bluuebunny/crossref_metadata_2025 huggingface dataset:
Analisis Saldo Kas Optimal Badan Layanan Umum: Studi Kasus pada Rumah Sakit Umum Pusat dr. Kariadi
Authors: Indra Rolly
Published: December 2018

Cash has an important role for private or public organizations. Public service agencies are authorized to manage cash. There is a phenomenon of high cash ratio at Kariadi Hospital compared to that of other hospitals, which indicate that cash balance management has not been effective. This study aims to analyze the optimal cash balances and analyze the causes of ineffective management of cash balances at Kariadi Hospital. The Optimal cash balance is analyzed using Miller and Orr methods. The ineffective management of cash balances is analyzed using factors to be considered when managing cash balances.In addition, the management of cash balances at Kariadi Hospital is compared to Sardjito Hospital (as benchmark) in order to analyze the differences. Factors, that are compared, are management’s policies and the management of cash balances, the contribution of the supervisory board and internal auditing unit, as well as the use of information technology. The results showed that the real cash balances in year 2016 were much higher than the optimal cash balances using the Miller-Orr model. factors to be considered, which caused the ineffevtive management of Kariadi Hospital’s cash balances, were the amount of cash balance outside the placement of time deposit that was not adjusted to the operational needs and cash forecastingand the policy of third party’s bill payment at the end of the year which caused the current liabilities declined and current ratio at the end of the year went up.   Abstrak Kas mempunyai peranan penting bagi organisasi privat dan publik. Badan layanan umum diberikan wewenang untuk mengelola kas. Terdapat fenomena rasio kas yang tinggi pada RSUP dr. Kariadi dibandingkan RSUP lain yang mengindikasikan pengelolaan saldo kas belum efektif. Penelitian ini bertujuan menganalisis saldo kas optimal RS Kariadi dan penye bab pengelolaan saldo kas yang belum efektif. Saldo kas optimal dianalisis menggunakan metode Miller dan Orr. Pengelolaan saldo kas yang belum efektif dianalisis menggunakan faktor-faktor yang dinilai dapat memengaruhi pengelolaan saldo kas. Kemudian, membandingkan dan menganalisis perbedaan pengelolaan saldo kas RS Kariadi dengan RS Sardjito (sebagai benchmark). Faktor-faktor yang dibandingkan ialah kebijakan dan pengelolaan saldo kas oleh manajemen, kontribusi dewan pengawas, dan satuan pemeriksa internal serta penggunaan teknologi informasi. Hasil penelitian menunjukkan bahwa saldo kas riil tahun 2016 jauh lebih tinggi dibandingkan saldo kas optimal model Miller-Orr. Faktor penyebab pengelolaan saldo kas RS Kariadi tidak efektif ialah besaran saldo kas di luar deposito yang tidak disesuaikan dengan kebutuhan dan cash forecasting. Selain itu, kebijakan pembayaran tagihan kepada pihak ketiga pada akhir tahun menyebabkan kewajiban lancar menurun pada akhir tahun dan rasio lancar menjadi tinggi.
El Huila, la tierra del olvido, el miedo y la indiferencia
Authors: Nuñez Daniela
Published: December 2018

El departamento del Huila es un territorio poseedor de incalculable patrimonio cultural, humano, arqueológico y natural, reconocido además como capital del desarrollo sur colombiano. Paralelo a esta belleza, el Huila también es una de las regiones más golpeadas por el trasegar del conflicto armado. Durante años ha constituido una zona de especial interés para todos los actores armados del conflicto colombiano y se ha consolidado entonces como una de las zonas más agredidas donde la población civil, como en casi todo el país, es generalmente la que pone los muertos. Cada uno de los actores armados del conflicto llámense paramilitares, guerrilla, ejército, policía, los ahora grupos emergentes o Águilas Negras, confluyen en una disputa por territorio y poder que incrementa a diario las cifras de violaciones a los derechos humanos e infracciones al Derecho Internacional Humanitario.
LOS WAYUU más allá de un proyecto de investigación
Authors: Marínez Pereira Carolina
Published: December 2018

La cultura Wayuu, una comunidad aborigen Colombiana símbolo de patrimonio cultural en el país y seguramente foco de muchas investigaciones desde cualquier campo profesional. Ubicados al Norte de Colombia, extendidos a lo largo y ancho del departamento de la Guajira. los Wayuu son reconocidos por sus costumbres, tradiciones y trabajo artesanal, especialmente por la tejeduría, quizá como la única forma de sustento económico que tienen hoy por hoy debido a tantos cambios socio-culturales a los que se han enfrentado, debido a la influencia de factores externos que van desde el cambio climático, hasta la forma de pensamiento de las nuevas generaciones. Una cultura que destaca por su manera de ver la vida e interpretarla a través de su trabajo, por medio de diversos símbolos que son su máxima expresión. Uno de los elementos más representativos de su artesanía es la mochila Wayuu, con un tejido muy característico realizado en redondo, que tiene como base el croché, pero en cada cadeneta tiene un alma o relleno en hilo que le da mayor rigidez al mismo, y por medio del cual plasman con variedad de colores los símbolos de su comunidad, son una de las piezas más comercializadas no solo en el país sino a nivel internacional, llamativa para la gran mayoría por su valor estético, además de responder a un mundo que a pesar de pertenecer a una era tecnológica, aun busca una mirada alternativa, valorando los procesos manuales y culturales.
Mass gathering public health and emergency medicine literature review: Levels of evidence
Authors: Arbon Paul , Cusack Lynette , Oenol Naomi
Published: December 2018

Introduction
The science of mass gatherings is a relatively new and developing field. It is currently at a stage where summarising the rigour of knowledge gained about the complex interrelationships between key characteristics of an event, spectator profiles and health implications are critical. This study seeks to summarise the levels of evidence in peer-reviewed journal articles concerning mass gathering public health and emergency medicine published 2001 to 2011. Until now, the evidence behind the science of mass gathering public health and emergency medicine has not been critically analysed.
Methods
Publications were reviewed by searching the following online databases: GALE, NLM, Web of Science, Elsevier, Wiley, BMJ Journals, OUP, IngentaConnect, RMIT, DOAJ and JSTOR. Published news articles and grey literature were omitted. The peer-reviewed articles were organised into pre-determined World Health Organisation categories and the levels of evidence were assessed using the effectiveness classifications developed by the Joanna Briggs Institute. Descriptive statistical analysis was then undertaken using Microsoft Excel®.
Results
Of all publications examined, 38·86% (n = 89) of the articles found in this review were categorised as observational studies, 36·68% (n = 84) were expert opinion or consensus, 20·09% (n = 46) were cohort studies, 2·18% (n = 5) were case-controlled studies and 2·18% (n = 5) were quasi-experimental studies.
Conclusion
High-level evidence studies may not be possible in the mass gathering context, but research in the middle-level should be encouraged to ensure that literature is less reliant on experience and expert opinion when applied to event management strategies which impact on public health and emergency medicine.
Fostering a Research Culture in Paramedicine: Selected Proceedings from the 2011-2013 Paramedic Research Forum at Auckland University of Technology
Authors: Tunnage Bronwyn
Published: December 2018

These are selected posters from the Auckland University of Technology Paramedic Research Forums in 2011-2013.
Student research: the future of paramedicine
Authors: O’Meara Peter
Published: December 2018

For the first time since the establishment of a paramedicine peer-reviewed journal in Australia and New Zealand a Special Edition is being published specifically for student contributions. This is an important juncture in the evolution of our profession that recognises the importance of the next generation of paramedic practitioners, scholars and leaders. It really does mark a departure from our vocational training roots to being a tertiary-educated health profession that works in partnership and alongside the other health professions
Simulation-based clinical assessment: Redesigning a signature assessment into a teaching strategy
Authors: Barr Nigel , Readman Kylie , Dunn Peter
Published: December 2018

Paramedics entering the professional workforce continually make judgements of their own and their peers’ performances. With little exposure to these processes, exercising these judgements is difficult. Teaching strategies that use self-assessment, peer assessment and reflective practice should improve the acquisition of clinical reasoning and application of clinical skills (1-4). However, clinical programs such as paramedic programs, present unique challenges in the development and assessment of clinical skills, because allowing undergraduate paramedic students to work with autonomy beyond their ability presents considerable risk to patient safety. The results of this pilot project indicate that changing a simulation-based clinical assessment (SCA) from a standalone assessment to a strategy encouraging student engagement through a focus on active learning rather than on passive teaching, have facilitated deeper understanding and developed desired attributes.
Pathway to Paramedicine Program Perspectives – Part 2 Secondary School Students
Authors: Ross Linda , Bertucci Jessica
Published: December 2018

Introduction

The Pathway to Paramedicine Program offers secondary school students with an interest in the paramedic disciple a unique opportunity to gain insight into the profession and the training required. This study aimed to evaluate the secondary school students’ perspectives of the program.

Methods

This pilot intervention study with paper based survey included 14 secondary school students enrolled in the Pathway to Paramedicine Program at Monash University, Victoria. The evaluation survey consisted of a combination of Likert and free text questions.

Results

All 13 Likert scale items received a median score of 4 (agree) or above. Ten items achieved a maximum median score of 5 (strongly agree). Nine items received a positive score of 4 or 5 from all students. Participants also indicated they gained insight into the disciple and confidence in their own skills. Fifty percent of Year 12 participants enrolled in paramedic degrees in 2014.

Conclusions

This study gave secondary school students valuable insight into paramedic practice and helped them make a decision about their future education and career paths. The results showed that the secondary school students had a tremendously positive perspective of the Pathway to Paramedic program, enjoyed and appreciated their interaction with paramedic student mentors and would recommend the program to others.
London Swoops on Australian Paramedics
Authors: Wallis Jaime , Ross Linda , Boyle Malcolm
Published: December 2018

This editorial looks at the London Ambulance Sservice and how it is “poaching Australian paramedics and graduate paramedics.
Mass gathering medical planning: An overview of the Australian Surf Life Saving Championships
Authors: Reid David , Leahy Stephen , Widermanski Anne-Marie
Published: December 2018

The Australian Surf Life Saving Championships (the ‘Aussies’) were held between 31 March and 6 April 2014, at Scarborough Beach in Western Australia. The event attracted 6,000 persons including competitors, support staff and officials. It is estimated that 70,000 spectators attended the event over the seven days of competition.This article provides an overview of the Aussies, outlines its medical planning and role of the medical team, and describes the team structure. Equipment and team deployment is described. This article also identifies some of the challenges that the Aussies present to medical planners because of the unique factors which influence the number and type of patient presentations. Finally, improvement recommendations are made which outline a number of simple, yet key strategies which will improve medical planning in the future.
Promoting the Next Wave of Paramedic Researchers
Authors: Boyle Malcolm J
Published: December 2018

This is an editorial for the special student issue
First aid knowledge retention in school children: A review of the literature
Authors: Lenson Shane , Mills Jason
Published: December 2018

IntroductionFirst aid training for lay people is recognised as an important capacity building component of pre-hospital care in communities. In countries such as Australia, this training is increasingly targeted to school children, but relatively little attention is directed to knowledge retention or optimal training methods for this population. This literature review aimed to determine whether the published literature demonstrates that first aid knowledge is retained by school children who have learnt first aid from professional first aid providers.MethodsA systematic search of the peer-reviewed and grey literature was conducted for narrative review. Journal articles were retrieved from three databases (MEDLINE, CINAHL, ERIC) using the search terms ‘first aid’; ‘resuscitation’; ‘training’; ‘child*’; and ‘school’. Inclusion and exclusion criteria were applied and review findings organised thematically.Results The search yielded four primary studies of European school children aged between 4 and 12 years trained by professional first aid providers. Subsequent review identified emergent themes of Resuscitative first aid and Non-resuscitative first aid. Heterogeneity was apparent in training and evaluation methods, and study quality varied. Reported first aid knowledge retention was mixed.ConclusionThere is a lack of quality evidence to guide optimal training methods and maximise first aid knowledge retention in school children. To date, research in this area has been limited to Europe. Further research is therefore recommended. Formal evaluation of professional first aid training can help guide training methods and enhance first aid knowledge retention in school children, thereby building more robust first aid capacity in the community.
Community Presentations of Anaphylaxis in Tasmania: Who is Administering the Adrenaline?
Authors: Edwards Dale , Blackhall Melanie , Berry Rachael
Published: December 2018

Background

Anaphylaxis is a significant health concern within the community. The early administration of adrenaline to patients experiencing anaphylaxis has long been recognised as the cornerstone of treatment. Health-care providers, including general practitioners, nurses and paramedics, are well equipped to manage anaphylaxis through the administration of adrenaline. Patients themselves also often have adrenaline auto injectors, allowing early self-management. The objective of this study was to determine the rates of adrenaline administration and identify the administering persons for all anaphylaxis patients presenting to ambulance services in Tasmania from January 1st 2008 until December 31st 2011 by using a retrospective chart review.

Methods

Ambulance Tasmania electronic case reports (n=226 421) from the period January 1st 2008 to December 31st 2011 were searched for all cases fitting the parameters of anaphylaxis, allergy or allergic reaction. Of these cases, 373 were given a final paramedic diagnosis of anaphylaxis and constituted the primary data for this report.

Results

Ambulance Tasmania attended 373 patients during the study period that were given a final primary diagnosis of anaphylaxis - of these 59 (15.8%) were excluded, leaving 314 electronic records for analysis. Of the cases identified, 71.7% (n=225) were administered adrenaline according to paramedic records. Adrenaline was administered by a range of health professionals, including general practitioners (n=27), paramedics (n=159), ambulance volunteers (n=4), nurses (n=1) and other health professionals (n=3). Adrenaline was self-administered by 12.4% (n=28) of patients, with an additional 11.6% (n=26) receiving adrenaline from a non-health care worker (layperson). In 10.2% of cases (n=23) adrenaline was administered by more than one provider. Administration of adrenaline prior to paramedic arrival was evident in fewer than 10% of cases treated with adrenaline (n=22).

Conclusion

The early administration of adrenaline in anaphylaxis is often vital for patient recovery. This study shows that adrenaline is administered by a number of different providers, with early administration accounting for only 9.8% of presentations treated with adrenaline. These findings raise the question, is adrenaline being administered early enough and often enough to improve health outcomes?
Using a Sociological Approach to Answering Questions about Paramedic Professionalism and Identity
Authors: Johnston Tania , Acker Joe
Published: December 2018

With evidence-based practice now the norm, paramedics today can confidently and readily search for answers to clinical questions. For anyone seeking to better understand the non-clinical aspects of paramedic practice, however, looking to social theory can be a starting point. Understanding social theory gives paramedic researchers a lens through which to closely examine every day events and behaviours that affect paramedic practice within the context of society. Arguably, the move towards professionalisation is one of the most significant events impacting paramedicine today. Alongside this professional evolution, the practitioner identity is gradually being challenged and reshaped, raising a number of important questions. The purpose of this article is to explore how paramedic researchers can use two prominent social theorists, Bourdieu and Goffman, to explore inevitable questions related to professions and professional identity.
Protective Effect of Paramedics’ Sense of Personal Accomplishment at Work: Mitigating the Impact of Stress on Sleep
Authors: Kukowski Charlotte , King David B , DeLongis Anita
Published: December 2018

Introduction

Paramedics are at high risk for the development of post-traumatic stress disorder (PTSD), trauma-related symptoms, and burnout. Despite the multitude of research linking both PTSD and burnout with poor sleep quality, there has been no research linking all three variables, in emergency workers or otherwise. Given the importance of sleep in a profession that is largely reliant on shift work, the goal of the current study was to examine the moderating effect of burnout on the association between post-traumatic stress and average sleep quality.

Methods

A sample of 87 paramedics from major urban centres across Canada completed the Maslach Burnout Inventory and the PTSD Checklist Civilian Version, in addition to reporting sleep quality for a period of one week.

Results

In support of our hypotheses, post-traumatic stress was associated with lower average sleep quality. Standard regression analyses further revealed that this effect was moderated by burnout, such that higher burnout exacerbated the effect of post-traumatic stress on sleep. In examination of the subscales of the MBI, this effect was maintained for personal accomplishment only, which interacted with stress so as to further impair quality of sleep.

Conclusions

These findings offer important considerations regarding the mitigating role of more positive workplace variables in paramedics suffering from post-traumatic stress, PTSD, and/or sleep problems. Interventions aimed at fostering a sense of personal accomplishment on the job may improve the health of emergency medical personnel via multiple pathways.
Examination of Undergraduate Paramedic Clinical Placement within a Traditional and Novel Setting
Authors: Smith Gavin
Published: December 2018

Background

Increasing student enrolments and limited capacity within traditional placements have defined a need to reassess the format of clinical placement programs. This study aimed to compare traditional and novel clinical placement experience of third year paramedic science students at Victoria University in order to report elements that may contribute to identifying an optimum model for future clinical placement programs.

Design

A descriptive study of clinical placement case exposure with comparative analysis of local and international student cohorts.

Setting

A paramedic student clinical placement program in two ambulance services: Ambulance Victoria (Australia) and Magen David Adom (Israel).

Methods

Descriptive statistics were used to report patient and student experience factors. Specific case exposure, demonstration of skills and use of pharmacological agents are reported as proportions.

Results

A total of 441 cases were analysed: 206 and 235 in the local and international study groups respectively. Mean caseload per paramedic student was not significantly different between the study groups at 1.2 cases (95% CI: -2.8-0.4, p=0.1)). The international group engaged in a greater range of shifts, including more afternoon shifts and the opportunity to experience night shifts.

Conclusion

This study provided the first descriptive analysis of a traditional and international clinical placement experience for paramedic undergraduate students, identifying benefit in both programs. Future studies incorporating a mixed methods design measuring practical exposure will add important depth and understanding to clinical placement optimisation.
What’s in a name? The confusion in nomenclature of low-acuity specialist roles in paramedicine.
Authors: Long David Nicholas , Clark Michele , Lim David , Devenish Scott
Published: December 2018

A significant paradigm shift in the care of non-urgent, low-acuity patients by paramedics has been gathering momentum over the last two decades. However the current nomenclature to define paramedics who specialise in the low-acuity setting is confusing, inconsistent and arguably misrepresentative. This commentary contends that two discernible paradigms lie along the spectra of low-acuity service delivery in paramedicine and argues that the nomenclature should also reflect this difference. Consistency in nomenclature has implications for the evolving professionalism in paramedicine and the movement towards national registration.
Experiencing Emergency Medical Services at Hajj
Authors: Leggio William J , Mobrad Abdulmajeed , D'Alessandro Kenneth J , Krtek Michael G , Alrazeeni Daifallah M. , Sami Mohammed A. , Raynovich William
Published: December 2018

Introduction

This article is a first-hand report on the experience of paramedic students providing emergency medical services (EMS) at Hajj, an annual mass gathering of Muslim pilgrims in Makkah, Saudi Arabia. Previous quantitative research on Hajj has primarily reported on demographic descriptive data. A qualitative approach to understanding Hajj was not discovered in the literature. This qualitative phenomenological study was conducted to investigate the experiences of EMS students providing patient care at Hajj.

Methods

This research was conducted using a qualitative phenomenological methodology. Focus group interviews were conducted on Bachelor degree students studying EMS at a public college in Riyadh, Saudi Arabia, who were all required to serve as support providers at Hajj as part of their paramedic training.

Results

Participants described their experiences as honorable and beneficial to their EMS education. Participants encountered medical and trauma patients and this provided opportunities to apply their EMS knowledge and medical skills. They reported an increase in motivation, confidence and ability to think critically. Common challenges included language barriers and difficulty reaching patients due to massive crowds. Participants provided recommendations for improving the EMS provided at Hajj, which were generally focused on increasing utilisation of EMS students, development of standards and scope of practice for EMS at Hajj and a preceptor-training program.

Conclusion

Attending the Hajj mass gathering was found to have significant educational value for EMS students. Specific recommendations on how to improve this education experience and provided emergency care at Hajj are made. These recommendations hold practical implications for EMS training programs and Hajj organizers.
Inquiry into the Establishment of a National Registration System: A Response to New South Wales
Authors: Moritz Dominique Lee
Published: December 2018

Introduction

The potential national registration of paramedics is a significant issue. Despite widespread support of paramedics joining other registered health practitioners under the National Registration and Accreditation Scheme, New South Wales continues to oppose.

Methods

This paper considers the New South Wales submission to the Senate Committee's inquiry into the establishment of a national registration system for Australian paramedics. It evaluates the reasons for New South Wales Health's opposition to national registration.

Aim

This paper considers the New South Wales submission to the Senate Committee's inquiry into the establishment of a national registration system for Australian paramedics. It evaluates the reasons for New South Wales Health's opposition to national registration.

Conclusion

New South Wales Health's reasons for opposing national paramedic registration include the cost to implement a registration scheme, the desire to maintain vocational entry to employment and the purported efficiency of their current regulatory system. However, their position fails to address the challenges of employer-based regulation and the significant public protection benefit, among other things, of national statutory regulation.
The Pre-Hospital and Healthcare System in Malang, Indonesia
Authors: Suryanto Suryanto , Boyle Malcolm , Plummer Virginia
Published: December 2018

Introduction

Malang is the second largest city in East Java and consists of three districts: Malang Regency, Malang City and Batu City. Malang has the most advanced emergency care education in East Java, and possibly Indonesia. The recent launch of the 119 Emergency Medical Service may influence pre-hospital care in Malang and assist in developing a more organised emergency medical system in the area.

Objective

This paper describes the pre-hospital care and healthcare structure in Malang and focuses on the health facilities, pre-hospital care service and healthcare providers.

Discussion

There are two major types of healthcare facilities in Malang, hospitals and primary healthcare centres called ‘puskesmas’. Ambulance service provision in Malang is either hospital-based or puskesmas-based. There is no organised emergency medical system in Malang. In the case of an emergency, the patient or bystander calls the hospital emergency department or puskesmas. The use of ambulances in Malang is low due to the perceived prohibitive cost of the service. Ambulance service fees for emergency cases outside of the hospital or puskesmas are not covered by the universal health insurance in the country. There is no specific pre-hospital trained staff in Malang. Nurses are responsible for staffing the ambulance, and there is no formal pre-hospital care education for those nurses working in an ambulance.
Paramedic confidence in estimating external blood loss
Authors: Harris Wayne , Rotheram Auston , Pearson Sue , Lucas Peter , Edwards Dale , Bowerman Lisa , Williams Anne-Marie
Published: December 2018

IntroductionStudies have identified that visual estimation of blood loss is highly inaccurate, however no research has investigated the relationship between this practice and the confidence of estimation by paramedics.The aim of this study was to determine paramedic confidence in the estimation of, and reporting of external blood loss due to medical or trauma aetiology, within an Australasian paramedic context.MethodsBetween July and September 2015, a cross-sectional survey was distributed through Australasian paramedic professional bodies to determine confidence in estimating and documentation of external blood loss. Using Likert scale and free text responses, participants provided demographic information and their self-perceived confidence in estimating and documenting external blood loss.ResultsFive thousand six hundred paramedics were invited to participate in an online survey. Two hundred and eight responses were received (3.8% response rate). A total of 86.6% of participants reported documenting blood loss in clinical reports, however only 47.8% of participants believed their estimation of external blood loss was accurate with 13% reporting underestimation and 33.5% reporting overestimation of blood loss. Additionally, only 51.6% of participants agreed to strongly agreed that they were confident in their estimation of blood loss.ConclusionThis research demonstrates the majority of paramedics estimate and document external blood loss, yet nearly half do not feel confident in doing so, despite indicating its importance. Educational and organisational changes are recommended to reflect the clear evidence against this practice. Further research is recommended to identify appropriate physiological parameters and practical assessment tools to replace this inaccurate form of clinical assessment.
Paramedic identification and management of victims of intimate partner violence: A literature review
Authors: Mackey Breanna
Published: December 2018

IntroductionIntimate partner violence (IPV) occurs between adults of the same or opposite sex in a current, or past, intimate relationship. The aim of this paper is to review the literature regarding paramedic confidence, capacity and accuracy when identifying adult victims of IPV and subsequent management of the scene when IPV is suspected or identified.MethodsA review of the literature using Ovid MEDLINE was conducted; five articles met the inclusion and exclusion criteria. ResultsResults show a consistency in findings across research areas in Australia, Canada and the United States and are clear in four separate areas: paramedics demonstrate a high degree of accuracy in identifying IPV victims; professional training effectively increases paramedic knowledge of IPV; greater than 50% of the paramedic population surveyed felt underprepared to deal with an IPV scene; and the majority of surveyed paramedics attend between one and 10 IPV scenes per year.ConclusionThis review indicates that paramedics have the capacity to accurately identify IPV victims, and that paramedics recognise a deficit in their professional IPV training. Further research is required, using a robust sample size, to construct appropriate training packages and guide improvement to paramedic clinical practice guidelines.
The Bachelor of Nursing/Bachelor of Emergency Health (Paramedic) Degree: How well does it Align with Course Objectives?
Authors: Plummer Virginia , Tozer-Jones Jennie , Williams Brett
Published: December 2018

Introduction

The Bachelor of Nursing/Bachelor of Emergency Health (Paramedic) Degree (BN/BEH-P) is a four-year on-campus double degree, combining essential units from both the accredited Bachelor of Nursing and Bachelor of Emergency Health courses. Graduates of this course are expected to be well equipped to manage the complexity of emergency care out-of-hospital, in-hospital and at the interface of these settings. The aim of this study was to explore student views of their preparation and intentions towards future practice and the alignment with course objectives.

Methods

A cross-sectional study was employed with a sample of first, second, third and fourth year undergraduate students of the BN/BEH-P. The results were mapped to course objectives by researchers.

Results

Written responses varied considerably making generalisations difficult; however, some common themes did emerge such as a need for greater flexibility in course delivery options, not enough simulation, a need for more clinical placements and better communication between the two schools. The level of satisfaction with course content and delivery was high. Timetabling problems and the allocation of clinical placements were a source of concern for many students and were found to be common to double degrees in general. There was alignment between student perspectives of course delivery with half of eight course objectives, but not in areas such as ethics, evidence based practice, professional communication and cultural values in practice.

Conclusion

The findings are important for students, universities and health services, informing a pedagogical alignment between student preparation and expectations. The findings are expected to provide valuable insight into the student view of undergraduate interprofessional education, how it shapes their intentions for future practice and how students and other stakeholders know if they will receive what is offered and funded.
Evaluating the potential of iPads to actively engage paramedicine students in an authentic learning experience
Authors: Clarkson Georgia
Published: December 2018

IntroductionParamedicine students are required to develop the skills of assessing and managing clinical presentations to prepare them for practice. Active learning strategies that are student centred, facilitate collaboration and mirror workplace practices can assist the development of requisite skills. iPads provide a portable means of integrating audiovisual material into these clinical scenarios. Use of such material has the potential to add a degree of authenticity to this environment and require students to play a more active part in their learning.MethodsThis study introduced the ‘iPad-SFS’, a system for using iPads as a platform for introducing audiovisual material into practical classes, as a means of promoting active learning. Students completed a Likert scale survey inviting quantitative and qualitative feedback to evaluate the impact of this intervention on their learning experience.ResultsThe data indicated using iPads promoted engagement, enhanced realism, promoted a more collaborative and authentic learning experience and improved critical thinking.ConclusionOverall, the iPad based system impacted positively on student learning experience. Health professional educators in paramedicine should consider the use of system similar to iPad-SFS in practical classes.
Impact of Loading and Transport on Effectiveness of External Chest Compressions – a Simulation Study
Authors: Chew Reyna , Price Clare , Moqadassi Hamed , Talbert Shaun , Hilliar Tim , Thyer Elizabeth , Simpson Paul M
Published: December 2018

Introduction

Effective external chest compressions (ECC) are recognised as being critical for increasing chances of survival in out-of-hospital cardiac arrest. The aim of this study was to: 1) determine the impact of movement and transport on effectiveness of ECC performed by student paramedics; 2) provide results to inform a future larger study; and 3) validate teaching methods in an undergraduate paramedicine program.

Methods

A prospective cohort design was utilised. Student paramedics performed ECC on a manikin under three different conditions: at ground level on a hard floor surface (ground ECC); at waist-height on a moving ambulance stretcher (extrication ECC; and during transport in the rear of a moving ambulance (transport ECC). Three minutes of ECCs was performed under each condition, with periods of rest between phases. The primary outcome was the composite ‘compression score’ (CS) (%).

Results

Twenty-seven student paramedics performed chest compressions under all three conditions. For the primary outcome comparison of CS, there were clinically significant differences in ECC quality across the three conditions. Ground ECC produced the highest CS (89%; IQR 46), followed by transport ECC (54%; IQR 40). Extrication ECC was least effective (CS 0%; IQR 14).

Conclusion

The conditions under which ECC are performed significantly affects ECC quality. The quality of ECC is substantially reduced if performed in the back of a moving ambulance, and futile if performed on a moving ambulance stretcher. Paramedics should consider these findings when deciding whether or not to move or transport patients before return of spontaneous circulation. Lower than expected CS on hard ground surfaces may indicate a need to review teaching of ECC in this cohort of students.
A Comparative Taxonomy of Australasian Paramedic Clinical Practice Guidelines
Authors: Colbeck Marc , Maria Sonja
Published: December 2018

Background

There are 10 state-run ambulance services in Australia and New Zealand, all of which are members of the Council of Ambulance Authorities (CAA). These CAA services use nine unique sets of clinical practice guidelines (CPGs) to direct the care that their paramedics deliver to patients. Although there are many similarities in these guidelines there are also notable differences in both structure and content. This paper is a comparative analysis of these CAA CPGs that contrasts the differences in organisation and also discusses the similarities and differences between the various CPGs themselves. This comparison was done as a preparatory exercise for the creation of a set of national CPGs by Paramedics Australasia.

Methods

The complete set of CPGs were obtained and analysed. All CPGs intended for operational road paramedics were examined. These included extended care paramedic, retrieval and intensive/critical care paramedic CPGs, and first responders. The 10 tables of contents were synthesised into one document and then restructured into a unique taxonomy determined by consensus of the authors. The authors reviewed the taxonomy to ensure the organisation was consistent and logical. Each CPG was then reviewed to ensure that it was appropriately placed in the new taxonomy. The CAA CPGs were further examined for similarities and differences independently by each author according to a predefined list of characteristics.

Results

A new taxonomy for Australasian CPGs is presented with a discussion of various issues of interest that became apparent during the development of the taxonomy. This taxonomy can provide guidance in the creation of a unified set of CPGs that can be used as a reference for developers, educators, clinicians, researchers, managers and industry representatives interested in consulting and developing a clear statement of the scope and standards of Australasian paramedics. The comparative analysis could be of interest to developers of CAA CPGs, and others.

Conclusion

This paper presents a novel taxonomy, or scheme of classification, that incorporates all CAA CPGs in preparation for the development of a uniform set of Australasian CPGs, which will be of use to various individuals and organisations.
Infection Control Protocols: Is it Time to Clean up our Act?
Authors: Makiela Sandrine , Weber Anthony , Maguire Brian J , Taylor-Robinson Andrew W
Published: December 2018

While paramedics in Australia respond to many call-outs daily, little is known of the risks of infectious disease transmission that may arise from contamination of vehicles, equipment, personnel and/or patients. We examine what is currently known of the current risks in Australia posed by contamination of emergency service vehicles by antimicrobial-resistant microorganisms.
Poder e Discurso
Authors: Fonseca Pedro
Published: December 2018

This article analyzes speeches of tenure of the Ministers of Foreign Affairs of Brazil made between 2003 and 2016, in the inaugural speech of former Minister José Serra. Using discourse analysis, the paper analyzes guidelines of the Foreign Policy of the Lula, Dilma and Temer governments. The paper seeks to corroborate the thesis that in the government of the Workers’ Party (PT) the guidelines of the Brazilian foreign policy emphasize global South relations, while in the government of the Party of the Brazilian Democratic Movement (PMDB) these guidelines prioritize relations with the centers of capitalism. To this end, we used the content analysis method proposed by Bardin (1977) and the software IRAMUTEQ.
DIVIDEND PAYOUTS: MAJORITY CONTROL AND RENT EXTRACTION
Authors: Besim Seniha , Adaoglu Cahit
Published: December 2018

In Eurasia, Turkey has a “crony” capitalist system with majority control and business groups (BGs) in the hands of a few families. These business groups are often organised around a holding company. We analyse the dividend payouts of family controlled Borsa Istanbul companies, which are affiliated to holding and non-holding BGs. We investigate and quantify the effects of several control-enhancing mechanisms (CEMs) on dividend payouts. We use precise quantitative proxies for CEMs to measure the divergence between control and ownership rights. Supporting the rent extraction hypothesis, holding business group companies have lower dividend payouts as the divergence between control and ownership rights widens and the pyramid wedge increases. However, controlling foreign-family coalitions in holding business group companies curb the rent extraction problem by having a positive effect on the dividend payouts. Overall, for family controlled holding BG companies, the effects of company-specific financial control variables on dividend payouts are stronger than the effects of CEMs. For family controlled non-holding BG companies, there is no empirical support for either the rent extraction or the reputation building hypotheses. The company-specific financial control variables are the main determinants of dividend payouts for family controlled non-holding BG companies.
EFFECTS OF THE PRE-REPURCHASE SYSTEMATIC RISK ON THE RELATIONSHIP BETWEEN INVESTOR BEHAVIOR, MARKET FACTORS AND THE STOCK PRICE RESPONSES
Authors: Liu Ying-Sing
Published: December 2018

This study explores the pre-repurchase systematic risk will affect the abnormal returns in the open-market repurchase event period and also change the relationship between the investor sentiment, trading activity, market factors and stock price response during the event on Taiwan stock market. Based on threshold regression models, it is found that the pre-repurchase systematic risk will significantly change the relationship between investor behavior, market factors and stock price responses and the asymmetry of the relationship exists when pre-repurchase systematic risk is lower than a repartition, which supports that institutional investors and credit trading investors differ in these existing relationships. When the pre-repurchase beta is below repartition, it will be detrimental to the returns in event period. But on the contrary, the returns in the short-term shock of news exposure period present the favorable results, which may be related to the fact that there exists sentiment premium in short-term when credit trading investors’ repurchase news exposure occurs. Finally, the study is to confirm the effect of systematic risk for returns and investor sentiment, these results have not been further explored in the past, and can be used as the firm’s evalu-ation reference to the repurchase program in the future.
The Carnegie-Chicago Hubble Program: Calibration of the Near-infrared RR Lyrae Period–Luminosity Relation with HST
Authors: Rich Jeffrey A. , Madore Barry F. , Monson Andrew J. , Freedman Wendy L. , Beaton Rachael L. , Clementini Gisella , Garofalo Alessia , Hatt Dylan , Hoyt Taylor , Jang In-Sung , Kollmeier Juna A. , Gyoon Lee Myung , Neeley Jillian R. , Scowcroft Victoria , Seibert Mark
Published: December 2018

We present photometry of 30 Galactic RR Lyrae variables taken with HST WFC3/IR for the Carnegie-Chicago Hubble Program. These measurements form the base of the distance-ladder measurements that comprise a pure Population II base to a measurement of H

o
at an accuracy of 3%. These data are taken with the same instrument and filter (F160W) as our observations of RR Lyrae stars in external galaxies so as to minimize sources of systematic error in our calibration of the extragalactic distance scale. We calculate mean magnitudes based on one to three measurements for each RR Lyrae star using star-by-star templates generated from densely time-sampled data at optical and midinfrared wavelengths. We use four RR Lyrae stars from our sample with well-measured HST parallaxes to determine a zero-point. This zero-point will soon be improved with the large number of precise parallaxes to be provided by Gaia. We also provide preliminary calibration with the TGAS and Gaia DR2 data, and all three zero points are in agreement, to within their uncertainties.
Spectroscopy of the K0 Binary Giant α UMa
Authors: Gray David F.
Published: December 2018

High-resolution spectroscopic observations of the K0 II–III star α UMa were taken at the Elginfield Observatory over 11 years. Radial velocities were measured for nine of these years. They do not cover enough of the 44.5 year orbital period to give definitive elements on their own, but combined with published visual orbits, the spectroscopic-orbit parameters are well constrained. The spectra show no evidence of the secondary star, which remains an unsolved puzzle. Line-depth ratios show that α UMa has temperature variations ∼3 K, possibly periodic, over the 2001–2010 interval. Fourier analysis of the line broadening gives the projected rotation velocity of 2.66 ± 0.15 km s−1 and a radial-tangential macroturbulence dispersion of 4.97 ± 0.08 km s−1. The third-granulation signature shows the granulation velocities of α UMa to be essentially solar, with a scale factor of 0.98 ± 0.10. The absolute radial velocity of the star, with granulation blueshifts removed is −10,035 ± 100 m s−1 at the mean time of the observations, 2005.2544. The line bisector of Fe i
λ6253 is normal and shows the classic “C” shape with the blue-most point commensurate with its absolute magnitude. Mapping this bisector on to the third signature gives a flux deficit similar to those of other giants, with a fractional area of 0.131, suggesting a temperature difference between granules and lanes of 127 K. The velocity position of the deficit is slightly higher than that for previously analyzed giants, extending the correlation with absolute magnitude.
AutoSpec: Fast Automated Spectral Extraction Software for IFU Data Cubes
Authors: Griffiths Alex , Conselice Christopher J.
Published: December 2018

With the ever-growing popularity of integral field unit (IFU) spectroscopy, countless observations are being performed over multiple object systems such as blank fields and galaxy clusters. With this, an increasing amount of time is being spent extracting one-dimensional object spectra from large three-dimensional data cubes. However, a great deal of information available within these data cubes is overlooked in favor of photometrically based spatial information. Here we present a novel yet simple approach of optimal source identification utilizing the wealth of information available within an IFU data cube, rather than relying on ancillary imaging. Through the application of these techniques, we show that we are able to obtain object spectra comparable to deep photometry-weighted extractions without the need for ancillary imaging. Further, implementing our custom-designed algorithms can improve the signal-to-noise ratio of extracted spectra and successfully deblend sources from nearby contaminants. This will be a critical tool for future IFU observations of blank and deep fields, especially over large areas where automation is necessary. We implement these techniques in the Python-based spectral extraction software, AutoSpec, which is available via GitHub at https://github.com/a-griffiths/AutoSpec and Zenodo at https://doi.org/10.5281/zenodo.1305848.