Engaging rural communities in health care through a paramedic expanded scope of practice

Introduction: This article explores how community engagement by paramedics in an expanded scope role contributes to both primary health care and to an overall improved emergency response capacity in rural communities. Understanding how expanded scope paramedics (ESP) can strengthen community healthcare collaborations is an important need in rural areas where low workforce numbers necessitate innovation.Methods: Four examples of Australian rural ESP roles were studied in Tasmania, New South Wales, South Australia and Victoria to gather information on consistent elements that could inform a paramedic expanded scope model. Qualitative data were collected from semi-structured interviews with key stakeholders and organisational documents. Thematic analysis within and across cases found community engagement was a key element in the varied roles. This article relies heavily on data from the Victorian and Tasmanian case studies because community engagement was a particularly strong aspect of these cases.Results: The ESP in the case studies increased interactions between ambulance services and rural communities with an overall benefit to health care through: increasing community response capacity; linking communities more closely to ambulance services; and increasing health promotion and illness prevention work at the community level. Leadership, management and communication skills are important for paramedics to successfully undertake expanded scope roles.Conclusion: ESP in rural locations can improve health care beyond direct clinical skill by active community engagement that expands the capacity of other community members and strengthens links between services and communities. As health services look to gain maximum efficiency from the health workforce, understanding the intensification of effort that can be gained from practitioner and community coalitions provides important future directions.<br /

The organisational and human resource challenges facing primary care trusts : protocol of a multiple case study

BACKGROUND: The study is designed to assess the organisational and human resource challenges faced by Primary Care Trusts (PCTs). Its objectives are to: specify the organisational and human resources challenges faced by PCTs in fulfilling the roles envisaged in government and local policy; examine how PCTs are addressing these challenges, in particular, to describe the organisational forms they have adopted, and the OD/HR strategies and initiatives they have planned or in place; assess how effective these structures, strategies and initiatives have been in enabling the PCTs to meet the organisational and human resources challenges they face; identify the factors, both internal to the PCT and in the wider health community, which have contributed to the success or failure of different structures, strategies and initiatives. METHODS: The study will be undertaken in three stages. In Stage 1 the key literature on public sector and NHS organisational development and human resources management will be reviewed, and discussions will be held with key researchers and policy makers working in this area. Stage 2 will focus on detailed case studies in six PCTs designed to examine the organisational and human resources challenges they face. Data will be collected using semi-structured interviews, group discussion, site visits, observation of key meetings and examination of local documentation. The findings from the case study PCTs will be cross checked with a Reference Group of up to 20 other PCG/Ts, and key officers working in organisational development or primary care at local, regional and national level. In Stage 3 analysis of findings from the preparatory work, the case studies and the feedback from the Reference Group will be used to identify practical lessons for PCTs, key messages for policy makers, and contributions to further theoretical development

Extending the paramedic role in rural Australia : a story of flexibility and innovation

Introduction: This article identifies trends in the evolving practice of rural paramedics and describes key characteristics, roles and expected outcomes for a Rural Expanded Scope of Practice (RESP) model.Methods: A multiple case study methodology was employed to examine the evolution of rural paramedic practice. Paramedics, volunteer ambulance officers and other health professionals were interviewed in four rural regions of south-eastern Australia where innovative models of rural paramedic practice were claimed to exist. The research team collected and thematically analysed the data using the filter of a sociological framework throughout 2005 and 2006.Results: The study found that paramedics are increasingly becoming first line primary healthcare providers in small rural communities and developing additional professional responsibilities throughout the cycle of care.Conclusions: Adoption of the RESP model would mean that paramedics undertake four broad activities as core components of their new role: (1) rural community engagement; (2) emergency response; (3) situated practice; and (4) primary health care. The model&rsquo;s key feature is a capacity to integrate existing paramedic models with other health agencies and health professionals to ensure that paramedic care is part of a seamless system that provides patients with well-organized and high quality care. This expansion of paramedics&rsquo; scope of practice offers the potential to improve patient care and the general health of rural communities.<br /

To Act and Learn: A Bakhtinian Exploration of Action Learning

This paper considers the work of the Russian social philosopher and cultural theorist, Mikhail Mikhailovich Bakhtin as a source of understanding for those involved in action learning. Drawing upon data gathered over two years during the evaluation of 20 action learning sets in the north of England, we will seek to work with the ideas of Bakhtin to consider their value for those involved in action learning. We consider key Bakhtin features such as Making Meaning, Participative Thinking, Theoreticism and Presence, Others and Outsideness, Voices and Carnival to highlight how Bakhtin's can enhance our understanding of the nature of action and learning

A simple inverse method for the interpretation of pumped flowing fluid electrical conductivity logs

Pumped flowing fluid electrical conductivity (FFEC) logs, also known as pumped borehole dilution testing, is an experimentally easy‐to‐perform approach to evaluating vertical variations in the hydraulic conductivity of an aquifer. In contrast to the simplicity of the logging equipment, analysis of the data is complex and laborious. Current methods typically require repeated solution of the advection‐dispersion equation (ADE) for describing the flow in the borehole and comparison with the experimental results. In this paper, we describe a direct solution for determining borehole fluid velocity that bypasses the need for complex numerical computation and repetitive optimization. The method rests on the observation that, while solving the ADE for concentration profile in the borehole (as required for modeling and combined methods) is computationally challenging, the solution for flow distribution along the length of the borehole given concentration data is straightforward. The method can accommodate varying borehole diameters, and uses the fact that multiple profiles are taken in the standard logging approach to reduce the impact of noise. Data from both a simulated borehole and from a field test are successfully analyzed. The method is implemented in a spreadsheet, which is available as supporting information material to this paper

Radio-Excess IRAS Galaxies: PMN/FSC Sample Selection

A sample of 178 extragalactic objects is defined by correlating the 60 micron IRAS FSC with the 5 GHz PMN catalog. Of these, 98 objects lie above the radio/far-infrared relation for radio-quiet objects. These radio-excess galaxies and quasars have a uniform distribution of radio excesses and appear to be a new population of active galaxies not present in previous radio/far-infrared samples. The radio-excess objects extend over the full range of far-infrared luminosities seen in extragalactic objects. Objects with small radio excesses are more likely to have far-infrared colors similar to starbursts, while objects with large radio excesses have far-infrared colors typical of pure AGN. Some of the most far-infrared luminous radio-excess objects have the highest far-infrared optical depths. These are good candidates to search for hidden broad line regions in polarized light or via near-infrared spectroscopy. Some low far-infrared luminosity radio-excess objects appear to derive a dominant fraction of their far-infrared emission from star formation, despite the dominance of the AGN at radio wavelengths. Many of the radio-excess objects have sizes likely to be smaller than the optical host, but show optically thin radio emission. We draw parallels between these objects and high radio luminosity Compact Steep-Spectrum (CSS) and GigaHertz Peaked-Spectrum (GPS) objects. Radio sources with these characteristics may be young AGN in which the radio activity has begun only recently. Alternatively, high central densities in the host galaxies may be confining the radio sources to compact sizes. We discuss future observations required to distinguish between these possibilities and determine the nature of radio-excess objects.Comment: Submitted to AJ. 44 pages, 11 figures. A version of the paper with higher quality figures is available from http://www.mso.anu.edu.au/~cdrake/PMNFSC/paperI

Innovation development – an action learning programme for medical scientists and engineers

© 2014, © 2014 Taylor & Francis. There is increasing evidence that action learning is valuable in a higher education setting. This paper goes on to report a personal development programme, based on principles of critical action learning, where the aim is to equip early-career scientists and engineers working in a university setting with the knowledge, skills and confidence to approach the management of innovation. After learning about action learning and critical reflection, the participants, all postdoctorate researchers, completed innovation projects at work, meeting in action learning sets as they proceed. We explain a method of critical thinking before reporting results from an evaluation study based on interviews and focus groups. We consider examples of projects undertaken before considering challenges for students with this approach to learning. Challenges included scepticism about the usefulness of management literature, difficulties in finding ‘problems’ within the constraints of postdoctoral work, and the discomfort and intensiveness of action learning. However, through adaptation by the tutors with students, some significant results were achieved

Experiencing uncertainty – on the potential of groups and a group analytic approach for making management education more critical.

This document is the Accepted Manuscript. The final, definitive version of this paper has been published in Management Learning, November 2017, DOI: https://doi.org/10.1177/1350507617697868. Published by SAGE Publishing. All rights reserved.This article points to the potential of methods derived from group analytic practice for making management education more critical. It draws on the experience of running a professional doctorate for more experienced managers in a university in the UK over a 16 year period. Group analysis is informed by the highly social theories of S.H. Foulkes and draws heavily on psychoanalytic theory as well as sociology. First and foremost, though, it places our interdependence at the heart of the process of inquiry, and suggests that the most potent place for learning about groups, where we spend most of our lives, is in a group. The article prioritises three areas of management practice for which group analytic methods, as adapted for research environment, are most helpful: coping with uncertainty and the feelings of anxiety which this often arouses; thinking about leadership as a relational and negotiated activity, and encouraging reflexivity in managers. The article also points to some of the differences between the idea of the learning community and psychodynamic perspectives more generally and the limitations of group analytic methods in particular, which may pathologise resistance in the workplace.Peer reviewe

Radio Properties of Infrared Selected Galaxies in the IRAS 2 Jy Sample

The radio counterparts to the IRAS Redshift Survey galaxies are identified in the NRAO VLA Sky Survey (NVSS) catalog. Our new catalog of the infrared flux-limited (S60 >= 2 Jy) complete sample of 1809 galaxies lists accurate radio positions, redshifts, and 1.4 GHz radio and IRAS fluxes. This sample is six times larger in size and five times deeper in redshift coverage (to z ~ 0.15) compared with those used in earlier studies of the radio and far-infrared (FIR) properties of galaxies in the local volume. The well known radio-FIR correlation is obeyed by the overwhelming majority (>98%) of the infrared-selected galaxies, and the radio AGNs identified by their excess radio emission constitute only about 1% of the sample, independent of the IR luminosity. These FIR-selected galaxies can account for the entire population of late-type field galaxies in the local volume, and their radio continuum may be used directly to infer the extinction-free star formation rate in most cases. Both the 1.4 GHz radio and 60 micron infrared luminosity functions are reasonably well described by linear sums of two Schechter functions, one representing normal, late-type field galaxies and the second representing starbursts and other luminous infrared galaxies. The integrated FIR luminosity density for the local volume is 4.8+/-0.5 x 10^7 L(sun) per Mpc^3, less than 10% of which is contributed by the luminous infrared galaxies with L(FIR) > 10^{11} L(sun) . The inferred extinction-free star formation density for the local volume is 0.015 +/- 0.005 solar mass per year per Mpc^3.Comment: 34 pages with 15 embedded figures and 7 tables. Latex using aastex and psfig.sty. To appear in the Astrophysical Journal (2001) (typos corrected and Fig. 13 replaced in v2.