A self-reported work sampling study in community pharmacy practice

Lack of time to implement pharmaceutical care has been cited as a barrier to the routine provision of this extended patient-care service. Using self-reported work sampling methodology, this study investigated how community pharmacists utilise their time. Pharmacists working in community pharmacies in the Greater Belfast area were found to spend approximately 49% of their time engaged in professional activities, 29% in semi-professional activities and 22% involved in non-professional activities. The activity to which pharmacists devoted the majority of their time was product assembly and labelling, this being a task which can be performed by trained technical staff. Only 9.5% of community pharmacists' time was devoted to counselling patients on their prescription medicines. Wide variation in the amount of time apportioned to each activity was observed between the participating community pharmacists (n=30). Staffing levels within the community pharmacy were found to significantly influence pharmacists' involvement in a number of activities, with pharmacists who worked in pharmacies employing multiple pharmacists devoting more time to the assembly and labelling of products and less time to administrative tasks, non-professional encounters and to miscellaneous professional activities. Pharmacists working in pharmacies with a high prescription turnover were found to devote significantly less time to counselling patients regarding OTC products and in responding to patient symptoms.

Participatory Action Research with and within community activist groups: capturing the collective experience of Ireland's Community and Voluntary Pillar

The inclusion of community activists in policy planning is increasingly recognized at the highest international level. This article shows how the use of Participatory Action Research (PAR) can present a deeper and more holistic picture of the experiences of Civil Society Organizations (CSOs) in shaping national-level social policy. By utilizing action-based research, the Community and Voluntary Pillar (CVP) of Ireland’s system of social partnership is shown to be an important agent in deliberating national bargaining outcomes (known as the Towards 2016 national agreement). The key contribution of this research is the reflective methodological considerations in terms of PAR design, execution and participant integration in the research process as a way to enrich and develop a deeper and more informed community of practice.

Perceptions of psychological content in the GP consultation - the role of practice, personal and prescribing attributes

Objective: The aim of the present study was to determine the relationship between the characteristics of general practices and the perceptions of the psychological content of consultations by GPs in those practices. Methods: A cross-sectional survey was conducted of all GPs (22 GPs based in nine practices) serving a discrete inner city community of 41 000 residents. GPs were asked to complete a log-diary over a period of five working days, rating their perception of the psychological content of each consultation on a 4-point Likert scale, ranging from 0 (no psychological content) to 3 (entirely psychological in content). The influence of GP and practice characteristics on psychological content scores was examined. Results: Data were available for every surgery-based consultation (n = 2206) conducted by all 22 participating GPs over the study period. The mean psychological content score was 0.58 (SD 0.33). Sixty-four percent of consultations were recorded as being without any psychological content; 6% were entirely psychological in content. Higher psychological content scores were significantly associated with younger GPs, training practices (n = 3), group practices (n = 4), the presence of on-site mental health workers (n = 5), higher antidepressant prescribing volumes and the achievement of vaccine and smear targets. Training status had the greatest predictive power, explaining 51% of the variation in psychological content. Neither practice consultation rates, GP list size, annual psychiatric referral rates nor volumes of benzodiazepine prescribing were related to psychological content scores. Conclusion: Increased awareness by GPs of the psychological dimension within a consultation may be a feature of the educational environment of training practices.

Scope of practice in forensic nursing

1. There is significant role variation, across the Western world, in relation to how forensic nurses practice. 2. The authors conducted a pilot survey of forensic nurses in Australia, New Zealand, the United States, and the United Kingdom to examine forensic nursing practice, role definition, and role boundaries. 3. Issues arising from the data include the visibility of forensic nurses, the client group, forensic-specific education, and role development.

The evolution of an online community - a case study

This article reflects findings from a long term case study of an online community of practice established through a network for the professional education of teachers in Ontario, Canada. The Education Network of Ontario/Réseau éducatif de l'Ontario (ENO/REO) was created in 1992–1993 to support and connect teachers from kindergarten to grade 12 in the province of Ontario. Its mandate was to ensure that all teachers had free access to the Internet and to each other and to encourage the development of skills in the area of information and communication technology with the ultimate goal of using those skills to improve classroom practice. The study investigated whether information technology had the potential to connect teachers to each other in order to build the capacity to create networks where professional learning could take place in a cost-efficient and flexible time and/or place. It was found that participants were early adopters who enjoyed innovation, that online networkswere supportive for learning but hard to maintain over time, and though they supported the integration of technology in the classroom, other barriers within schools could challenge this effect.

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.

Zones of practice : embodiment and creative arts research

This article presents the trans-disciplinary encounters with and perspectives on embodiment of three creative-arts practitioners within the Deakin University research project Flows & Catchments. The project explores how creative arts participate in community and the possibility of well-being. We discuss our preparations for creative work exhibited at the 2012 Lake Bolac Festival un regional Western Victoria, Australia

Advancing community engagement practice for strategic urban planning : learning from allied and remote disciplines

Urban planning has the potential to draw on allied and remote disciplines to improve community consultation processes for strategic planning projects. Urban design and landscape architecture have quantitative and qualitative methods which can be utilised to visualise different options of urban intensification which may fit within communities’ expectations of change. Furthermore political science has long used scientifically established psychometric techniques to collect data from broad sections of the population, analysing demographic profiles of communities and understanding their perceptions and attitudes. By appropriating quantitative and qualitative methods from other disciplines, urban planning policies can be developed which may reflect communities’ aspirations of amenity and neighbourhood character. The aim of this paper is to assist local government urban planners with their community engagement practice in order to form policies which are acceptable to the affected communities. The paper draws on Victoria as a case study of community engagement practice, examines research methods from allied and remote disciplines and proposes a community engagement framework which introduces rigour within the community engagement process.

Leaning towards collegiality: narratives of university communities of practice

This study explored the relationship between professional learning, community, narrative and identity in strategic communities established to enhance teaching and learning at three Australian universities. It adds to the field by proposing an adaptive model for understanding and fostering future communities of practice in higher education.

Community organization practice.

Bibliography: p. 411-431.

Australian and New Zealand practice in intensive care (ANZPIC II: The spectrum of practice in the diagnosis and management of pneumonia in patients requiring mechanical ventilation

This study of ventilated patients investigated current clinical practice in 476 episodes of pneumonia (48% community-acquired pneumonia, 24% hospital-acquired pneumonia, 28% ventilator-associated pneumonia) using a prospective survey in 14 intensive care units (ICUs) within Australia and New Zealand. Diagnostic methods and confidence, disease severity, microbiology and antibiotic use were assessed. All pneumonia types had similar mortality (community-acquired pneumonia 33%, hospital-acquired pneumonia 37% and ventilator-associated pneumonia 24%, P = 0.15) with no inter-hospital differences (P = 0.08-0.91). Bronchoscopy was performed in 26%, its use predicted by admission hospital (one tertiary: OR 9.98, CI 95% 5.11-19.49, P < 0.001; one regional: OR 629, CI 95% 3.24-12.20, P < 0.001), clinical signs of consolidation (OR 3.72, CI 95% 2.09-662, P < 0.001) and diagnostic confidence (OR 2.19, CI 95% 1.29-3.72, P = 0.004). Bronchoscopy did not predict outcome (P = 0.11) or appropriate antibiotic selection (P = 0.69). Inappropriate antibiotic prescription was similar for all pneumonia types (11-13%, P = 0.12) and hospitals (0-16%, P = 0.25). Blood cultures were taken in 51% of cases. For community-acquired pneumonia, 70% received a third generation cephalosporin and 65% a macrolide. Third generation cephalosporins were less frequently used for mild infections (OR 0.38, CI 95% 0.16-0.90, P = 0.03), hospital-acquired pneumonia (OR 0.40, CI 95% 0.23-0.72, P < 0.01), ventilator-associated pneumonia (OR 0.04, CI 95% 0.02-0.13, P < 0.001), suspected aspiration (OR 0.20, CI 95% 0.04-0.92, P = 0.04), in one regional (OR 0.26, CI 95% 0.07-0.97, P = 0.05) and one tertiary hospital (OR 0.14, CI 95% 0.03-0.73, P = 0.02) but were more commonly used in older patients (OR 1.02, CI 95% 1.01-1.03, P = 0.01). There is practice variability in bronchoscopy and antibiotic use for pneumonia in Australian and New Zealand ICUs without significant impact on patient outcome, as the prevalence of inappropriate antibiotic prescription is low. There are opportunities for improving microbiological diagnostic work-up for isolation of aetiological pathogens.

Universities Masters World Cup Soccer:integrated sports science research and implementation of an international masters soccer community

Ageing populations with greater wellness and athletic expectations require quality sports and active living experiences in order to increase and sustain participation levels. Responding to the diverse needs and circumstances of Masterslveterans players is a complex and multi-faceted process. While sports science contributions have been very effective at enhancing active living in a variety of youth and adult sports events, very little has been documented regarding their efficacy in events for Masterslveteran players. This paper draws upon action research to examine the growth and development of a unique Masters World Cup 6-0-side Soccer Tournament, involving representative teams from twelve nations. lntegrated sports science concepts and strategies were employed to develop quality soccer experiences. Longitudinal data suggest that fostering a community of practice is critical to the success of Masters soccer programs. In addition to critical leadership contributions, an eclectic range of age-appropriate and responsive soccer experiences are essential to ensure that Masters events meet the diverse needs and circumstances of the players.

Teacher talk: A community of colleagues that values practical teacher knowledge through sharing experiences

The purpose of this study was to describe the experiences of five educators participating in a teacher-initiated learning community that valued practical teacher knowledge. Connelly and Clandinin (2000) argued that practical teacher knowledge grew out of experience through interaction in the professional knowledge landscape. Collaboration that promoted teacher learning was the foundation to effective school change (Wood, 1997). This teacher-initiated learning community consisted of members who had equal status and collaborated by participating in discourse on curriculum and instruction. The collegiality of the community fostered teacher professionalism that improved practice and benefited the school. This study focused on the following research questions: (1) What was the experience of these five educators in this learning community? (2) What did these five individuals understand about the nature of practical teacher knowledge? (3) According to the participants, what was the relationship between teacher empowerment and effective school change? ^ The participants were chosen because each voluntarily attended this teacher-initiated learning community. Each participant answered questions regarding the experience during three semi-structured tape-recorded interviews. The interviews were transcribed, and significant statements of meaning were extracted. Using a triangulation of ideas that were common to at least three of the participants ensured the trustworthiness of the analysis. These statements were combined to describe what was experienced and how the participants described their experience. The emerging themes were the characteristics of and the relationships, methods, conditions, and environment for the teachers. The teachers described how a knowledge base of practical teacher knowledge was gained as a spirit of camaraderie developed. The freedom that the teachers experienced to collaborate and learn fostered new classroom practice that affected school change as student interaction and productivity increased. ^ The qualitative analysis of this study provided a description of a learning community that valued practical teacher knowledge and fostered professional development. This description was important to educational stakeholders because it demonstrated how practical teacher knowledge was gained during the teachers' daily work. By sharing every day experiences, the teacher talk generated collaboration and accountability that the participants felt improved practice and fostered a safe, productive learning environment for students. ^