Domiciliary Care: The Formal and Informal Labour Process

Domiciliary carers are paid care workers who travel to the homes of older people to assist with personal routines. Increasingly, over the past 20 years, the delivery of domiciliary care has been organised according to market principles and portrayed as the ideal type of formal care; offering cost savings to local authorities and independence for older people. Crucially, the work of the former ‘home help’ is transformed as domiciliary carers are now subject to the imperative of private, competitive accumulation which necessitates a constant search for increases in labour productivity. Drawing on qualitative data from domiciliary carers, managers and stakeholders, this article highlights the commodification of caring labour and reveals the constraints, contradictions and challenges of paid care work. Labour Process Theory offers a means of understanding the political economy of care work and important distinctions in terms of the formal and informal domiciliary care labour process

The influence of the media on practice in mental health : a bricolage of a single case study

This paper has its genesis in the convergence of two individuals’interests – one with a long-standing interest in representations of mental health and one with an interest in the use of bricolage as a research approach. These interests converged around the ways in which mental health care practitioners might react to and subsequently reflect on images of mental health they came across in the media. A bricolage was developed relating to newspaper coverage of a homicide carried out by someone with a mental health problem. The bricolage draws on the assumption that practitioners will have immediate reactions to material they come across, take a more considered overview of this material, and subsequently attempt to contextualize this reflection in terms of academic literature. The bricolage as presented mirrors this process for an experienced practitioner. Suggestions are made concerning the use of newspaper reports on mental health, to enable both novice and experienced practitioners to gain vicarious experience through reflection on these reports

Fitting in with the team: facilitative mentors in physiotherapy student placements’

Clinical placements are central to Physiotherapy students’ education, providing an environment in which students can apply learning they have been introduced to in academic settings. However placement learning has been identified as fraught with problems and resultant stress and there is limited evidence available on what exactly makes a good placement for Physiotherapy students. This paper reports on selected findings from a study exploring narratives of Physiotherapy students over three years, relating to their overall experiences of being a student. A narrative prompt provided an opportunity for the students to speak about ‘episodes’ of their learning experiences. A number of these ‘episodes’ related to the students’ experiences of clinical placements thus it was decided to extract these from the narratives and undertake a separate qualitative analysis of these placement experiences. The majority of the students reported positive experiences of placements overall, however, it was clear that some placement teams and mentors did not support students appropriately. A welcoming team and a mentor who facilitated learning from an individual student perspective were considered to be key to a good placement experience; whilst an unwelcoming team and a mentor who objectified the student resulted in bad placement experiences

Disclosure decisions within transition narratives: How ex-drug users decide what information to share when working toward employment in the substance misuse field

Ex-user narratives often “end” at the point where treatment ends, leaving much to discover regarding what happens next. Within this post-treatment experience, ex-users making the transition to work in the drugs field must decide whether or not to disclose their past substance use and, if they do disclose, further personal decision-making relates to how much to disclose, to whom, and in what context. This article explores ex-drug users’ decisions around disclose of their background to colleagues and service users. In-depth narrative interviews were undertaken with 11 ex-drug users to explore their journey to become substance misuse practitioners and their decisions around disclosure within this transition. Process mapping was used to enable participants to structure their story in their own way. Following thematic analysis, it became apparent that most participants received little or no guidance regarding disclosure. In the absence of clear guidelines regarding personal disclosures,reflective practice could be seen as a potential tool to enable participants to assess such risks and rewards. Alongside personal reflexivity, consideration should be given by service providers to disclosure policies, induction and ongoing training, and supervision in order to support ex-user drug workers’ disclosure decision-making

How events in emergency medicine impact doctors' psychological well-being

© Author(s) (or their employer(s)) 2018. No commercial re-use. See rights and permissions. Published by BMJ. Background: Emergency medicine is a high-pressured specialty with exposure to disturbing events and risk. We conducted a qualitative study to identify which clinical events resulted in emotional disruption and the impact of these events on the well-being of physicians working in an ED. Methods: We used the principles of naturalistic inquiry to conduct narrative interviews with physicians working in the ED at Central Manchester University Hospitals NHS Foundation Trust, between September and October 2016. Participants were asked, Could you tell me about a time when an event at work has continued to play on your mind after the shift in which it occurred was over?' Data were analysed using framework analysis. The study had three a priori themes reported here. Other emergent themes were analysed separately. Results: We interviewed 17 participants. Within the first a priori theme (clinical events') factors associated with emotional disruption included young or traumatic deaths, patients or situations that physicians could relate to, witnessing the impact of death on relatives, the burden of responsibility (including medical error) and conflict in the workplace. Under theme 2 (psychological and physical effects), participants reported substantial upset leading to substance misuse, sleep disruption and neglecting their own physical needs through preoccupation with caring. Within theme 3 (impact on relationships), many interviewees described becoming withdrawn from personal relationships following clinical events, while others described feeling isolated because friends and family were non-medical. Conclusions: Clinical events encountered in the ED can affect a physician's psychological and physical well-being. For many participants these effects were negative and long lasting

Benchmarking factor selection and sensitivity: a case study with nursing courses

There is an increasing requirement in higher education (HE) worldwide to deliver excellence. Benchmarking is widely used for this purpose, but methodological approaches to the creation of benchmark metrics vary greatly. Approaches require selection of factors for inclusion and subsequent calculation of benchmarks for comparison. We describe an approach using machine learning to select input factors based on their value to predict completion rates of nursing courses. Data from over 36,000 students, from nine institutions over three years were included and weighted averages provided a dynamic baseline for year on year and within year comparisons between institutions. Anonymised outcomes highlight the variation in benchmarked performances between institutions and we demonstrate the value of accompanying sensitivity analyses. Our methods are appropriate worldwide, for many forms of data and at multiple scales of enquiry. We discuss our results in the context of HE management, highlighting the value of scrutinising benchmark calculations

Rupture by damage accumulation in rocks

The deformation of rocks is associated with microcracks nucleation and propagation, i.e. damage. The accumulation of damage and its spatial localization lead to the creation of a macroscale discontinuity, so-called "fault" in geological terms, and to the failure of the material, i.e. a dramatic decrease of the mechanical properties as strength and modulus. The damage process can be studied both statically by direct observation of thin sections and dynamically by recording acoustic waves emitted by crack propagation (acoustic emission). Here we first review such observations concerning geological objects over scales ranging from the laboratory sample scale (dm) to seismically active faults (km), including cliffs and rock masses (Dm, hm). These observations reveal complex patterns in both space (fractal properties of damage structures as roughness and gouge), time (clustering, particular trends when the failure approaches) and energy domains (power-law distributions of energy release bursts). We use a numerical model based on progressive damage within an elastic interaction framework which allows us to simulate these observations. This study shows that the failure in rocks can be the result of damage accumulation

'Drowning in here in his bloody sea' : exploring TV cop drama's representations of the impact of stress in modern policing

The Criminal Justice System is a part of society that is both familiar and hidden. It is familiar in that a large part of daily news and television drama is devoted to it (Carrabine, 2008; Jewkes, 2011). It is hidden in the sense that the majority of the population have little, if any, direct contact with the Criminal Justice System, meaning that the media may be a major force in shaping their views on crime and policing (Carrabine, 2008). As Reiner (2000) notes, the debate about the relationship between the media, policing, and crime has been a key feature of wider societal concerns about crime since the establishment of the modern police force. He outlines the recurring themes in post-war debates in this field. For Conservatives there has been an ongoing concern that the media is criminongenic, as it serves to undermine traditional institutions, including the police. From the viewpoint of radical criminology, the impact of the media is two-fold: it exaggerates legitimate concerns about crime and emphasises the bureaucratic and other restrictions under which the police operate (Reiner, 2000). This is seen as undermining due process and legitimatising what can be termed a ‘maverick’ approach to policing. An early example of this can be seen in Clint Eastwood’s Dirty Harry movies (Siegel, 1971) where Harry Callaghan acts as a one-man law enforcement system outside of the formal legal process, a process portrayed as corrupt, inefficient, and concerned with offenders’ rights rather than protecting victims. From a policing perspective, Reiner (2000) argues that film and TV drama creates a simplistic narrative of crime solving that is almost completely divorced from the reality of modern police work, a finding consistent with more recent work by Cummins et al., (2014)