Role, training and job satisfaction of physiotherapy assistants

Physiotherapy assistants form approximately 20% of the work force within physiotherapy departments and yet little is known about them.The purpose of this study was to assess the current role of physiotherapy assistants in one NHS Region via postal questionnaire, identifying tasks performed and levels of responsibility and supervision; assessing the level of satisfaction of physiotherapy assistants; and comparing these findings with a previous study in 1991. A response rate of 85% (424 assistants) was achieved.The results showed that there is indication of increasing responsibility, independence and specialist skills of physiotherapy assistants since 1991. Training is locally determined and varied. Update of national training initiatives is limited. Overall physiotherapy assistants are satisfied with their jobs (91%). Specific areas of dissatisfaction are pay and career development. Satisfaction is associated with levels of supervision, in-service training and age (p < 0.05)

Factors determining the current use of physiotherapy assistants

Physiotherapy assistants form approximately 20% of the work force within physiotherapy departments and account for a large proportion of the delivery of physiotherapy care. There is great interest in developing the scope of practice of physiotherapy assistants and evidence that this is under way. Little is known about the factors determining use of physiotherapy assistants and their views on their future role. The purpose of this study was to investigate how the role of physiotherapy assistants was changing, identify the factors that affect the development of the physiotherapy assistants' role and determine the views of physiotherapy assistants and physiotherapists on the future work of physiotherapy assistants. Semi-structured interviews were carried out with a stratified random sample of 18 physiotherapy assistants from the South and West Region and separately, with their 18 physiotherapy supervisors. The physiotherapy assistants worked in a range of settings – elderly care, paediatrics, outpatients and primary care. Analysis of the interviews showed that there was variation in scope of activities of physiotherapy assistants and in the level of supervision. Supervision was reduced primarily in particular specialty areas, such as elderly and primary care. Changes were primarily locally determined. A change or shortage of qualified staff was regarded as being instrumental in the development of practice. Training, levels of responsibility and supervision, and the development of generic workers were issues of concern for this changing workforce

Linkages between coral assemblages and coral proxies of terrestrial exposure along a cross-shelf gradient on the southern Great Barrier Reef

Coral core records, combined with measurements of coral community structure, were used to assess the long-term impact of multiple environmental stressors on reef assemblages along an environmental gradient. Multiple proxies (luminescent lines, Ba/Ca, δ15N) that reflect different environmental conditions (freshwater discharge, sediment delivery to the nearshore, nutrient availability and transformations) were measured in Porites coral cores collected from nearshore reefs at increasing distance from the intensively agricultural region of Mackay (Queensland, Australia). The corals provide a record (1968–2002) of the frequency and intensity of exposure to terrestrial runoff and fertilizer-derived nitrogen and were used to assess how the present-day coral community composition may have been influenced by flood-related disturbance. Reefs closest to the mainland (5–32 km offshore) were characterized by low hard coral cover (≤10%), with no significant differences among locations. Distinct annual luminescent lines and elevated Ba/Ca values (4.98 ± 0.63 μmol mol−1; mean ± SD) in the most inshore corals (Round Top Island; 5 km offshore) indicated chronic, sub-annual exposure to freshwater and resuspended terrestrial sediment that may have historically prevented reef formation. By contrast, corals from Keswick Island (32 km offshore) indicated episodic, high-magnitude exposure to Pioneer River discharge during extreme flood events (e.g., 1974, 1991), with strongly luminescent lines and substantially enriched coral skeletal δ15N (12–14‰). The reef assemblages at Keswick and St. Bees islands were categorically different from all other locations, with high fleshy macroalgal cover (80.1 ± 7.2% and 62.7 ± 7.1%, respective mean ± SE) overgrowing dead reef matrix. Coral records from Scawfell Island (51 km offshore) indicated little exposure to Pioneer catchment influence: all locations from Scawfell and further offshore had total hard and soft coral cover comparable to largely undisturbed nearshore to middle shelf reefs of the southern Great Barrier Reef