bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of Simulation on the Clinical Competence of Swedish Ambulance Nurses
Authors: Hagiwara Magnus Andersson , Kängström Anna , Jonsson Anders , Lundberg Lars
Published: December 2018

Introduction

Simulation has become an established method for education and training of Emergency Medical Services personnel in different skills such as advanced airway techniques, also in evaluation and initial care of stroke patients and in pre-hospital trauma. Simulation can be a useful method to improve learning. The aim of the present study was to investigate the effect of simulation on the clinical competence in a pre-hospital trauma care course for ambulance nurses.

Methods

The study was performed using a before-after design. Seventeen ambulance nurse students who participated in a trauma care course were evaluated in two simulated trauma cases. All subjects had passed the initial theoretical part of the course. The pre-test was performed in the beginning of the following part of the course involving simulation and the post-test at the end of the course. The analysis was performed by assessment of performance, as seen on video-tapes from the pre-tests and the post-tests. A validated instrument was used to determine the level of student's clinical competence. Paired t-test was used to confirm differences between the pre-test and post-test results.

Results

There was a significant increase in the over-all results for the post-test, with a difference of 1.12 points (t=4.642, df=16, p=0.001) Situation Awareness, Patient Assessment and Decision Making showed the most pronounced improvements.

Conclusion

The results imply that simulation in addition to traditional theoretical education improves the clinical competence of the students, in comparison to traditional education and training without any significant amount of simulation.
Gaining a New Respect for the Other Guys: Scripted Scenarios for Inter Professional Education in Paediatric Emergencies
Authors: Lazarsfeld-Jensen Ann , Bridges Donna
Published: December 2018

Introduction

This project aimed to find ways of staging and evaluating simulations as a tool of interprofessional education (IPE). A series of scripted paediatric emergencies was used to create an intense learning environment to explore knowledge exchange and shared learning between GP registrars and paramedics. Although simulation is a familiar tool in medical education, its use in IPE is difficult to facilitate because of its many dimensions.

Methods

A complex set of observational methods was utilised comprising contemporaneous focus groups, questionnaires, video observation and participant feedback. These multiple methods captured richly descriptive data through triangulation, to overcome the problem of simulation becoming a staged performance.

Results

The research demonstrated there is great scope for simulation as a tool of IPE despite the time and labour intensity. Participants reported an interesting, exciting, quality learning experience and deep immersion in the scenarios.

Conclusion

To achieve its full potential, future IPE simulation would need to be paired with instructional clinical workshops for the practice and evaluation of skills, and close collaboration with the participants’ own medical educators. However the possibilities of enhancing IPE learning by immersing different groups of health care professionals in unfamiliar, scripted, scenarios are probably only limited by budgets and the imagination of educators.
A Systems Approach to Learning, Practice and Reflection in Emergency Primary Health Care: Student Perspectives
Authors: Mellifont Daniel , Barr Nigel , Dunn Peter
Published: December 2018

Introduction

Clinical decision making skills are essential for professional practice in primary emergency healthcare and are an intended outcome of clinical and professional programs. This article documents an interdisciplinary exploration of learning and teaching of clinical decision making and critical dialectical reflection (the systems approach) at The University of the Sunshine Coast (USC), Australia.

Methods

Using an online survey we explored students’ perspectives on how working with the systems approach impacted upon their confidence and capacity to engage in emergency clinical scenarios.

Results

USC's systems approach, integrated with a focus on critical reflection and case-based learning, is strongly associated with improved student confidence to engage in emergency primary health care scenarios. Most participants reported increased confidence post intervention and believed that the systems approach helped them to improve their capacity for other critical components.

Conclusion

This study indicates the beneficial nature of a systems approach to the learning and teaching of clinical decision-making. The tool could be further developed, to improve perceived ability to communicate more effectively.
Student Paramedic Attitudes towards the Elderly: A Cross-Sectional Study
Authors: Ross Linda , Duigan Tom , Boyle Malcolm J , Williams Brett
Published: December 2018

Introduction

It is well known that Australia has an aging population and that the elderly are disproportionately overrepresented in the patients seen by ambulance paramedics. While research to date has primarily focussed on the attitudes towards the elderly held by nursing and medical students, there is a current paucity of research about the perspective of paramedic students. The objective of this study was to identify the attitudes of paramedic students from a large Australian university towards the elderly.

Methods

In 2013, second year paramedic students from Monash University, Melbourne, Australia were invited to participate in this cross-sectional study and record their attitudes towards the elderly (age >65) using the Aging Semantic Differential (ASD) questionnaire. The ASD utilises a 7 point bipolar Likert scale questionnaire consisting of 32 items and three subscales: Instrument—Ineffective; Autonomous—Dependent; Personal Acceptability—Unacceptability.

Results

Fifty six second year paramedic students participated in the study. The participants were predominantly <26 years of age n=48 (85.7%) and female n=36 (64.3%). Subscale results produced the following mean scores: Instrument—Ineffective (mean=35.05, SD=5.01); Autonomous—Dependent (mean=34.25, SD=4.26); Personal Acceptability—Unacceptability (mean=49.47, SD=6.44).

Conclusion

These results suggest that while student paramedics possess a healthy respect for the elderly, they also harbour some preconceived negative ideas about them. Ultimately, these attitudes may impact on a paramedic's interaction with, and management of the elderly patient, which raises questions about whether students are being adequately prepared for clinical practice.
Perceptions of Student Paramedic Interpersonal Communication Competence: A Cross-Sectional Study
Authors: Ross Linda , Boyle Malcolm , Williams Brett , Fielder Christopher , Veenstra Rebecca
Published: December 2018

Introduction

Interpersonal communication skills are essential to the healthcare practitioner aiding in high quality, effective and safe clinical practice. Effective communication exerts a positive influence on the patient's physical and emotional status resulting in better patient outcomes and satisfaction. By identifying strengths and weaknesses, self-assessment of interpersonal communication skills can be used as an intervention tool to inform future curriculum renewal. The objective of this study was to identify paramedic students’ perceptions of their interpersonal communication competence.

Methods

Second year paramedic students from Monash University (Victoria) were invited to participate in a survey that asked them to record perceptions of their interpersonal communication skills using the Interpersonal Communication Competence Scale (ICCS). The ICCS is a 30-item unipolar questionnaire using a Likert scale ranging from 1 (almost never) to 5 (almost always). Mean and standard deviations (SD) were used to report results.

Results

Fifty-six second year paramedic students participated in the study. Participants were predominantly aged less than 25 years (85.7%) and male n=36 (64.3%). Students reported ‘often’ or ‘almost always’ for the items: ‘I put myself in others’ shoes’, n=46 (82%), mean=3.98 (SD 0.59); and, ‘I let others know that I understand what they say’, n=45 (80%), mean=3.96 (SD 0.66). Students reported ‘sometimes’, ‘often’ or ‘almost always’, for the items: ‘I have trouble convincing others to do what I want them to do’, n=55 (98%), mean=3.5 (SD 0.63); and, ‘My mind wanders during conversations’, n=41 (73%), mean=3.05 (SD 0.88).

Conclusion

Preliminary results suggest that student paramedics self-report their interpersonal communication skills highly apart from areas related to assertiveness and listening skills. These results could be indicative of student age, personality or experience level and warrant further research with larger sample sizes.
Engaging Paramedic Students in Research: A Case Report
Authors: Lim David , Grant-Wakefield Courtenay , Tippett Vivienne
Published: December 2018

The use of volunteer undergraduate students to support simulated training for peers is common in paramedic science. However, there are limited examples of engaging paramedic student-volunteers in research as compared to that reported in cognate disciplines such as medicine and nursing. This case report shares our experience with engaging a penultimate year paramedic student in evaluation research. This information we hope will start the dialogue on the epistemology and pedagogies for effective engagement of undergraduate paramedic students as future researchers.
Antibiotic Prophylaxis in Pre-Hospital Trauma Care: A Review of the Literature
Authors: Smit Lynsey , Boyle Malcolm
Published: December 2018

Introduction

Penetrating and open wounds expose an otherwise sealed and protected body to foreign bodies, leaving the patient vulnerable to potentially fatal infection. The objective of this study was to determine if the administration of systemic prophylactic antibiotics by paramedics for penetrating and/or open wounds leads to decreased infection rates and improved patient outcomes.

Methods

A literature search of the electronic medical databases CINAHL, Cochrane, EMBASE and MEDLINE was conducted. The databases were reviewed from January 2000 to March 2013. A pre-hospital search filter was applied to each database with additional search terms of ‘open wound’, ‘penetrating wound’, ‘prophylactic antibiotic’. References of retrieved articles were also reviewed. Articles were included if they reported on the administration of prophylactic antibiotics by paramedics for penetrating or significant open wounds.

Results

A total of 1280 articles were identified in the search with four articles meeting the inclusion criteria. All four articles focused on the combat setting and management of soldiers with combat-related open or penetrating wounds. Two studies supported the use of prophylactic antibiotics whereas the third did not, stating that the evidence was low level and the practice of antibiotic administration was more opinion based.

Conclusion

This study identified that there is scant evidence to support the use of systematic antibiotic prophylaxis in the civilian pre-hospital setting for open wounds. There is a need for further research to identify if this view may change in the future.
The Year that Was
Authors: Boyle Malcolm
Published: December 2018

This is the editorial for issue 6 of Volume 11
Abstracts of the 2014 Paramedics Australasia International Conference
Authors: Boyle Mal
Published: December 2018

These are the conferences abstracts for oral and poster presentations at the Paramedics Australasia International Conference, Gold Coast, Queensland, Australia, on 19th and 20th of September 2014.
Ems and Ebola
Authors: Boyle Malcolm J , Wallis Jaime , Perera Chantal
Published: December 2018

This editorial questions the EMS readiness to deal with Ebola infected patients.
Rural People's Use of Ambulances to Reach Emergency Departments in Potentially Serious Health Emergencies: Identifying Patterns of Use and Non-Use
Authors: Reed Buck , Bendall Jason
Published: December 2018

Introduction

Ambulance use in rural and remote parts of Australia has been reported anecdotally to be lower than urban areas. Experiences of paramedics in rural locations gave rise to questions of whether this phenomenon was occurring and to what degree.

Methods

Data from Emergency Department (ED) records was obtained from the Hunter New England Area Health Service from 1 July 2008 to 30 June 2009. In total, 354,909 records were obtained. These records were de-identified and analysed to determine the method of arrival to ED, specifically in high acuity patients.

Results

People from Inner Regional areas are 41.5% less likely overall and 27.7% less likely in serious health emergencies to attend EDs by ambulance compared to people in Major Cities. People from Outer Regional and Remote areas are 55.1% less likely overall and 27.9% less likely in serious health emergencies to attend EDs by ambulance compared to people living in Major Cities. Logistic regression modelling indicated rurality was a significant factor in ambulance use in adults in areas outside Major Cities and in children in Inner Regional areas. Age was a significant predictor of ambulance demand with older people using ambulance more.

Conclusion

This study indicates disparity between rates of ambulance use in urban and non-urban areas. The concept of unmet need should be considered as a more complex phenomenon than simply a utilisation gap and exploration of unmet need is warranted. A clearer understanding of how rurality affects ambulance use has a number of implications for ambulance services.
Capturing the Experience: Lessons of Consumers and Carers in Rural Mental Health Education
Authors: McGarry Denise , Andrews Neil , Buchta Mary , Kent Kathryn , McFarlane Chris , McFarlane John
Published: December 2018

In 2012 the School of Nursing, Midwifery and Indigenous Health, Charles Sturt University introduced guest lectures from consumers of mental health services and their carers. These lectures were placed within the introductory mental health subjects of both the Mental Health Nursing and Paramedic undergraduate programs. This paper describes this experience by combining the recollections of six key stakeholders: the NGO carer support organisation CentaCare Wilcannia-Forbes, a consumer, two carers, a student and the academic involved. Each provided responses to five aspects: the background to the project, the gains from the experience, the personal hopes and concerns when the project was proposed, the perceived value of the project and finally thoughts about the future of the project.Risks are recognised at an individual level for students, carers and consumers of a re-traumatising nature, and of inadvertent reinforcement of pre-existing stereotyping or stigmatising positions. However, overall, the project was well regarded and is considered worthy of continuing, supported by some research to identify the germane elements.
Review by Fouche and Zverinova
Authors: Morley Peter
Published: December 2018

This letter raises issues about the study conducted by Fouche and Zverinova.
The Administration of Prehospital Ketamine for Chemical Restraint Does Not Prolong On-Scene Times Compared to Haloperidol Based Sedation
Authors: Burnett Aaron , Panchal Dolly , Peterson Bjorn , Ernest Eric , Griffith Kent , Frascone Ralph J , Engebretsen Kristin
Published: December 2018

Introduction

Agitated patients who present a danger to themselves or emergency medical services (EMS) providers may require chemical restraints. Haloperidol is employed for chemical restraint in many EMS services. Recently, ketamine has been introduced as an alternate option for prehospital sedation. On-scene time is a unique metric in prehospital medicine which has been linked to outcomes in multiple patient populations. When used for chemical restraint, the impact of ketamine relative to haloperidol on on-scene time is unknown.

Objective

To evaluate whether the use of ketamine for chemical restraint was associated with a clinically significant (≥5 minute) increased on-scene time compared to a haloperidol based regimen.

Methods

Patients who received haloperidol or ketamine for chemical restraint were identified by retrospective chart review. On-scene time was compared between groups using an unadjusted Student t-test powered to 80% to detect a ≥5 minute difference in on-scene time.

Results

110 cases were abstracted (Haloperidol = 55; Ketamine = 55). Of the patients receiving haloperidol, 11/55 (20%) were co-administered a benzodiazepine, 4/55 (7%) received diphenhydramine and 34/55 (62%) received the three drugs in combination. There were no demographic differences between the haloperidol and ketamine groups. On-scene time was not statistically different for patients receiving a haloperidol based regimen compared to ketamine (18.2 minutes, [95% CI 15.7-20.8] vs. 17.6 minutes, [95% CI 15.1-20.0]; p = 0.71).

Conclusions

The use of prehospital ketamine for chemical restraint was not associated with a clinically significant (≥5 minute) increased on-scene time compared to a haloperidol based regimen.
Pre-Hospital Use of Intravenous In-Line Fluid Warmers to Reduce Morbidity and Mortality for Major Trauma Patients: A Review of the Current Literature
Authors: Collins Nicholas , Daly Stuart , Johnson Patricia , Smith Gavin
Published: December 2018

Introduction

In-line fluid warmers are an established treatment for delivering warmed intravenous (IV) fluid in the hospital setting. Recently their potential application within the pre-hospital setting has been highlighted to potentially reduce mortality and morbidity. Currently ambulance paramedics only administer warmed fluid to patients assessed as hypothermic, and this fluid is subject to further cooling on exposure to ambient environmental conditions. This review examined the peer-reviewed literature to determine the available evidence for in-line fluid warmer effectiveness and potential inclusion in pre-hospital emergency care.

Methods

A review of the electronic literature, including the Medline and Ebscohost databases was conducted using the terms “intravenous fluid warmers” “hypothermia”, “ trauma”, “ fluid”, “coagulopathy”, “ acidosis”, “hypothermia and trauma patients”, “accidental hypothermia”, “lethal triad” and “trauma care”. Articles were included if they represented a study of in-line fluid warmers within the surgical, general hospital or pre-hospital emergency care settings. Articles not available in English or as full text were excluded.

Results

The review identified 23 relevant articles for analysis. Of note, up to 40% of trauma patients with signs of hypoperfusion were reported to arrive at hospital in a hypothermic state post-incident. Hypothermia plays a significant role in contributing to the ‘triad of death’- a condition that results in poor patient outcomes and high mortality rates.

Conclusion

This review identified that current pre-hospital practice does not prescribe warmed fluid to the normothermic trauma patient. The review also identified that there is a need for in-line fluid warmers in ambulance practice to prevent or limit hypothermia and reduce patient morbidity and mortality associated with trauma.
Characteristics and Outcomes of Patients Assessed by Paramedics and Not Transported to Hospital: A Pilot Study
Authors: Keene Toby , Davis Megan , Brook Carol
Published: December 2018

Introduction

Patients seen by ambulance paramedics but not transported to hospital have not previously been studied in Australia. The purpose of this pilot study is to determine the feasibility of telephone interviews to describe and analyse patient factors, and determine short term patient outcomes associated with paramedic no-transport decisions.

Method

Twenty (20) patients participated in semi-structured telephone interviews 13-30 days following an episode of care from an Australian urban ambulance service. Data analysis was conducted in two phases; firstly, a quantitative description of the patient characteristics and their outcomes; and secondly, a qualitative analysis using a thematic framework to determine if there were any common themes emerging from the interviews.

Results

Only three (3) patients refused to participate in the interviews and none were unable to be located. The reasons patients expressed for not accepting transport were varied, though a common factor related to patient expectations of the service provided by paramedics. Patients had poor recall of advice provided by paramedics. All except one patient were successfully diverted from the emergency health system. Overall, patients expressed high satisfaction with their experience.

Conclusion

The reasons patients choose for not being transported require further study but appear to be driven by their expectations of the service provided by Paramedics. Telephone interviews are a viable method for collecting data on non-transported ambulance patients.
Predatory Publishing Houses: Challenging the Legitimacy of Open Access Journals
Authors: Smith Gavin
Published: December 2018

This editorial looks at the issue of predatory publishing houses
Paramedic Capstone Education Model: Building Work Ready Graduates
Authors: Thompson James , Grantham Hugh , Houston Don
Published: December 2018

In Australia, the last decade has witnessed considerable changes to both the scope of paramedic practice and the education of these practitioners. Notably within education, there has been a national trend to move from on-the-job training, towards a pre-employment, undergraduate university qualification. Despite increases in depth, breath and consistency to the curriculum and delivery by subject experts with training in education, criticism remains targeted at the preparation of the graduate for readiness to undertake the paramedic role. Australian undergraduate courses are currently experiencing unprecedented enrolment numbers, with complex student learning expectations and requirements. Producing work ready graduates within traditional curriculum frameworks is a challenge. Capstone courses target the final preparation of the graduating student, with a strong emphasis on articulating them successfully with their chosen industrial settings. While widely accepted in other disciplines, such as engineering, capstone is a new concept to paramedicine. This paper discusses how a capstone topic was created and implemented at Flinders University within the Bachelor of Paramedic Science degree. It describes the differentiated student learning methodology employed and the strategies used to respond to specific student and industry concerns regarding university teaching.
Critical Incident Technique – a Useful Method for the Paramedic Researcher's Toolkit
Authors: Mulholland Peter , Barnett Tony , Woodroffe Jess
Published: December 2018

Introduction

Critical Incident Technique (CIT) is a research method which has been used to investigate activities across many fields including psychology, medicine, nursing, counselling, education, learning and marketing. This paper explores this potential by investigating the use of CIT as a research method for the paramedic and pre-hospital environment.

Methods

A search using the term ‘Critical Incident Technique'was conducted using the University of Tasmania ‘Megasearch’ facility. Some 2935 papers were then filtered to include one or more of the terms ambulance, pre-hospital, paramedic, transport, retrieval, emergency medical service/s (EMS), emergency medical technician/s (EMT) and emergency. Using these terms, four research articles used CIT as a methodological approach. Searching CINAHL, SCOPUS and MEDLINE via PubMed individually, contributed one further article. A further search with the same terms was conducted using ‘Google Scholar’, and identified a further seven relevant papers.

Results

Although Critical Incident Technique has been used as a research method since 1954, its use in the examination and study of paramedic work (pre-hospital care) was limited and quite new. An analysis of the articles indicated five distinct themes relating to how CIT was used: physical dimensions of job performance (equipment and technology), teamwork and communication (how team members work and communicate), psychological dimensions of work (how paramedics felt about their work), student learning and experience and patient care.

Conclusion

CIT is a research method that has been used effectively to inform various psychological and physical dimensions of paramedic work. Paramedic work is about caring for those who require pre-hospital care, and further consideration of the application of CIT in pre-hospital research may increase our understanding of this work to improve service delivery and patient outcomes.
Should Civilian Pre-Hospital Emergency Care Provision Include Tourniquets for the Management of Uncontrolled Traumatic Haemorrhage?
Authors: Wright Georgia , Mcdonald Samantha , Smith Gavin
Published: December 2018

Introduction

Tourniquets are used extensively in military settings, where they have proven to be an effective means of controlling major traumatic haemorrhage. This review aims to determine the value of tourniquets in the civilian pre-hospital setting.

Method

A literature search was performed using the following electronic databases from inception to June 2014: Medline, Academic Search Premier and Cochrane Library. Additional searches were conducted in the Victoria University Library search engine. Key search terms included pre-hospital, tourniquet, military, complications, failure, ischemia, metabolic changes, history, and paramedics. Using the search terms outlined above, 236 articles were identified. With further examination 220 were excluded, leaving 16 for review (dated from 1974 - 2014). Of the 16 articles, 2 were determined to be relevant, published and peer reviewed case reports whilst the other 14 were peer reviewed and published studies.

Results

Tourniquet use for controlling major haemorrhage is more accepted for military rather than civilian applications. Factors contributing to this include: lack of education and training, variation and incidence of specific mechanisms of injury, complications such as ischemia, decreased civilian scene times, and decreased civilian transport times to definitive care. Civilian research was inhibited by study numbers, with much of the data emanating from military research.

Conclusion

To date, there is little evidence of tourniquet use in civilian environments. They are considered controversial due to complications and shortfalls. These factors contribute to user apprehension.
Paramedics’ Perceptions and Educational Needs with Respect to Palliative Care
Authors: Rogers Ian R , Shearer Freya R , Rogers Jeremy R , Ross-Adjie Gail , Monterosso Leanne , Finn Judith
Published: December 2018

Introduction

To identify and measure paramedics’ perspectives and educational needs regarding palliative care provision, as well as their understanding of the common causes of death.

Methods

All St John Ambulance Western Australia paramedics were invited to complete a mixed methods qualitative and quantitative survey using a tool previously validated in studies involving other emergency care providers. Quantitative results are reported using descriptive statistics, while Likert-type scales were converted to ordinal variables and expressed as means +/- SD. Qualitative data was analysed using content analysis techniques and reported as themes.

Results

Completed surveys were returned by 29 paramedics. They considered palliative care to be strongly focussed on end-of-life care, symptom control and holistic care. The dominant educational needs identified were ethical issues, end-of-life communication and the use of structured patient care pathways. Cancer diagnoses were overrepresented as conditions considered most suitable for palliative care, compared with their frequency as a cause of death. Conditions often experienced in ambulance practice, such as heart failure, trauma and cardiac arrhythmias were overestimated in their frequency as causes of death.

Conclusions

Paramedics have a sound grasp of some important aspects of palliative care including symptom control and the holistic nature of the palliative approach. They did however tend to equate palliative care with that occurring in the terminal phase and saw it as being particularly applied to cancer diagnoses. Paramedic palliative care educational efforts should focus on ethical issues and end-of-life communication, as well as increasing understanding of the common causes of death and those where a palliative approach might be beneficial.
Undergraduate Paramedic Students’ Perception of Mental Health Using a Pre and Post Questionnaire
Authors: Emond Kate , Furness Susan , Deacon-Crouch Melissa
Published: December 2018

Introduction

It is well recognised that mental illness causes significant morbidity and mortality, and has been identified as a national health priority. Despite this, there is a paucity of research about paramedic student perceptions and attitudes toward those experiencing mental health presentations. The objective of this study was to explore the mental health perceptions of a final year cohort of paramedic students from a regional Victorian university.

Methods

Final year undergraduate paramedicine students enrolled in the core subject Advanced Mental Health Practice were invited to participate in both pre- and post-subject surveys and record their perceptions of mental health using electronic questionnaires. The questionnaires used nine 5-point Likert scale questions and three multiple option questions using declarative statements.

Results

Of the 25 eligible students, 16 completed the pre-subject questionnaire and 12 completed both the pre- and post-subject questionnaires. The results indicated that this cohort held common myths and misconceptions relating to mental health combined with a lack of general knowledge about mental illness and its paramedic management. These perceptions altered following the introduction of the mental health subject.

Conclusion

The results suggest that the implementation of a mental health subject into paramedicine undergraduate curriculum has the ability to positively alter perceptions of mental health. This may lead to students acquiring the knowledge and attitudes required to manage mental health presentations.
Pre-Hospital Medicine: A Glimpse of the Future
Authors: Davison Keron , Forbes Malcolm P
Published: December 2018

The availability and utilisation of technology in pre-hospital medicine has increased exponentially in the past half-century. New technologies, including telepresence, robotics and 3D printing, will revolutionise the way we practise in the 21st century. In order to maintain relevance and continue to provide exceptional patient care, we must stay abreast of technological advances, critically appraise new technologies, and be early adapters to change.
The Glut of Graduate Paramedics – What do we do with Them?
Authors: Boyle Malcolm J , Wallis Jaime
Published: December 2018

This editorial looks at the excess of paramedic graduates and issues raised by a student on local radio
Time to Improve Prehospital Care in Developing Countries
Authors: Boyle Malcolm , Wallis Jaime , Suryanto S
Published: December 2018

This editorial highlights the issue of prehospital care in developing countries
Rural Paramedic Practitioner – A future model of care
Authors: Reaburn Greg , Zolcinski Rob , Fyfe Scott
Published: December 2018

This commentary looks at the introduction of a rural paramedic practitioner (RPP). A RPP is a rural paramedic that has completed advanced medical training in primary health care and is able to provide prehospital, hospital and primary health care.
Reviewer Acknowledgement for 2016 Published Articles
Authors: Boyle Mal
Published: December 2018

This is a list of the people who reviewed manuscripts that were published in 2016.
A qualitative exploration of infection prevention and control guidance for Australian paramedics
Authors: Barr Nigel , Holmes Mark , Roiko Anne , Lord William
Published: December 2018

IntroductionThe paramedic work setting in Australia presents challenges for applying recommended infection prevention and control (IPC) practices. Our study had two aims: to describe the guidance provided across a range of documents used by Australian ambulance services; and to explore the views of health experts regarding the adequacy of guidance on IPC practices for Australian paramedics.MethodsContent analysis was used to evaluate the degree of alignment between IPC operating procedures from four state ambulance services and the IPC guidelines issued by the National Health and Medical Research Council (NHMRC) in 2010. Semi-structured interviews were conducted to explore perspectives of 14 experts about IPC practices among paramedics and IPC guidance provided to them. ResultsWhile the ambulance operating procedures aligned well with the NHMRC IPC guidelines, we identified differences in the nature of advice provided that could lead to differing practices by paramedics across Australia. Experts identified several domains of IPC practices by paramedics that would benefit from closer scrutiny and/or more specific guidance, including hand and environmental hygiene, governance and surveillance, environmental challenges, vehicle design, cultural barriers and communication with state health regulators. ConclusionOur study has further highlighted unique challenges faced by paramedics in adhering to recommended IPC practices while providing healthcare in the mobile primary emergency environment. Two recommendations arise from our research. First, there is a need to adapt the current national risk-based framework for IPC in Australia to paramedicine. Second, that targeted research into staff compliance is required to identify the key barriers and enablers to the uptake of IPC practices in paramedicine.
Do training programs improve a paramedic’s ability to identify and report child abuse and neglect? A systematic review
Authors: Johnson Kate Brooke , Doecke Elizabeth , Damarell Raechel A , Grantham Hugh
Published: December 2018

IntroductionParamedics are often the first trained personal to assess sick or injured children. This raises the question of how well trained paramedics are to identify signs of child abuse or neglect. This systematic literature review seeks to establish the extent to which training programs improve a paramedic’s competence and confidence when it comes to identifying and reporting child abuse and neglect.MethodsSelected search terms were entered into eight databases to identify potentially relevant publications. Inclusion and exclusion criteria were applied and articles were categorised as relevant or irrelevant based on a review of title and abstract and, when necessary, full text review.ResultsThe initial electronic search yielded 872 articles. After duplicates were removed and the inclusion and exclusion criteria applied, four publications were identified as relevant and included in this systematic literature review. Of these, three were cross-sectional studies and one was a one-group pre-test post-test study. In total, 2499 subjects were examined across the four articles. Despite the limitations of each study, the results for all four studies were consistent with one another, demonstrating that higher levels of training correlated with greater knowledge and/or confidence regarding both the identification process and the correct procedures for reporting child abuse.ConclusionThe limited evidence published so far suggests that training improves confidence and ability levels of the paramedic in recognising and reporting child abuse. However, the limitations of these studies need to be considered before drawing robust conclusions. We call for further research into the topic and suggest that, owing to the complexity of the issue, a qualitative study may be the best way of exploring the variety of barriers to reporting, and the extent to which training would overcome these.
Learning Approach and Trait Anxiety on Paramedic and Nursing Students
Authors: Uzuntarla Yasin
Published: December 2018

Introduction

Learning approach and anxiety are important factors in the quality of education. This study was carried out to measure learning approach and trait anxiety levels on paramedic and nursing students.

Methods

This cross-sectional study – undertaken between July and December 2016 – aimed to evaluate paramedic and nursing students studying in Ankara in Turkey. A survey system was used for data collection utilising the Revised Two Factor Study Process Questionnaire and State-Trait Anxiety Inventory methods. The SPSS statistical package program was used to analyse the data. The Kolmogorov-Smirnov test, the Mann Whitney-U test, the t-test, Spearman correlation analysis and multiple regression analysis were used for data analysis.

Results

It was determined that students preferred deep learning; over half of the students were observed to demonstrate lower anxiety levels using this method. As a sub-dimension of surface learning, surface motive was more expressively preferred by the paramedic students. Statistically, no significant relationship was observed between study process and trait anxiety.

Conclusion

Developing deep learning education systems and creating an environment to reduce anxiety is beneficial to students. Further research should be undertaken to determine the relationship between learning approach, socio-demographic characteristics and anxiety.
Factors Affecting the Education of Pre-Employment Paramedic Students during the Clinical Practicum
Authors: McCall Louise , Wray Natalie , Lord Bill
Published: December 2018

Aim

To identify factors that affect the education of pre-employment paramedic students during the clinical practicum.

Methods

A purposive sampling technique was employed to recruit undergraduate students from the Bachelor of Emergency Health (Paramedic) (BEHP) who had recently completed their first or final clinical placement. Qualitative data was collected via a total of 3 focus group discussions; two focus group discussions were conducted with students on completion of their final placement, and one focus group discussion was conducted with students who had recently completed their first placement. Participants were asked to share their career and placement expectations, placement experiences, career path intentions, and the impact of placements on their career decisions.

Results

This paper reports on student perception of education in the clinical environment and their impression of the strengths and weaknesses of this model. We identified four major themes: (1) communication, (2) appropriate placements, (3) capacity building and, (4) adequate preparation for students.

Conclusion

The University, ambulance service and students need to form a relationship to foster the quality of clinical education. Each party needs to adequately communicate and prepare for quality learning to occur in placements. Good mechanisms for the identification of problems early, particularly in relation to student support and case load are necessary. Ongoing evaluation of the quality of clinical placement education is required and should include all parties who are also committed to continuous improvement.
Training library staff in the Republic of Cameroon
Authors: Zemengue J.
Published: December 2018

Negative trends in the system of library education in the Republic of Cameroon and their the exterior and intrinsic factors are examined. Among the exterior factors are: the low economic development of the country and the labor market; lack of efficient standards and laws and state regulation of education, culture and library activities; low literacy and education level; undeveloped information culture; severe natural and climatic conditions. Insufficient standard, regulation, methodological, staff and logistical support of library education, insufficient application of modern pedagogical and information and communication technologies of education make the intrinsic factors. The author also emphasizes that the exterior and intrinsic factors are interrelated and interdependent: developed information and communication technologies, finances and logistics of library professional education always depend on the country’s economic development, and library education legislation depends on the national policy for libraries and education, and this is true for the Republic of Cameroon. Until the negative factors are eliminated, the level of professional training of librarians and their professional motivation will remain low.
Dynamics of the demand for the union Internet-catalog of books and periodicals in the collections of the RAS LNS Centralized Library System
Authors: Vlasova S. A. , Kalenov N. E.
Published: December 2018

The organization principles and retrieval functionalities of RAS LNS Centralized Library System union Internet-catalog of books and periodicals are examined. The catalog embraces every publication centrally acquired into the collections of over 50 RAS research institutions within RAS LNS Centralized Library System. The catalog entries are generated within “Bibliobus” integrated library system designed by RAS LNS professionals. Unlike other Internet-catalogs oriented toward the search logic of the traditional catalogs, the RAS LNS catalog enables to process practically unlimited range of queries embracing any elements of bibliographic entries and subject headings linked with Boolean operators “AND”, “OR”, “AND NOT”. Adding complexity of the search interface was chosen to minimize noise. To define whether the clients use the advanced search functionality and how often they do so, the analysis of demand was accomplished. The comparative qualitative and quantitative analysis data characterizes the demand for two periods: the first after 9 months of operation started in the mid-2016; the second – in 2018 for the following 18 months of operation. Main use indicators are compared and their dynamics is discussed.
Evaluating the quality of research activities: Investigating into the uniqueness
Authors: Glavcheva Yu. N. , Kanishcheva O. V. , Glavchev M. I.
Published: December 2018

Today, the research activities of scientists and research organizations is estimated through the informetrical methods (bibliometrics) with absolute and relative indicators based on the number of publications and their citations in scientometric databases. The leading authors  and research organizations are given grants and awards, become international laureates, get financial support or other dividends. The authors argue that the method of research activities evaluation influences the authors’ behavior and increases plagiarism, rigged citation and academic dishonesty.

The fraud practices misrepresent the estimations of research activities quality and the current status of a discipline and publication activities. The problem is analyzed; simultaneous use of bibliometric methods and most advanced scientific methods of modern methods of defining writing styles is suggested as a solution. The authors emphasize that traditionally libraries are meant to educate, to popularize knowledge and to inform. Today, they have to go into non-traditional functions, i.e. to support linguistic research and to build linguistic corpora. This would prevent manipulations when estimating publication activities with bibliometric methods and would promote academic honesty in academic practices.
Validation of Yield Component Traits Identified by Genome‐Wide Association Mapping in a tropical japonica × tropical japonica Rice Biparental Mapping Population
Authors: Eizenga Georgia C. , Jia Melissa H. , Jackson Aaron K. , Boykin Debbie L. , Ali M. Liakat , Shakiba Ehsan , Tran Nhien T. , McCouch Susan R. , Edwards Jeremy D.
Published: December 2018

The Rice Diversity Panel 1 (RDP1) was developed for genome‐wide association (GWA) studies to explore five rice (Oryza sativa L.) subpopulations (indica, aus, aromatic, temperate japonica, and tropical japonica). The RDP1 was evaluated for over 30 traits, including agronomic, panicle architecture, seed, and disease traits and genotyped with 700,000 single nucleotide polymorphisms (SNPs). Most rice grown in the southern United States is tropical japonica and thus the diversity in this subpopulation is interesting to U.S. breeders. Among the RDP1 tropical japonica accessions, ‘Estrela’ and ‘NSFTV199’ are both phenotypically and genotypically diverse, thus making them excellent parents for a biparental mapping population. The objectives were to (i) ascertain the GWA QTLs from the RDP1 GWA studies that overlapped with the QTLs uncovered in an Estrela × NSFTV199 tropical japonica recombinant inbred line (RIL) population evaluated for 15 yield traits, and (ii) identify known or novel genes potentially controlling specific yield component traits. The 256 RILs were genotyped with 132 simple sequence repeat markers and 70 QTLs were found. Perl scripts were developed for automatic identification of the underlying candidate genes in the GWA QTL regions. Approximately 100 GWA QTLs overlapped with 41 Estrela × NSFTV199 QTL (RIL QTL) regions and 47 known genes were identified. Two seed trait RIL QTLs with overlapping GWA QTLs were not associated with a known gene. Segregating SNPs in the overlapping GWA QTLs for RIL QTLs with high R2 values will be evaluated as potential DNA markers useful to breeding programs for the associated yield trait.
FINANCIAL HEALTH OF ENTERPRISES INTRODUCING SAFEGUARD PROCEDURE BASED ON BANKRUPTCY MODELS
Authors: Schönfeld Jaroslav , Kuděj Michal , Smrčka Luboš
Published: December 2018

This paper is focused on the financial situation of enterprises introducing safeguard procedure (in other words moratorium) in the Czech Republic. The paper’s aim is to show if the enterprises asking for the safeguard procedure do have financial conditions for recovering and maintaining the going concern principle. The safeguard procedure should help the enterprise to solve their problematic situation because it protects them against creditors for the court approved time period. The safeguard procedure cannot be successful when the financial situation is extremely poor and therefore this paper analyses the enterprises’ financial situation upon applying for safeguard. The situation is evaluated using bankruptcy models, such as Altman Z-Score, Kralicek Quick Test, IN 99 and IN05. The evaluation is conducted in different time moments, specifically one year, two years and three years before implementing the safeguard procedure. Results for the individual enterprises are summed up by basic descriptive statistics as mean, median, low and upper quartiles. The results show that the financial situation of most enterprises was very poor before introducing the safeguard procedure and it had deteriorated during the years before.
SMART GRID TECHNOLOGIES IN ELECTRIC POWER SUPPLY SYSTEMS OF PUBLIC TRANSPORT
Authors: Bartłomiejczyk Mikołaj
Published: December 2018

Nowadays the issue of electric energy saving in public transport is becoming a key area of interest which is connected both with a growth in environmental awareness of the society and an increase in the prices of fuel and electricity. It can be achieved by improving the usage of regenerative breaking. In 2016 the Przedsiębiorstwo Komunikacji Trolejbusowej (PKT, Trolleybus Transport Company) in Gdynia began practical implementation of Smart Grid solutions within its trolleybus network. These activities constitute an element of the project ELIPTIC, realised by PKT within the scientific research fund Horizon 2020. The first stage of implementing intelligent network solutions was completed in 2016, and further activities are planned for the next few years. This paper presents a review of Smart Grid solutions which can be implemented in urban traction supply systems, describes the PKT experience concerning the implementation of Smart Grid solutions in trolleybus network supply system to date.