Assessment Work of Paramedics on the Front lines of Emergency Health Services

This article draws on an institutional ethnographic inquiry into the work of paramedics and the institutional setting that organizes and coordinates their work processes. Drawing on over 200 hours of observations and over 100 interviews with paramedics (average length of 18 minutes) and other emergency medical personnel, this article explores the standard and not so standard work of paramedics as they assess and care for their patients on the front lines of emergency health services. More specifically, I focus on the multiplicity of interfacing social, demographic, locational, situational, and institutional factors that shape and organize the work of paramedics. In doing so, this article provides insights into how paramedics orient to the social context in which their work occurs and contrasts this actual work with how their work is institutionally reported and made visible; what gets counted institutionally is not necessarily the same as what counts for the paramedics. This article problematizes this demarcation between what is known institutionally and “systematic practices of ‘not knowing’” (DeVault, 2008, p. 290).

Street Medicine – Assessment Work Strategies of Paramedics on the Front lines of Emergency Health Services

This article is based on an institutional ethnographic inquiry into the work of paramedics and the institutional setting that organizes and coordinates their work processes in a major City in Canada. Drawing on over 200 hours of observations and over 100 interviews with paramedics (average length of 18 minutes) and other emergency medical personnel, this article explores the standard and not so standard work of paramedics as they assess and care for their patients on the front lines of emergency health services. The multiplicity of interfacing social, demographic, locational, and situational factors that shape and organize the work of paramedics are analyzed. In doing so, this article provides insights into the complex work of an understudied yet ever-important profession in healthcare.

Production and Productive Reason

This article explores two rival understandings of production and what it means to be a rational productive subject. Against ‘technicist’ models of productive reason, it defends a ‘phronetic’ model on both normative and pragmatic grounds. The discussion begins with a description of the general principles underpinning technicist theories of workplace organisation, principles which continue to inform work design approaches to this day. The technicist model is thereafter criticised on three counts: that it represents a specific managerial agenda which privileges sectional interests; that it is suspect morally for a number of reasons; and that despite its aspiration of arriving at ‘one best method’, it represents but one way of organising work processes. The phronetic model is then set out using the notion of ‘practices’ as a guide. This notion is important in providing a view of production in which technical reason is subsumed under a broader practical reason incorporating individual experience and judgement. Against the charge that this view is merely an instance of nostalgic craft romanticism having little relevance to present industrial realities, there are recognisable contemporary instances of phronetic production, one of the most interesting being Volvo’s innovations in automotive assembly systems.

Multiprofessional Views on Older Patients' Participation in Care Planning Meetings in a Hospital Context

Care planning meetings (CPMs; sometimes referred to as family meetings) for older patients involve group decision-making between the multidisciplinary team, the older person and their family. However, service user participation is challenged by the inequity of knowledge and power between participants, together with organisational and resource pressures for timely discharge. The effective use and perhaps, potential misuse of communication strategies within CPMs is of ethical concern to all participants. Habermas' essential critique of participatory communication provides insight as to how older people's involvement can be either enabled or blocked by healthcare professionals (HCPs) depending on their use of communication strategies. Seven discipline-specific mini-focus groups provided an opportunity for HCPs to reflect on the participation of patients over 65 and their families in CPMs. Findings explore HCPs' understanding of older patients involvement based on key dimensions of communicative participation, namely, mutuality, inclusiveness, patient centredness and clear outcomes. Whilst the benefits of collaborative decision-making were confirmed, legitimate concerns as to the quality of participatory practices, limited attention to group work processes and the exclusion of older patients with cognitive impairment were identified. © 2013 Copyright British Association of Social Workers.

Empleo y actividad económica en jóvenes: tendencias actuales en las economías avanzadas de Europa occidental”

This article describes the evolution of the labour market position of youth in European advanced economies in the last 3 decades, its main institutional determinants and policy instruments. In this period of time, we have witnessed the rise of the phenomenon of youth unemployment and, more recently, of joblessness. Still, youth fares quite differently across European countries. These differentials seem to be linked to institutional features of educational systems (school-to-work transitions) and labour markets (insiders-outsiders divide), and their interactions. Remedies have concentrated on the supply side of this equation (ALMP, minimum wages), leaving on the side the demand one (job creation). We conclude drawing some implications for the Chilean youth labour market concerning the necessity to develop active labour market measures to improve the transition to work processes, and to deal with the strong segmentation which still characterizes it.

Understanding how HR systems work: the role of HR philosophy and HR processes

Despite the proliferation of studies of HR systems, there are still substantial gaps in our understanding
of how such systems actually work. This article, by focusing on the neglected areas of HR philosophy
and HR processes in the composition of HR systems, and by using a qualitative, employee-centred
approach in the collection and analysis of data, provides new insights into the working of HR systems.
Using data from interviews with 56 knowledge workers employed in the information and
communications technology sector in Ireland and the UK, we explore employee-level reactions to two
different types of HR systems. We highlight the various ways in which HR processes interact with HR
practices and the different outcomes that may result, and we identify the key role of HR philosophy in
HR system operation.

Parents' Views on Social Work Interventions in Child Welfare Cases

This article reports the findings of the third part of a three-part research project examining the potential for social workers to shift from a child protection to a child welfare orientation in their practice. Whilst social workers in the United Kingdom have been encouraged to make such changes they have been hampered by concerns to manage risk. Findings from the first two parts of the project had indicated that there was potential for a substantial proportion of child protection work to be redesignated as child welfare work, but that were this was achieved in practice there was evidence of continued influence of child protection processes as social workers sought to manage the risks inherent in child welfare cases. The study reported here sets out to ascertain the views of parents who were subject to child welfare interventions. The findings indicate that while parents feel apprehension with regard to contact with social workers, in the majority of cases successful relationships are formed. It is argued that social workers display considerable skill in monitoring potential risks whilst engaging with families and that the subtleties involved in such activity are not captured by official measures of governance which concentrate on more abstract indicators of performance.

Statistical Monitoring of Dynamic Multivariate Processes: Part I: Modeling Auto- and Cross-Correlation

The work in this paper is of particular significance since it considers the problem of modelling cross- and auto-correlation in statistical process monitoring. The presence of both types of correlation can lead to fault insensitivity or false alarms, although in published literature to date, only autocorrelation has been broadly considered. The proposed method, which uses a Kalman innovation model, effectively removes both correlations. The paper (and Part 2 [2]) has emerged from work supported by EPSRC grant GR/S84354/01 and is of direct relevance to problems in several application areas including chemical, electrical, and mechanical process monitoring.

Statistical Monitoring of Dynamic Multivariate Processes: Part II: Identifying Fault Magnitude and Signature

This paper builds on work presented in the first paper, Part 1 [1] and is of equal significance. The paper proposes a novel compensation method to preserve the integrity of step-fault signatures prevalent in various processes that can be masked during the removal of both auto- and cross correlation. Using industrial data, the paper demonstrates the benefit of the proposed method, which is applicable to chemical, electrical, and mechanical process monitoring. This paper, (and Part 1 [1]), has led to further work supported by EPSRC grant GR/S84354/01 involving kernel PCA methods.

Experimental investigation of the processes determining x-ray emission intensities from charge-exchange collisions

Absolute cross sections have been measured for single and double charge exchange and x-ray line emission for highly charged ions of C, N, 0, and Ne colliding with He, H-2 CO2, and H2O at collisions energies of 7q keV. Present results of charge exchange in He and H-2 compare favorably with previous results. For CO2 and H2O, where prior work is scarce, the classical overbarrier model is found to overestimate results by up to a factor of 3. An analysis of the relative intensities of the observed Lyman x-ray transitions indicates that capture into l states is not statistical, as collision velocities are insufficient to populate the highest angular-momentum states. The importance of autoionization following multiple capture is highlighted, and enhanced radiative stabilization following double capture is observed and compared to other studies. Present results are also discussed in terms of mechanisms likely to generate x-ray emission in comets.

Psychological processes underlying nurses' handwashing behaviour

Aim/Background Psychological models of behaviour change have been found to be useful in predicting health-related behaviour in patients but have rarely been used in relation to the health behaviour of staff. This study explored the association between a range of psychological variables and self-reported handwashing in a sample of nurses who work in a large general hospital. Method A questionnaire-based cross-sectional, correlational study was used. Questionnaires examining demographics, self-efficacy, perceived importance of handwashing, perception of risk, occupational stress and training related to handwashing were administered to an opportunity sample (n = 76) of nurses drawn from an acute hospital. ANOVAs, correlation and regression analyses were performed to determine significant covariates of handwashing behaviour. Findings There was a weak relationship between demographic variables and self-reported handwashing. The degree to which employees perceived their workplace to assist handwashing and perceived importance of handwashing were related to self-reported handwashing. Accordingly further covariates of these variables were sought. Training received and occupational stress both covaried with nurses’ perceptions of the degree to which their workplace assisted handwashing. Nurses’ beliefs regarding the transmission of infections covaried with perceived importance of handwashing. Conclusion Occupational stress was observed to reduce the perception of having a supportive employer: organisations need to facilitate handwashing and protect staff from factors that have a detrimental impact, such as work-related stress. Nurses’ perceived importance of the potential for poor handwashing practice to contribute to the transmission of infections should be highlighted in interventions.

Characterisation of fluidised bed granulation processes using in situ Raman spectroscopy

Previous work by the authors Walker et al. [2007b. Fluidised bed characterisation using Raman spectroscopy: applications to pharmaceutical processing. Chemical Engineering Science 62, 3832–3838] illustrated that Raman spectroscopy could be used to provide 3-D maps of the concentration and chemical structure of particles in motion in a fluidised bed, within a relatively short (120 s) time window. Moreover, we reported that the technique, as outlined, has the potential to give detailed in-situ information on how the structure and composition of granules/powders within the fluidised bed (dryer or granulator) vary with the position and evolve with time. In this study we extended the original work by shortening the time window of the Raman spectroscopic analysis to 10 s, which has allowed the in-situ real-time characterisation of a fluidised bed granulation process. Here we show an important new use of the technique which allows in-situ measurement of the composition of the material within the fluidised bed in three spatial dimensions and as a function of time. This is achieved by recording Raman spectra using a probe positioned within the fluidised bed on a long-travel x–y–z stage. In these experiments the absolute Raman intensity is used to provide a direct measure of the amount of any given material in the probed volume, i.e. a particle density. Particle density profiles have been calculated over the granulation time and show how the volume of the fluidised bed decreases with an increase mean granule size. The Raman spectroscopy analysis indicated that nucleation/coalescence in this co-melt fluidised hot melt granulation system occurred over a relatively short time frame (t<30 s). The Raman spectroscopic technique demonstrated accurate correlation with independent granulation experiments which provided particle size distribution analysis. The similarity of the data indicates that the Raman spectra accurately represent solids ratios within the bed, and thus the techniques quantitative capabilities for future use in the pharmaceutical industry.

The evolution of authoritarian processes: Fostering cooperation in large-scale groups

Authoritarianism, comprising conventionalism, authoritarian submission, and authoritarian aggression, is an important factor underlying prejudice and social discrimination and therefore is typically perceived as socially problematic. In contrast, our work examines adaptive features of authoritarianism. Evolutionary game theoretical considerations (e.g., biased social learning) point to authoritarian psychological processes that establish and foster group life (e.g., high levels of ingroup cooperation). First, the evolution of social learning (particularly conformist and prestige biases) leads to the establishment of local and distinct cultural groups (conventionalism). Second, local cultural rules solve coordination dilemmas by transforming these rules into normative standards against which others are evaluated (authoritarian submission). Third, the common rules within a particular culture or group are reinforced by a tendency to reward norm compliance and punish norm deviations (authoritarian aggression). Implications regarding the deduction of novel research questions as well as dealing with authoritarianism as a social problem are discussed.

Prising open the black box: Critical realism, action research and social work

There is a growing interest in critical realism and its application to social work. This article makes a case for adopting this philosophical position in qualitative social work research. More specifically, it suggests that there is a concordance between critical realist premises and action research with its cyclical inquiry and advancement of social change. This combination of philosophy and method, it is argued, promotes anti-oppressive social work research and illuminates the processes shaping outcomes in programme evaluations. Overall, the article underscores the importance of 'depth' in qualitative inquiry by conceiving the social world in terms of five interlacing, social domains.

The perspectives of young children in care about their circumstances and implications for social work practice

Recent reviews of research regarding children in care have concluded that there remains little research which specifically focuses on young children. This paper presents the findings of research carried out with a sample of young children in care (aged 4-7 years) regarding their perspectives of their circumstances. The findings reveal that they have deeply held views regarding living with risk; removal from their families; unresolved feelings of guilt and loss; and not being listened to. This paper considers the implications of these findings for social work practice. It concludes by stressing the capacity of young children in care to express their perspectives, and the importance of practitioners seeking these views and incorporating them into assessment and decision-making processes.