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Browsing Health by Author "Daly, Tamara J."
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Item Open Access Mental Health and Psychosocial Calls in the Prehospital Setting in Ontario: A Qualitative Case Study(2020-05-11) Ford-Jones, Polly Christine; Daly, Tamara J.Paramedics have seldom been included in discussions of mental health care and yet play a significant role in the chain of mental health care for many. This thesis explores the nature of paramedic work and the mental health and psychosocial calls encountered by paramedics in the community. This project is a case study of mental health and psychosocial calls in paramedicine in Ontario and was designed to explore the care provided by paramedics on mental health and psychosocial calls, the training and resources for these calls, and the experiences of paramedics in managing these calls. Using both a feminist political economy and social determinants of health approach, this thesis explores questions around care provision on the front lines, but also beyond into community mental health services and to the social determinants of health impacting an individuals need for care from paramedic services. I conducted interviews with front-line paramedics, paramedic services management, paramedic educators and Base Hospital physicians/managers; observation in three paramedic services including urban, rural/suburban and rural with varying degrees of engagement on the issue of mental health in paramedicine; and document analyses of the standards guiding paramedic practice in this area. This thesis reframes issues of mental health calls in paramedicine from an issue of misuse of emergency services, to one which accounts for the contexts creating distress as well as existing constraints for work and care. Findings from this study support enhanced training and education for paramedics, specific mental health related programming for paramedic services, as well as the importance of working conditions for both care providers and care recipients. I argue that there must be a balance between efforts placed on establishing appropriate supports for managing mental health and psychosocial calls as well as addressing necessary training and education in this area, while simultaneously ensuring sufficient focus remains at the level of prevention at the broader social, political, and economic determinants of physical and mental health.Item Open Access Querying Everyday Scarcity: A Feminist Political Economy Analysis of Kidney Dialysis and Transplantation in Rural British Columbia(2015-08-28) Brassolotto, Julia Marina; Daly, Tamara J.This thesis uses a feminist political economy perspective to analyze the findings from a qualitative case study regarding kidney dialysis and transplantation in rural and remote British Columbia. This case study was conducted in order to investigate the concept of "scarcity," which is very common in organ transfer discourse. Critical ethnography and document analysis were used to examine the ways in which scarcity manifests in policy, practice, and everyday life. The main areas of focus include: the systemic context for the practices; the intersection of social location and geographic isolation; the intersection of gender, work and health; the implications of work in the local resource industry for renal health and renal replacement options; the role of unpaid care work provided by family members; and the implications of shifting care from institutions to families and individuals – particularly in a rural and remote context. Broadly, I argue that the scarcity of transplantable organs remains the dominant public discourse, that this discourse informs policies and practices, and that, despite these trends, lived experiences of scarcity at this site of study have more to do with the scarcity of human and health care resources, particular services, and health and life-sustaining resources for patients.