PP10 ‘The ones that don’t say’; challenges in managers identifying potentially traumatised ambulance staff

2019 ◽  
Vol 36 (1) ◽  
pp. e4.3-e5
Author(s):  
Joshua Miller ◽  
Keyword(s):  
Emergency Services ◽  
Small Sample Size ◽  
Small Sample ◽  
Ambulance Service ◽  
Structured Interviews ◽  
Framework Analysis ◽  
Face To Face ◽  
Ethical Approval ◽  
Changing Roles ◽  
The Uk

BackgroundStress and psychological illness among emergency services personnel is reported at higher prevalence than the general population, with one UK ambulance service ascribing it to 15% of staff sickness. Research in this field has focused on ambulance crew views, while manager experiences are limited to EMS systems outside the UK. This qualitative study explored how UK ambulance service managers try to identify staff at risk of becoming traumatised by their work.MethodsFace-to-face, semi-structured interviews were audio-recorded with a purposive sample of six paramedic managers working for an NHS ambulance service. The author transcribed these interviews and analysed them using framework analysis. Ethical approval and informed consent were obtained.ResultsAll participants claimed to see the identification of potentially traumatised staff as a vital part of their role. They outlined the use of case factors such as visceral elements and child involvement, and staff factors such as home life and resilience. Interviewees talked about their changing roles as managers, peers, parent figures, clinicians, and adjudicators.Factors found as enabling the identification of potentially traumatised staff included: knowing the staff, formalising handover to other managers, and manager presence – both at incidents and on station. Disabling factors included: atypical cases, hierarchical culture, and isolated remote staff. All participants reported concerns about staff being reluctant to report distress.ConclusionsLimitations of this study include the small sample size, possible response bias, and respondents conforming to social norms, as their practice was self-reported, rather than observed. Manager presence was highlighted as very important by participants; services should consider this in their structures and policies. Further studies could examine staff reluctance to report psychological distress, as well as staff resilience, which participants saw as beneficial, yet difficult to define or predict.

Reluctant managers: Methodist ministers and management

2014 ◽  
Vol 33 (7) ◽  
pp. 680-693 ◽  
Author(s):  
Yvonne Guerrier ◽  
Christopher Bond
Keyword(s):  
Design Methodology ◽  
Small Sample Size ◽  
Small Body ◽  
Small Sample ◽  
Language And Identity ◽  
Structured Interviews ◽  
Content Type ◽  
Size Limits ◽  
The Uk ◽  
Practical Implications

Purpose – The purpose of this paper is to present a research from a study undertaken with Methodist circuit ministers in the UK and those that work closely with them. It considers in what way and to what extent ministers think of themselves as managers and to what extent and in what way they are expected to perform as managers by those they work with. Design/methodology/approach – The research that informs this paper was gathered through a qualitative study which involved in-depth semi-structured interviews with 22 participants both Methodist ministers and those who worked closely with them. Findings – The study shows that, whilst those who work with ministers typically do not problematize management and expect managers to be able to perform management tasks, the ministers themselves are ambiguous about or rejecting of the discourse of management. Research limitations/implications – The relatively small sample size limits generalizability. Practical implications – The study challenges trainers in this context and in other contexts where the “language” of management is contested or rejected to find a discourse of management which is acceptable. Originality/value – The study contributes to the small body of literature on management and the development of managers within religious organizations. It contributes to the literature on managerial identity and the importance of management language in becoming a manager by presenting an example where this language and identity is contested or rejected.

scholarly journals PP14  Improving access to, and experience of, ambulance care for eastern european migrants: a paramedic interview study

2020 ◽  
Vol 37 (10) ◽  
pp. e8.1-e8
Author(s):  
Viet-Hai Phung ◽  
Zahid Asghar ◽  
Milika Matiti ◽  
Niro Siriwardena
Keyword(s):  
Service Providers ◽  
Ambulance Service ◽  
Eastern European ◽  
Structured Interviews ◽  
Framework Analysis ◽  
Quality Healthcare ◽  
European Languages ◽  
East Midlands ◽  
The Uk ◽  
Key Terms

BackgroundThe UK has experienced significant immigration from Eastern Europe following European Union (EU) expansion in 2004. Lincolnshire is a predominantly rural county in the East Midlands region of the UK with a large Eastern European migrant population requiring healthcare, including urgent ambulance care. The Equality Act 2010 requires public bodies such as health services to provide access to high quality healthcare, while the Equality Delivery System seeks to ensure that NHS organisations comply with the legislation. This study aimed to explore the perceptions and experiences of ambulance staff attending Eastern European migrants in Lincolnshire.MethodsQualitative semi-structured interviews were conducted with 15 ambulance staff at locations across Lincolnshire. Purposive and maximum variation sampling ensured that participants were knowledgeable about Eastern European migrants’ use of ambulance care and covered a range of demographic characteristics. The data were analysed using framework analysis.ResultsDifficulty in accessing professional interpreters meant that some patients relied instead on family members. Some Eastern European migrants brought back foreign language medication, which ambulance staff could not understand. It was common for patients to not be registered with GPs because they were temporarily resident, did not understand how the UK healthcare system worked or preferred to go to their home country for treatment. By not registering with GPs, patients were sometimes transported to the Emergency Department for primary care conditions.ConclusionsThe practical recommendations for service delivery improvements may be valuable for service providers and could be incorporated into future protocols. These include: having a glossary of key terms in Eastern European languages; simple packs explaining how and when to use the ambulance service translated into different languages where necessary; encouraging patients to register with GPs; and face-to-face meetings where the ambulance service inform the Eastern European communities about how to use their services.

scholarly journals Younger workers’ attitudes and perceptions towards older colleagues

2018 ◽  
Vol 22 (3) ◽  
pp. 129-138 ◽  
Author(s):  
Jasmine Patel ◽  
Anthea Tinker ◽  
Laurie Corna
Keyword(s):  
Older Workers ◽  
Generational Differences ◽  
Small Sample Size ◽  
Team Building ◽  
Well Being ◽  
Small Sample ◽  
Structured Interviews ◽  
Content Type ◽  
Younger Workers ◽  
The Uk

Purpose The purpose of this paper is to investigate younger workers’ perceptions of older colleagues, including whether there is evidence of ageism. Design/methodology/approach Convenience sampling was used to recruit ten individuals who were both below the age of 35 and employed at a multigenerational workplace in England. The study is qualitative, involving semi-structured interviews that were audio-recorded, transcribed and analysed using thematic analysis. Findings This study found that whilst some younger employees valued working with older colleagues as they believe that their differing characteristics are complementary, others felt that it leads to intergenerational conflict due to contrasting approaches towards work. Positive perceptions of older workers included their increased knowledge and experience, reliability and better social skills; however, ageism was also prevalent, such as the perception of older workers as resistant to change, slower at using technology and lacking the drive to progress. This study also provided evidence for the socioemotional selectivity and social identity theories. Research limitations/implications This study has a small sample size and participants were only recruited from London. Practical implications In order to create working environments that are conducive to the well-being of employees of all ages, organisations should place an emphasis on reducing intergenerational tension. This could be achieved by team building sessions that provide an opportunity for individuals to understand generational differences. Originality/value There is minimal evidence from the UK focussing on the perceptions of specifically younger workers towards older colleagues and the basis of their attitudes. Only by gaining an insight into their attitudes and the reasoning behind them, can efforts be made to decrease ageism.

“There is still a perception that homelessness is a housing problem”: devolution, homelessness and health in the UK

2016 ◽  
Vol 19 (2) ◽  
pp. 33-44 ◽  
Author(s):  
Martin Whiteford ◽  
Glenn Simpson
Keyword(s):  
Qualitative Interviews ◽  
Homeless People ◽  
Small Sample ◽  
Issue Salience ◽  
Structured Interviews ◽  
Healthcare Provision ◽  
Policy And Practice ◽  
Content Type ◽  
The Uk ◽  
Comparative Policy

Purpose The purpose of this paper is to provide an exploratory account of the links between devolution, homelessness and health in the UK. Specifically, it focusses on the policy context and governance structures that shape the systems of healthcare for homeless people in London, Scotland, Wales and Northern Ireland. Design/methodology/approach Empirically the paper draws on semi-structured interviews with a small sample of policy and practice actors from the devolved territories. Qualitative interviews were supplemented by a comparative policy analysis of the homelessness and health agenda within the devolved regions. Theoretically, it takes inspiration from Chaney’s concept of the “issue salience of homelessness” and explores the comparative character of healthcare as pertains to homeless people across the devolved territories. Findings The paper provides clear evidence of areas of divergence and convergence in policy and practice between the devolved regions. These features are shown to be strongly mediated by the interplay of two factors: first, the scope and scale of national and local homelessness prevention strategies; and second, intra-national variation in public health responses to homelessness. Originality/value The paper offers considerable insight from a comparative policy perspective into the nature of healthcare provision for homeless people in the devolved regions.

Individuals' waste separation practice in a relationship with social bonds: a case study of Hanoi, Vietnam

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Thi Kim Nhung Nguyen
Keyword(s):  
Social Bonds ◽  
Small Sample Size ◽  
Influential Factors ◽  
Small Sample ◽  
Household Waste ◽  
Mixed Method Research ◽  
Structured Interviews ◽  
Content Type ◽  
Sociological Approach ◽  
Waste Separation

PurposeThe paper aims to ascertain whether residents in Nguyen Du ward still sort their waste at source following the end of the 3R project that ended in 2009. Additionally, this paper aims to explore the relationship between waste separation practices and social bonds.Design/methodology/approachThe Travis Hirschi theory of social control was applied, together with the mixed method research design which included a structured questionnaire survey. Twelve semi-structured interviews were also conducted with residents and the data processed by SPSS software, using Chi-Square test, Independent-Samples t-test and Pearson's correlation analysis.FindingsA proportion of respondents has continued practicing waste separation since the 3R project ended. The study also indicated that the greater the involvement in family and neighborhood activities the more the participants were likely to practice waste separation.Research limitations/implicationsThe small sample size limits the extent to which the most influential factors can be determined and therefore the degree to which the findings can be generalized.Practical implicationsThe study includes implications for rerunning the waste separation programs for households as together with community campaigns to improve individuals' attachment and commitment and thus their participation in pro-environmental behaviors.Originality/valueTo the author’s knowledge, this is the first study to take a sociological approach to investigate factors affecting household waste separation, which has attracted little attention in previous studies. Useful information is also provided to local authorities for a policy-making process to implement effective domestic waste policies.

scholarly journals Trade-based money laundering (TBML) empowers criminals to run free post-Brexit

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Mariola Jolanta Marzouk
Keyword(s):  
Developing Countries ◽  
Law Enforcement ◽  
Money Laundering ◽  
Subject Matter ◽  
Small Sample ◽  
Subject Matter Experts ◽  
Structured Interviews ◽  
Content Type ◽  
The Government ◽  
The Uk

Purpose This paper aims to provide unique empirical findings exploring the impact of the UK’s post-Brexit Economic Strategy to boost trade with developing countries on the UK banking sector’s ability to manage trade-based money laundering risks. Design/methodology/approach Exploratory research design that used structured literature review, followed by semi-structured interviews with key subject matter experts employed by large UK banks. Findings Both banks and law enforcement struggle to prioritise trade-based money laundering (TBML) intelligence discovery due to deficient skills, resources, technology and lack of strong regulatory stimulus. The regulated sector calls for the UK anti-money laundering (AML) reform that would better incentivise TBML deterrence, yet the Government underestimates the money laundering risks while trading with high-risk jurisdictions post-Brexit. Research limitations/implications The findings are based on a small sample of six semi-structured interviews with difficult to access population of key subject matter experts. Despite the small sample, participants provided well-articulated and informed insights. Practical implications The UK’s post-Brexit Economic Strategy to boost trade with developing countries downplays the TBML risks it carries. The findings should alert UK banks, law enforcement and the Government who will collectively bear the responsibility to effectively manage TBML while enabling smooth trading. Originality/value The research provides unique perceptions of UK banks’ senior subject matter experts on managing TBML threats from opportunistic criminals.

‘There is no sincerer love than the love of food’ (George Bernard Shaw, 1903): The meaning of food and its uses in prison subculture

2018 ◽  
Vol 16 (2) ◽  
pp. 127-146 ◽  
Author(s):  
Tomer Einat ◽  
Moran Davidian
Keyword(s):  
Small Sample Size ◽  
Food Products ◽  
Analysis Data ◽  
Small Sample ◽  
Structured Interviews ◽  
Maximum Security ◽  
Maximum Security Prison ◽  
The Social ◽  
Bernard Shaw

This study examines the ways in which the prison service handles food and analyses the uses and meanings of food in prison subculture. Using semi-structured interviews and content analysis, data were collected and analysed from 20 ex-prisoners who were incarcerated in maximum-security prison facilities for a period of three years or more. Our main findings are that, according to the interviewees’ testimonies, (a) the Israel Prison Service (IPS) makes manipulative and abusive use of food in order to perpetuate its power; and (b) food serves as a means to determine the relationship between prisoners and staff, govern social status or rejection in the prison subculture, or pass the time. We have four main conclusions. First, the IPS nutrition policy differentiates and discriminates among prisoners and clearly violates the basic human rights of prisoners, thus suggesting an abuse of power. Second, the IPS’s use of food as a tool for punishing or rewarding introduces and perpetuates inequalities and encourages the illegal prison trade in food and food products. Third, cooking in prison, especially in light of its illegality, constitutes a symbolic expression of resistance to the institution and a meaningful way of coping with boredom. Lastly, food and its possession in prison serve as very powerful tools for constructing and perpetuating exploitation and unequal power relations among prisoners. Although the study suffers from two limitations – the validity of the adolescents’ responses and the small sample size – its findings lead us to propose that an improvement in the food products that are accessible to prisoners and permission to cook in their cells are inexpensive and legitimate means of bettering both the prisoners’ quality of life and the social atmosphere in prison.

Exploring digital servitization trajectories within product–service–software space

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Juliana Hsuan ◽  
Marin Jovanovic ◽  
Diego Honorato Clemente
Keyword(s):  
Small Sample Size ◽  
Small Sample ◽  
Software Systems ◽  
Structured Interviews ◽  
Content Type ◽  
Digital Ecosystem ◽  
Product Service ◽  
Practical Implications ◽  
Mapping Exercise

PurposeThis study shows various pathways manufacturers can take when embarking on digital servitization (DS) journeys. It builds on the DS and modularity literature to map the strategic trajectories of product–service–software (PSSw) configurations.Design/methodology/approachThe study is exploratory and based on the inductive theory building method. The empirical data were gathered through a workshop with focus groups of 15 servitization manufacturers (with 22 respondents), an on-site workshop (in-depth case study), semi-structured interviews, observations and document study of archival data.FindingsThe DS trajectories are idiosyncratic and dependent on design architectures of PSSw modules, balancing choices between standardization and innovation. The adoption of software systems depends on the maturity of the industry-specific digital ecosystem. Decomposition and integration of PSSw modules facilitate DS transition through business model modularity. Seven testable propositions are presented.Research limitations/implicationsWith the small sample size from different industries and one in-depth case study, generalizing the findings was not possible.Practical implicationsThe mapping exercise is powerful when top management from different functional departments can participate together to share their expertise and achieve consensus. It logs the “states” that the manufacturer undergoes over time.Originality/valueThe Digital Servitization Cube serves as a conceptual framework for manufacturers to systematically map and categorize their current and future PSSw strategies. It bridges the cross-disciplinary theoretical discussion in DS.

Extra care housing: exploring motivations, expectations and perceptions

2020 ◽  
Vol 23 (1) ◽  
pp. 15-26
Author(s):  
Michael James Buckland ◽  
Anthea Tinker
Keyword(s):  
Social Life ◽  
Housing Association ◽  
Small Sample Size ◽  
Well Being ◽  
Small Sample ◽  
Structured Interviews ◽  
Content Type ◽  
High Expectations ◽  
Health And Social Care ◽  
Extra Care Housing

Purpose The purpose of this paper is to explore and compare the motivations and expectations that older people have when choosing to move into either a private or housing association (HA) extra care housing (ECH) scheme, and any effects this had on its residents. Design/methodology/approach This qualitative study is based on findings from four HA schemes in Tower Hamlets, London, and one private scheme in Warwickshire. Eight semi-structured interviews were conducted with five women and three men of varying backgrounds, from schemes managed by different associations and companies. Interview transcripts were coded and analysed thematically. Findings All residents moved into ECH in response to deteriorating health. However, almost all residents had felt obliged to move by others, generally their children. Few residents had any expectations of ECH on arrival, but many developed high expectations of an increased sense of independence and security and of an improved social life. ECH appeared to be beneficial for residents’ health and well-being. Research limitations/implications The inability to recruit an equal number of people from HA and private scheme, alongside the small sample size, may compromise the external validity of any conclusions drawn from any comparisons. Practical implications This research identifies a lack of knowledge about ECH among the general population and offers insight into areas of poor management within ECH schemes which could be improved. Social implications Inadequacies in the ECH model could be attributed to failures in the current health and social care system. Differences between expectations and perceptions of HA vs private schemes should be acknowledged and responded to. Originality/value This is a rare example of research exploring the relationships between ECH residents’ motivations and expectations (Hillcoat-Nallétamby and Sardani, 2019), and between those in HA vs private schemes.

scholarly journals Pharmacogenetic Tests in Reducing Accesses to Emergency Services and Days of Hospitalization in Bipolar Disorder: A 2-Year Mirror Analysis

2019 ◽  
Vol 9 (2) ◽  
pp. 22 ◽  
Author(s):  
Camilla Callegari ◽  
Celeste Isella ◽  
Ivano Caselli ◽  
Nicola Poloni ◽  
Marta Ielmini
Keyword(s):  
Bipolar Disorder ◽  
Cost Saving ◽  
Emergency Services ◽  
Small Sample Size ◽  
Economic Value ◽  
Small Sample ◽  
Control Group ◽  
First Year ◽  
Potential Cost ◽  
Related Group

Despite the enormous costs associated to mood disorders’, few studies evaluate potential cost saving from the use of pharmacogenetic tests (PGT). This study compares 12 months before the execution of the PGT versus 12 months after, in terms of number and days of hospitalization and accesses to emergency services, in a sample of 30 patients affected by bipolar disorder. Secondarily, the study gives an economic value to the data based on the diagnosis-related group (DRG). Patients included in the study were required to be aged ≥18 years, sign an informed consent, have a score of Clinical Global Impression item Severity (CGIs) ≥3, and have a discordant therapy compared to the PGT in the 12 months preceding it and a therapy consistent with it for the following 12 months. Cost saving has been evaluated by paired t-tests in a mirror analysis. Statistically significant differences in all the comparisons (p < 0.0001) emerged. Important cost saving emerged after the use of PGT (€148,920 the first year versus €39,048 the following year). Despite the small sample size and lack of a control group in this study, the potential role of PGT in cost saving for the treatment of bipolar disorder treatment emerged. To confirm this result, larger and clinical trials are needed.

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