elite-sport-in-juicy-espn-doco-20200511-p54rwc.html>. Maurice, Megan. “Australia’s Summer of Cricket during COVID Is about Money and Power—and Men”. 6 Jan. 2021. 8 Mar. 2021 <https://www.theguardian.com/sport/2021/jan/06/australias-summer-of-cricket-during-COVID-is-about-money-and-power-and-men>. Murphy, Catherine. “Cricket Australia Contributed to Circumstances Surrounding Ball-Tampering Scandal, Review Finds”. ABC News 20 Oct. 2018. 8 Mar. 2021 <https://www.abc.net.au/news/2018-10-29/scathing-report-released-into-cricket-australia-culture/10440972>. News.com.au. “How an AFL Star Wide’s Instagram Post Led to a Hefty Fine and a Journalist Being Stood Down.” NZ Herald 3 Aug. 2020. 8 Mar. 2021 <https://www.nzherald.co.nz/sport/how-an-afl-star-wifes-instagram-post-led-to-a-hefty-fine-and-a-journalist-being-stood-down/7IDR4SXQ6QW5WDFBV42BK3M7YQ>. Nicholson, Matthew, Anthony Kerr, and Merryn Sherwood. Sport and the Media: Managing the Nexus. 2nd ed. London: Routledge, 2015. Pavlidis, Adele. “Being Grateful: Materialising ‘Success’ in Women’s Contact Sport.” Emotion, Space and Society 35 (2020). 8 Mar. 2021 <https://www.sciencedirect.com/science/article/abs/pii/S1755458620300207>. Phillips, Sam. “‘The Future of the Season Is in Their Hands’: Palaszczuk’s NRL Warning.” Sydney Morning Herald 10 Aug. 2020. 8 Mar. 2021 <https://www.smh.com.au/sport/nrl/the-future-of-the-season-is-in-their-hands-palaszczuk-s-nrl-warning-20200810-p55k7j.html>. Pierik, Jon, and Ryan, Peter. “‘I Own the Consequences’: Stack, Coleman-Jones Apologise for Gold Coast Incident.” The Age 5 Sep. 2020. 8 Mar. 2021 <https://www.theage.com.au/sport/afl/i-own-the-consequences-stack-apologises-for-gold-coast-incident-20200905-p55spq.html>. Poposki, Claudia, and Louise Ayling. “AFL Star’s Wife Who Caused Uproar by Breaching Quarantine to Go to a Spa Reveals She’s Been Smashed by Vile Trolls.” Daily Mail Australia 29 Aug. 2020. 8 Mar. 2021 <https://www.dailymail.co.uk/news/article-8674083/AFL-WAG-Brooke-Cotchin-breached-COVID-19-quarantine-spa-cops-abuse-trolls.html>. Ramsey, Michael. “Axed Swan Spared Jail over Ex-Girlfriend Assault.” AFL.com.au 2 Dec. 2020. 8 Mar. 2021 <https://www.afl.com.au/news/526677/axed-swan-spared-jail-over-ex-girlfriend-assault>. Read, Brent. “The NRL Is Set to Finish the Season on a High after Stunning Financial Results.” The Australian 1 Dec. 2020. 8 Mar. 2021 <https://www.theaustralian.com.au/sport/nrl/the-nrl-is-set-to-finish-the-season-on-a-high-after-stunning-financial-results/news-story/1ce9c2f9b598441d88daaa8cc2b44dc1>. Reel, Justine, J., and Emily Crouch. “#MeToo: Uncovering Sexual Harassment and Assault in Sport.” Journal of Clinical Sport Psychology 13.2 (2018): 177–79. Rogers, Michael. “Buckley, Sanderson to Pay Pies’ Huge Fine for COVID Breach.” AFL.com.au 1 Aug. 2020. 8 Mar. 2021 <https://www.afl.com.au/news/479118/buckley-sanderson-to-pay-pies-huge-fine-for-COVID-breach>. Richardson, David, and Richard Denniss. “Gender Experiences during the COVID-19 Lockdown: Women Lose from COVID-19, Men to Gain from Stimulus.” The Australia Institute June 2020. 8 Mar. 2021 <https://australiainstitute.org.au/report/gender-experiences-during-the-COVID-19-lockdown>. Rowe, David. “All Sport Is Global: A Hard Lesson from the Pandemic.” Open Forum 28 Mar. 2020. 8 Mar. 2021 <https://www.openforum.com.au/all-sport-is-global-a-hard-lesson-from-the-pandemic>. ———. “And the Winner Is … Television: Spectacle and Sport in a Pandemic.” Open Forum 19 Sep. 2020. 8 Mar. 2021 <https://www.openforum.com.au/and-the-winner-istelevision-spectacle-and-sport-in-a-pandemic>. ———. Global Media Sport: Flows, Forms and Futures. London: Bloomsbury, 2011. ———. “Scandals and Sport.” Routledge Companion to Media and Scandal. Eds. Howard Tumber and Silvio Waisbord. London: Routledge, 2019. 324–32. ———. “Subjecting Pandemic Sport to a Sociological Procedure.” Journal of Sociology 56.4 (2020): 704–13. Schout, David. “Cricket Prepares for Mental Health Challenges Thrown Up by Bubble Life.” The Guardian 8 Nov. 2020. 8 Mar. 2021 <https://www.theguardian.com/sport/2020/nov/08/cricket-prepares-for-mental-health-challenges-thrown-up-by-bubble-life>. Spaaij, Ramón. Sport and Social Mobility: Crossing Boundaries. London: Routledge, 2011. The Sporting Bubble. Dir. Peter Dickson. Nine Network Australia, 2020. Swanston, Tim. “With Coronavirus Limiting Interstate Movement, Queensland Is the Nation’s Sporting Hub—Is That Really Safe?” ABC News 29 Aug. 2020. 8 Mar. 2021 <https://www.abc.net.au/news/2020-08-29/coronavirus-queensland-rules-for-sports-teams-explainer/12542634>. Toffoletti, Kim. “How Is Gender-Based Violence Covered in the Sporting News? An Account of the Australian Football League Sex Scandal.” Women's Studies International Forum 30.5 (2007): 427–38. Urry, John. Mobilities. Cambridge: Polity Press, 2007. Walter, Brad. “From Shutdown to Restart: How NRL Walked Tightrope to Get Season Going Again.” NRL.com 25 May 2020. 8 Mar. 2021 <https://www.nrl.com/news/2020/05/25/from-shutdown-to-restart-how-nrl-walked-tightrope-to-get-season-going-again>. Wade, Lisa. “Rape on Campus: Athletes, Status, and the Sexual Assault Crisis.” The Conversation 7 Mar. 2017. 8 Mar. 2021 <https://theconversation.com/rape-on-campus-athletes-status-and-the-sexual-assault-crisis-72255>. Webster, Andrew. “Sydney Roosters’ Mitchell Pearce Involved in a Drunken Incident with a Dog? And Your Point Is ...?” Sydney Morning Herald 28 Jan. 2016. 8 Mar. 2021 <https://www.smh.com.au/sport/nrl/sydney-roosters-mitchell-pearce-involved-in-a-drunken-incident-with-a-dog-and-your-point-is--20160127-gmfemh.html>. Whittaker, Troy. “Three-Peat Not Driving Broncos in NRLW Grand Final.” NRL.com 24 Oct. 2020. 8 Mar. 2021 <https://www.nrl.com/news/2020/10/24/three-peat-not-driving-broncos-in-nrlw-grand-final>. Yahoo! Sport Staff. “‘Not Okay’: Uproar over ‘Disgusting’ Find inside Quarantine.” Yahoo! Sport 9 July 2020. 8 Mar. 2021 <https://au.sports.yahoo.com/wnba-disturbing-conditions-coronavirus-bubble-slammed-003557243.html>.