60 research outputs found
Exploring example models of cross-sector, sessional employment of pharmacists to improve medication management and pharmacy support in rural hospitals
INTRODUCTION: Many rural hospitals in Australia are not large enough to sustain employment of a full-time pharmacist, or are unable to recruit or retain a full-time pharmacist. The absence of a pharmacist may result in hospital nurses undertaking medication-related roles outside their scope of practice. A potential solution to address rural hospitals' medication management needs is contracted part-time ('sessional') employment of a local pharmacist external to the hospital ('cross-sector'). The aim of this study was to explore the roles and experiences of pharmacists in their provision of sessional services to rural hospitals with no on-site pharmacist and explore how these roles could potentially address shortfalls in medication management in rural hospitals. METHODS: A qualitative study was conducted to explore models with pharmacists who had provided sessional services to a rural hospital. A semi-structured interview guide was informed by a literature review, preliminary research and stakeholder consultation. Participants were recruited via advertisement and personal contacts. Consenting pharmacists were interviewed between August 2012 and January 2013 via telephone or Skype for 40-55 minutes.RESULTS: Thirteen pharmacists with previous or ongoing hospital sessional contracts in rural communities across Australia and New Zealand participated. Most commonly, the pharmacists provided weekly services to rural hospitals. All believed the sessional model was a practical solution to increase hospital access to pharmacist-mediated support and to address medication management gaps. Roles perceived to promote quality use of medicines were inpatient consultation services, medicines information/education to hospital staff, assistance with accreditation matters and system reviews, and input into pharmaceutical distribution activities. CONCLUSIONS: This study is the first to explore the concept of sessional rural hospital employment undertaken by pharmacists in Australia and New Zealand. Insights from participants revealed that their sessional employment model increased access to pharmacist-mediated medication management support in rural hospitals. The contracting arrangements and scope of services may be evaluated and adapted in other rural hospitals
Ghosts in the Garden: locative gameplay and historical interpretation from below
© 2017 Steve Poole. Published with licence by Informa UK Limited, trading as Taylor & Francis Group. The heritage industry now makes extensive use of digital audioguides and similar interpretation tools to reach new audiences but many remain rooted in authoritative and didactic conservatism. This paper critically evaluates the state of play in the field, from downloadable audio tours and apps, through more complex engagements with theatrically enhanced and affective simulation, to attempts at fuller dialogic visitor participation and the use of gps or RFID-triggered game mechanics. While âarmchairâ and home screen-based game and interpretation models are addressed, particular attention is paid to the use of mobile and locative design, where embodiment in place is privileged over less associative or remote experience. The paper takes a research project led by the author as a case study. Ghosts in the Garden was conceived in collaboration with a museum and an experience design SME to test the potential of immersive, affective real world games on public understandings of history. It sought to engage visitors with researched history from below by using a pervasive media soundscape, the âghostsâ of past visitors and a âchoose-your-own-adventureâ game mechanic in which outcomes are variable, visitor agency is retained and a more radical model of historical knowledge suggested
Cross-sector, sessional employment of pharmacists in rural hospitals in Australia and New Zealand: a qualitative study exploring pharmacistsâ perceptions and experiences
Background: Many rural hospitals in Australia and New Zealand do not have an on-site pharmacist. Sessional employment of a local pharmacist offers a potential solution to address the clinical service needs of non-pharmacist rural hospitals. This study explored sessional service models involving pharmacists and factors (enablers and challenges) impacting on these models, with a view to informing future sessional employment. Methods: A series of semi-structured one-on-one interviews was conducted with rural pharmacists with experience, or intention to practise, in a sessional employment role in Australia and New Zealand. Participants were identified via relevant newsletters, discussion forums and referrals from contacts. Interviews were conducted during August 2012-January 2013 via telephone or Skypeâą, for approximately 40â55 minutes each, and recorded.Results: Seventeen pharmacists were interviewed: eight with ongoing sessional roles, five with sessional experience, and four working towards sessional employment. Most participants provided sessional hospital services on a weekly basis, mainly focusing on inpatient medication review and consultation. Recognition of the value of pharmacistsâ involvement and engagement with other healthcare providers facilitated establishment and continuity of sessional services. Funds pooled from various sources supplemented some pharmacistsâ remuneration in the absence of designated government funding. Enhanced employment opportunities, district support and flexibility in services facilitated the continuous operation of the sessional service. Conclusions: There is potential to address clinical pharmacy service needs in rural hospitals by cross-sector employment of pharmacists. The reported sessional model arrangements, factors impacting on sessional employment of pharmacists and learnings shared by the participants should assist development of similar models in other rural communities
Settler state apologies and the elusiveness of forgiveness : The purification ritual that does not purify
Peer reviewedPostprin
Maximising the availability and use of high quality evidence for policymaking:Collaborative, targeted and efficient evidence reviews
Abstract A number of barriers have been identified to getting evidence into policy. In particular, a lack of policy relevance and lack of timeliness have been identified as causing tension between researchers and policy makers. Rapid reviews are used increasingly as an approach to address timeliness, however, there is a lack of consensus on the most effective review methods and they do not necessarily address the need of policy makers. In the course of our work with the Scottish Governmentâs Review of maternity and neonatal services we developed a new approach to evidence synthesis, which this paper will describe. We developed a standardised approach to produce collaborative, targeted and efficient evidence reviews for policy making. This approach aimed to ensure the reviews were policy relevant, high quality and up-to-date, and which were presented in a consistent, transparent, and easy to access format. The approach involved the following stages: 1) establishing a review team with expertise both in the topic and in systematic reviewing, 2) clarifying the review questions with policy makers and subject experts (i.e., health professionals, service user representatives, researchers) who acted as review sponsors, 3) developing review protocols to systematically identify quantitative and qualitative review-level evidence on effectiveness, sustainability and acceptability; if review level evidence was not available, primary studies were sought, 4) agreeing a framework to structure the analysis of the reviews around a consistent set of key concepts and outcomes; in this case a published framework for maternal and newborn care was used, 5) developing an iterative process between policy makers, reviewers and review sponsors, 6) rapid searches and retrieval of literature, 7) analysis of identified literature which was mapped to the framework and included review sponsor input, 8) production of recommendations mapped to the agreed framework and presented as âsummary topsheetsâ in a consistent and easy to read format. Our approach has drawn on different components of pre-existing rapid review methodology to provide a rigorous and pragmatic approach to rapid evidence synthesis. Additionally, the use of a framework to map the evidence helped structure the review questions, expedited the analysis and provided a consistent template for recommendations, which took into account the policy context. We therefore propose that our approach (described in this paper) can be described as producing collaborative, targeted and efficient evidence reviews for policy makers
Adorno?s Grey, Taussig?s Blue: Colour, Organization and Critical Affect
In this article we seek to open up the study of affect and organization to colour. Often simply taken for granted in organizational life and usually neglected in organizational thought, colour is an affective force by default. Deploying and interweaving the languages of affect theory, critical theory, and organization studies, we discuss colour as a primary phenomenon for the study of ?critical affect?. We then trace colour?s affect in conditioning the unfolding of organization in two particular ?colour/spaces? ? Adorno?s grey and Taussig?s blue of our title ? and discuss both its ambiguity and critical potential. Finally, we ponder what colour might do to the style of an organizational scholarship attuned to affect, where sentences blur with things and forces more than they seek to represent them
Herding QATs: Quality Assessment Tools for Evidence in Medicine
Medical scientists employ âquality assessment toolsâ (QATs) to measure the quality of evidence from clinical studies, especially randomized controlled trials (RCTs). These tools are designed to take into account various methodological details of clinical studies, including randomization, blinding, and other features of studies deemed relevant to minimizing bias and error. There are now dozens available. The various QATs on offer differ widely from each other, and second-order empirical studies show that QATs have low inter-rater reliability and low inter-tool reliability. This is an instance of a more general problem I call the underdetermination of evidential significance. Disagreements about the strength of a particular piece of evidence can be due to differentâbut in principle equally goodâweightings of the fine-grained methodological features which constitute QATs
Guilt and Child Soldiers
The use of child soldiers in armed conflict is an increasing global concern. Although philosophers have examined whether child soldiers can be considered combatants in war, much less attention has been paid to their moral responsibility. While it is tempting to think of them as having diminished or limited responsibility, child soldiers often report feeling guilt for the wrongs they commit. Here I argue that their feelings of guilt are both intelligible and morally appropriate. The feelings of guilt that child soldiers experience are not self-censure; rather their guilt arises from their attempts to come to terms with what they see as their own morally ambiguous motives. Their guilt is appropriate because it reaffirms their commitment to morality and facilitates their self-forgiveness
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