bluuebunny/crossref_metadata_2025 huggingface dataset:
Boosting the elongation potential of paper by mechanical refining and additives
Authors: Strand Anders , Kouko Jarmo , Oksanen Antti , Salminen Kristian , Ketola Annika , Retulainen Elias , Sundberg Anna
Published: December 2018

The procedures used in restraining the web during drying will severely affect paper properties. In this work, the main differences between restrained drying and unrestrained drying on paper properties were identified. The mechanical properties of paper were studied as a function of low-consistency mechanical refining energy; wet-end additions of carboxymethyl cellulose (CMC) with cationic starches; as well as spray addition of alginate, chitosan, and cationic guar gum. After restrained drying, the tensile index and tensile stiffness increased with increasing refining energy, but the elongation at break was severely limited. After unrestrained drying, the elongation at break increased linearly with increasing refining energy. However, unrestrained drying also resulted in significantly lower tensile index and tensile stiffness values. After restrained drying, the largest increases in tensile index and stiffness were obtained by sequential wet-end addition of CMC and cationic starches. Certain combinations could mitigate all of the decrease in tensile index from unrestrained drying, while maintaining the distinctively high elongation potential of the paper. Wet-end addition of CMC and cationic starches could mitigate some of the decrease in tensile stiffness, but not completely. Spray addition of alginate, chitosan, or cationic guar gum increased the tensile index after both restrained and unrestrained drying. Spray addition of alginate resulted in significant increases in elongation at break and two-dimensional formability of the handsheets after unrestrained drying. After restrained drying, the tensile stiffness increased after spray addition of all of the different polysaccharides. After unrestrained drying, however, stiffness was unaffected by all of the tested polysaccharide spray additions. The same pulp treatment/additives will increase either stiffness or stretch, depending on the drying technique, but both properties could not be maximized simultaneously.
Production of polyhydroxyalkanoates (PHA)-based renewable packaging materials using photonic energy: A bench and pilot-scale study
Authors: Joyce Michael , Pal Lokendra , Tran Tom
Published: December 2018

This work describes the utilization of a new photonic heat treatment technology in combination with polyhydroxyalkanoates (PHA) materials for the development of biofriendly packaging and coated substrate materials. This technology advances the use of aqueous PHA coatings as a replacement for less environmentally friendly extruded plastic and fluorotreated packaging papers and boards. The new technology utilizes short burst photonic energy to heat PHA latex coatings. Utilizing a rapid pulse of photonic energy enables PHA particles to melt and form a film within milliseconds, as compared to conventional equilibrium drying that takes several minutes. Coatings were applied to commercially produced papers in order to validate the combined use of photonic treatment technology with PHA materials for commercial applications. Photonic treatment for both bench-top and roll-toroll pilot-scale studies resulted in kit values of 12, and 2 min Cobb values of <2 g/m2. Repulpability studies showed the material to be completely repulpable, having 100% accepts after screening. The results demonstrate that the photonic treatment of PHA polymers could be used in current commercial settings to produce environmentally friendly packaging and coated products.
Crown-to-implant ratio of short locking-taper implants placed in posterior areas of the maxilla: a retrospective study 2 years after loading
Authors: Giorgio Lombardo , Jacopo Pighi , Giovanni Corrocher , Pallares Miguel Angel Simancas , Mauro Marincola , Pier Francesco Nocini
Published: December 2018

Introduction: The purpose was to study any relationship between crown-to-implant ratio and peri-implant bone loss of short, plateau-design, locking taper implants in posterior maxillary areas. Methods: This retrospective clinical study was conducted between May 2013 and September 2013. The sample was composed of patients who had received at least one short implant(5-to-8-mm-long) between January 2009 and December 2011. The outcome variables were implant failure and peri-implant bone loss in relation to crown-to-implant ratio. Analysis of variance (ANOVA) was used to check out correlations between crown-to-implant ratio and peri-implant bone loss. Results: Thirty-six subject who received 79 locking-taper implants were followed for an average of 24 months. Four implants failed, giving a cumulative survival rate (CSR) of 94.9%. The mean crown-to-implant ratio was 2.01. The peri-implant bone loss between prosthetic loading and last recall was 0.21 mm. No statistically significant relationship was observed between increasing crown-implant ratios and marginal bone loss (P = .93). Conclusion: The crown-to-implant ratio, although high, was not associated to increased bone loss. However further studies with longer follow-up are needed to confirm our data.
Application of ultrasound in endodontics
Authors: Orekhova L.Yu. , Porkhun T.V. , Vashneva V.Y. , Rubezhova E.A.
Published: December 2018

The aim of this study is to evaluate the efficiency of ultrasound in endodontic practice in various clinical cases. Objects and methods. Extracted teeth, divided into 2 experimental groups, were used to assess the degree of the tooth cavity cleaning. In the first group, the tooth cavity was treated mechanically and medically without ultrasound use. In the second group, the tooth cavity was treated mechanically and medically with ultrasound use. Ultrasound treatment was found to improve significantly the level of tooth cavity cleaning at the preparatory stage for endodontic treatment. Extracted teeth, divided into 3 experimental groups were used in our study to demonstrate the efficiency of passive ultrasonic irrigation. Results and discussion. The results of scanning electron microscopy of extracted teeth slices which show the level of purification of the root canal previously treated mechanically and medically are attached to the article. Our research leads to the conclusion that the activation of the irrigation solution with sound or ultrasound leads to significant increase in quality of root canal cleaning. The article presents 3 clinical cases of ultrasound application in procedure of extraction a silver post, a fiberglass post and a fragment of the canal filling instrument from the root canal. The research has found that use of ultrasound in modern endodontic practice facilitates the extraction of intracanal posts and instrument fragments, with duration of intervention being reduced and the possibility of saving the tooth in complicated clinical cases being increased. Conclusion. The results of the research lead to the conclusion that ultrasound should be used almost at every stage of endodontic treatment.
Перспектива развития инновационных технологий в диагностике в стоматологии
Authors: Дедова Л.Н. , Городецкая О.С. , Шульган С.В.
Published: December 2018

Перспективным направлением развития микробиологической диагностики является разработка и создание диагностических наборов (скрининг- или экспресс-тестов), которые применяются непосредственно в стоматологическом кресле врачом в короткое время. Цель исследования. Обозначить актуальность разработки микробиологических экспресс-тестов в диагностике пациентов с болезнями периодонта. Объекты и методы исследования. Проведено микробиологическое обследование содержимого периодонтальных карманов 120 пациентов в возрасте 35–44 с хроническим генерализованным периодонтитом методом ПЦР-диагностики. Результаты исследования и их обсуждение. В результате проведенных микробиологических исследований в периодонтальных карманах были выявлены периодонтопатогенные микроорганизмы: Treponema denticola – у 75 % (93) пациентов, Porphyromonas gingivalis – у 70 % (87) пациентов, Bacteroides forsythus – у 80 % (98) пациентов. Сроки готовности микробиологических исследований составляли от 8 до 14 дней, что увеличило сроки лечения, повысило количество посещений (в среднем на 3–4). Для проведения микробиологических исследований в условиях оборудованной лаборатории задействовано 1–2 квалифицированных специалиста. Заключение. В настоящее время в Республике Беларусь обоснованно и перспективно выполнение комплекса клинико-экспериментальных исследований, которые дают возможность совершенствовать диагностику в сокращении сроков лечения и уменьшении количества посещений, модификация которых обеспечит проведение превентивные лечебно-диагностических мероприятия. Это открывает дополнительные возможности для широкого применения методов микробиологической диагностики.
Периодонтология: лекарственная терапия в концепции биологической системы периодонта
Authors: Дедова Л.Н. , Кандрукевич О.В.
Published: December 2018

Многолетняя научно-практическая деятельность дала возможность обозначить принципы лекарственной терапии в периодонтологии, реализация которых целесообразна для эффективного планирования и выполнения лечебно-профилактических мероприятий. При лекарственной терапии в концепции биологической системы периодонта следует учитывать целенаправленность воздействия, системность выбора лекарственного средства, комплексность воздействия, а также принципы этики и деонтологии. Целесообразность разработанных подходов к выбору лекарственных средств в периодонтологии подтверждена долгосрочным высоким терапевтическим эффектом в ближайшие и отдаленные сроки наблюдения, собственными научными исследованиями и успехами в клинической практике
Creativity and Machines
Authors: Holloway Eric
Published: December 2018

Some philosophical problems can be analyzed by creating mathematical analogues which can be analyzed more rigorously. Even when different classes of causation are theoretically capable of producing the same results, a combination of information theory and probability theory can be used to analyze the relative probabilities of each class of cause. In this case, the halting problem is leveraged to show that certain classes of causes are more likely to produce certain classes of results.
INSTAGRAM MESSAGE ON ACCOUNT @ SUPORTERCERDAS.ID AND KNOWLEDGE FOLLOWERS
Authors: Khadijah Siti , Yusuf Dede
Published: December 2018

Instagram application can be used as a tool to increase knowledge. A lot of knowledge can be gained, namely knowledge of religion, events, politics and sports. As an account upload @ suportercerdas.id contains a lot of knowledge about Indonesian football. Like about football clubs, colors pride of the club, supporters in Indonesia, and much more. The purpose of this study to determine whether there is a relationship message on account Instagram @ suportercerdas.id to knowledge followers. The method used is quantitative with explanative survey type research. The subjects of the study were followers account @ suportercerdas.id as many as 100 respondents and the sample technique used was accidental sampling. The results showed that from several messages uploaded instagram account @ suportercerdas.id,hastag has the largest percentage.It shows that the hastag written instagram account contains many messages of peace for all supporters in Indonesia. While the value of the largest correlation of the photo to knowledge. It proves that photos with knowledge are very real.
Determinan Penerimaan dan Belanja Daerah: Studi pada 10 Provinsi di Indonesia
Authors: Noviriani Eliza , Febrianty Anniza Dwi
Published: December 2018

The aim of this study is to determine local government revenue and expenditure determinants from 10 provinces in Indonesia. The factors which affect local government revenue are Gross Regional Domestic Product (GDPR), inflation, and exchange rate. The local government revenue will affect local government expenditure. By using panel data, the research showed that variable of GDPR did not have influence on local government revenue. In addition, variable of inflation had a negative and significant influence on the local government revenue. Exchange rate had a positive and significant effect on local government revenue. Finally, local government revenue had a positive and significant impact on local government expenditure.                         Abstrak Penelitian ini bertujuan untuk menguji determinan penerimaan dan belanja daerah di 10 Provinsi di Indonesia. Adapun faktor-faktor yang mempengaruhi penerimaan daerah adalah Produk Domestik Regional Bruto (PDRB), inflasi serta kurs. Penerimaan daerah akan berpengaruh terhadap belanja pemerintah daerah. Hasil pengujian dengan menggunakan data panel memperoleh hasil bahwa variabel PDRB tidak memiliki pengaruh terhadap penerimaan daerah. Selain itu, variabel inflasi memiliki pengaruh yang negatif dan signifikan terhadap penerimaan daerah. Variabel kurs berpengaruh positif dan signifikan terhadap penerimaan daerah. Akhirnya, variabel penerimaan daerah berpengaruh positif dan signifikan terhadap belanja pemerintah daerah.
Tinjauan Pelaksanaan Pembayaran Non Tunai pada Belanja Bantuan Sosial: Studi Kasus Program Keluarga Harapan
Authors: Akhmadi Muhammad Heru
Published: December 2018

Social Assistance is a government instrument in carrying out a fiscal policy for reducing poverty.  Cash transfer, which has been given to social assistance recipients of the hope familiy program, has weaknesses in area both social and economical benefits, especially for financial inclusion program. To cope with the weaknesses, the government has adopted non-cash payments since 2016. This research investigated key success factors in implementing non-cash payments by using the hope family program as an sample. The result findings indicated that there was a need to make some adjustments,  such as improving payment mechanism, improving understanding of financial information for social assistance recipients, adopting NIK as a basis for social assistance recipients database, simplificating of institutional bodies, integrating social assistance programs, and developing of information system for social assistance. Abstrak Bantuan Sosial merupakan instrumen pemerintah dalam melakukan kebijakan fiskal untuk menanggulangi kemiskinan. Sistem Pembayaran Tunai yang diberikan kepada penerima Bantuan Sosial Program Keluarga Harapan masih memiliki kelemahan baik dari sisi manfaat sosial maupun manfaat ekonomi khususnya program inklusi keuangan. Mengatasi hal ini, pemerintah melakukan ujicoba pembayaran non tunai sejak tahun 2016. Penelitian ini mencoba menggali faktor-faktor kesuksesan dalam sistem pembayaran non tunai dengan kasus Program Keluarga Harapan. Hasil penelitian menunjukkan bahwa perlunya melakukan penyesuaian seperti penyempurnaan mekanisme pembayaran, peningkatan pemahaman keuangan penerima bantuan, penggunaan NIK sebagai basis data penerimaan bantuan sosial, penyederhanaan kelembagaan, integrasi program bantuan sosial serta pengembangan sistem informasi bantuan sosial.
Kebijakan Fiskal di Persimpangan, Pro Growth atau Pro Poor?
Authors: Utama Zamrud Siswa , Khusaini M , Wahyudi Setyo Tri
Published: December 2018

ABSTRACT Indonesian fiscal policy is designed as pro growth and pro poor. Fiscal space and inequality rapid growth become constraints for this policy. Beside that constraints, pro poor and pro growth fiscal policy was debatable. Okun’s Law, Kuznet Theory and inclusive growth concept were sources of this debate. This paper investigates the impact of fiscal policy on growth and inequality. Using Error Correction Model (ECM), this paper shows that between 1980 until 2015, fiscal policy become more pro growth than pro poor. ABSTRAK Kebijakan fiskal Indonesia dirancang dalam kerangka pro growth dan pro poor. Keterbatasan ruang fiskal dan tingginya kecepatan peningkatan ketimpangan menjadi kendala. Selain kendala tersebut, usaha untuk merancang kebijakan fiskal yang pro growth dan pro poor menjadi perdebatan. Teori Kuznet, Hukum Okun, dan konsep pertumbuhan inklusif menjadi pangkal perdebatan ini. Penelitian ini bertujuan melihat dampak kebijakan fiskal terhadap pertumbuhan dan ketimpangan.  Menggunakan Error Correction Model (ECM), hasil penelitian menemukan bahwa selama periode 1980 sampai dengan 2015 kebijakan fiskal cenderung mendorong pertumbuhan dibanding pemerataan.
Evaluasi Penerapan Manajemen Risiko Pada Strategi Pengelolaan Utang: Studi Kasus Pemerintah Indonesia Periode 2005 - 2014
Authors: Dhoni Des
Published: December 2018

Deficit financing using debt has to be faced various risks such as the risk of changes in exchange rates , interest rates , refinancing and fiscal sustainability . To anticipate the risk, Indonesian government prepare debt management strategy in which there are risk indicator targets to be achieved. This study aimed to find out and understand the risks of debt management, any policy that has been conducted by the Government of Indonesia in order to manage those risks and how the various achievements over the target risk indicators that have been determined . The method used is a qualitative descriptive describing each type of risk and explain the various factors that influence it. The data used consist of primary data sourced from in-depth interviews with sources actors and secondary data obtained from the literature as well as other publications. The results showed that some of the risk indicators of fiscal sustainability is not achieved. In addition there are some implementation of policies that have not been optimal in terms of risk management, debt management, which has not implemented hedging transactions, the implementation of the Asset - Liability Management is still limited in liquidity, and the differences in perspective between DJPPR as debt management unit and DJPB as a cash management unit in terms of debt issuance strategy in the early years (front loading). Abstrak Pembiayaan defisit menggunakan utang memiliki berbagai risiko yang harus dihadapi seperti risiko perubahan nilai tukar, tingkat bunga, pembiayaan kembali dan kesinambungan fiskal. Untuk mengantisipasi risiko tersebut Pemerintah Indonesia menyusun strategi pengelolaan utang yang di dalamnya terdapat target indikator risiko yang ingin dicapai. Penelitian ini bertujuan untuk memahami risiko pengelolaan utang, kebijakan apa saja yang telah dilakukan oleh PemerinPengelolaan Utang Pemerintahtah Indonesia dalam rangka mengelola risiko tersebut dan bagaimana capaian atas target indikator risiko. Metode penelitian yang digunakan adalah deskriptif kualitatif dengan menguraikan setiap jenis risiko dan menjelaskan berbagai faktor yang mempengaruhinya. Data yang digunakan terdiri dari data primer yang bersumber dari wawancara mendalam dengan narasumber pelaku dan data sekunder yang bersumber dari literatur serta publikasi lainnya. Hasil penelitian menunjukkan bahwa beberapa indikator risiko kesinambungan fiskal tidak tercapai. Selain itu, ditemukan beberapa pelaksanaan kebijakan yang belum optimal, yaitu belum dilaksanakannya transaksi lindung nilai, pelaksanaan Asset-Liability Management yang masih terbatas pada likuiditas, dan perbedaan perspektif antara DJPPR sebagai unit pengelola utang dan DJPB sebagai unit pengelola kas dalam hal strategi penerbitan utang di awal tahun (front loading).
Violence against Paramedics – When Will it Stop?
Authors: Boyle Malcolm J , Wallis Jaime
Published: December 2018

This editorial looks at the acts of violence against paramedics
The Contribution of Instructor Presence to Social Evaluation Anxiety, Immersion and Performance within Simulation-Based Learning Environments: A Within-Subject Randomised Cross-Over Trial with Paramedic Students
Authors: Mills Brennen , Carter Owen BJ , Ross Nathan P , Quick Jason K , Rudd Cobie J , Reid David N
Published: December 2018

Introduction

Previous research suggests removing instructors from simulation-based learning environments is popular with students who report greater task immersion and decreased anxiety. However, the specific impact of social evaluation anxiety on students’ immersion and performance remains equivocal.

Methods

N=31 paramedic students completed two simulation-based clinical scenarios in random order, one in the presence of an instructor and one without. Students’ distraction and time-to-completion were quantified via review of head-mounted video cameras, anxiety via continuous heart-rate (HR), and performance via two expert assessors reviewing video footage using a structured clinical assessment checklist. One-on-one, in-depth interviews followed with 12 randomly selected students.

Results

Students completed scenarios 1.8 minutes quicker when instructors were ‘absent’ compared to ‘present’ (6.6 vs. 8.4 min, p<.001), approximately half of this additional time was spent interacting with instructors (61.4 sec, SD=33.4). Peak HR was higher in the instructor ‘present’ than ‘absent’ group (121 vs. 116 bpm, p=.035), but no between-group difference was found for average HR (98 vs. 100 bpm, p=.407). Interview data suggested students felt greater stress in the presence of instructors. No statistical difference was evident between students’ performance scores in the instructor ‘absent’ versus ‘present’ conditions (71.6% vs. 69.4% respectively, p=.314).

Conclusion

Students were more immersed, reported being less stressed and distracted, and were significantly quicker at completing clinical tasks with instructors absent, with no detriment to performance. Removing instructors during simulation-based training is likely to enhance students’ immersion and potentially decrease social evaluation anxiety, but immediate performance is unlikely to improve.
Informing Our Future: The Development of a Regulatory Framework for Registered Paramedics in Australia
Authors: Acker Joseph James
Published: December 2018

This editorial outlines the process as paramedics head towards registration
Pain Assessment in Older Adults with Dementia: An Exploratory Pilot Study of Paramedic Students’ Perceptions of the Utility of Two Validated Assessment Tools
Authors: Lucas Peter Vincent , Mason Ron , Annear Michael , Harris Wayne , McCall Michael , Robinson Andrew , McInerney Fran
Published: December 2018

Introduction

This paper presents findings from an exploratory study in which undergraduate paramedic students’ trialled the use of two pain assessment tools as part of an interprofessional learning experience in residential aged care facilities. The research sought to identify the potential utility of the Abbey Pain Scale and PAINAD tools for use by paramedics with people with advanced dementia who have limited ability to communicate.

Methods

Thirty-one final year undergraduate paramedic students completed a 5-day clinical placement in in four residential aged care facilities in Tasmania, Australia. While on placement students used the two tools to assess pain in residents with known pain issues, under the supervision of nursing staff and paramedic tutors. A mixed methods approach, utilising a quantitative survey and a qualitative open-ended questionnaire, was adopted to ascertain students’ views on the potential for the tools to be used in paramedic practice.

Results

The research found both tools had potential for use in paramedic practice. Feedback from students indicated both pain assessment tools had strengths and weaknesses. Recommendations were made for how each of the tools could be adapted to make them suitable for use by paramedics.

Conclusion

Forecast increases in the number of people living with dementia, and the changing nature of paramedic practice, means that paramedics are more likely to be called on to assess pain in this population in community settings. Further research is needed to inform the development of pain assessment tools specifically for use by paramedics in these settings.
Paramedic Perceptions of Barriers to Prehospital Oral Analgesia Administration
Authors: Vlahaki Dean , Vlahaki Elayne , Welsford Michelle
Published: December 2018

Introduction

Pre-hospital analgesia is administered at a suboptimal rate. We aimed to identify barriers to pre-hospital oral analgesia administration to adult patients, as perceived by paramedics, using qualitative methods.

Methods

Paramedics from a county emergency medical service were invited to participate in semi-structured interviews. The interviews consisted of two questions regarding barriers to pre-hospital administration of oral analgesia using a previously established medical directive. The same investigator completed all interviews, which were audio recorded and transcribed verbatim. Barriers to analgesia administration to adult patients were identified from the interview transcripts using open coding of the data. Two investigators completed the coding process independently and discrepancies were then resolved by consensus. Code frequencies were tabulated and thematic analysis was used to organise the data into broad domains and themes.

Results

In total, 44 paramedics of a possible 46 (95.7%) completed a semi-structured interview. The final sample size was 43 after exclusion criteria were applied. The median paramedic age and practice experience was 39 and 9.5 years respectively, 58% of the participants were male. Barriers to oral analgesia administration emerged in the domains of patient, medical directive, and paramedic factors.

Conclusion

Paramedic perceived barriers to pre-hospital oral analgesia administration were identified and include those related to patient, medical directive, and paramedic factors. Minimising these barriers should be undertaken to reduce rates of pre-hospital under-treatment of pain and improve pre-hospital pain management.
Erratum to: Abstracts of the 2015 Paramedics Australasia International Conference – Paramedic student compliance with the Triage Sieve for a simulated major incident: Compliance with primary and secondary triage based on physiological findings
Authors: Boyle Mal
Published: December 2018

This is a correction to a previously published abstract.
Paramedic Student Anxiety Levels towards Topics in Applied Pharmacology at a Regional University in Australia
Authors: Caffey Matthew R , Crane James W , Ireland Matthew F
Published: December 2018

Introduction

Science-based subjects have a long history of inducing stress and anxiety among many health care students. While there has been substantial research conducted across many allied health courses, very little research has examined the impact of pharmacology stress in paramedic students. In this study we set out to explore the perceived anxiety levels to various topics in second-year university applied pharmacology.

Methods

Using a paper based questionnaire conducted at the start and end of the teaching semester in a second year applied pharmacology subject, students were asked to record their perceived levels of anxiety to concepts and scenarios in applied pharmacology. Students ranked areas of anxiety from highest to lowest and were able to respond with short answers.

Results

A total of 140 students completed the questionnaire. Calculating dosages and understanding the mechanism of action ranked high with 69% and 70% of students respectively scoring 4 or 5 out of 5. Other areas such as contraindications and side effects scored lower (28% and 24%, respectively) with indications scoring only 11%. By the end of the semester students still reported high anxiety levels towards calculating drug concentrations, remembering all medications and understanding pre-existing patient medications.

Conclusion

The results of this study indicate that students commence and leave with high levels of perceived anxiety towards various aspects of pharmacology. This outcome suggests that further pedagogical tools could be employed to assist students to lessen this anxiety to assist the students in better understanding the material to ensure confident graduates.
Evaluating the Knowledge Base and Current Training of Paramedics in the Southwest United States in Assessing and Managing Toxic Alcohol Exposures
Authors: Bare Christopher , Grundmann Oliver
Published: December 2018

Introduction

Toxic alcohol overdose poses a problem in patients who are suffering from the toxicological consequences of toxic alcohol exposure and front line emergency care providers, such as paramedics, need to be well versed in assessing patients, identifying specific toxicities, and implementing appropriate therapies.

Objectives

The aim of this research was to identify the current knowledge base of paramedics to recognise key clinical, pathophysiological and treatment features of toxic alcohol poisoning. Additionally, the emphasis in training and education of paramedics in terms of the level of importance assigned to toxic alcohol emergencies was evaluated.

Methods

The study was conducted as an anonymous online survey. Demographic data, timed choice and open-ended questions were collected to evaluate knowledge and identify gaps in toxic alcohol poisoning training by paramedics. The survey link was sent out to emergency medical services (EMS) organisations and individual paramedics in the southwest United States. Bivariate analysis via Pearson correlation coefficient (PCC) was used to compare variables.

Results

Eighty paramedics participated in the survey, with 60 (75%) participants completing all questions. Respondents were able to identify common sources of toxic alcohol exposure to varying degrees with 58% for methanol and 89% for ethylene glycol. Data indicated that a lack of knowledge of the underlying pathophysiology was related to missing education (PCC <0.05) in toxicology. Education appears to have been insufficient in regards to recognising and treating toxic alcohol exposure. A majority of respondents (68.6%) believed that assessment and treatment of toxic alcohol poisoning is an important component of their training.

Conclusions

Although symptom recognition for toxic alcohol poisoning is present in most EMS providers, pharmacological intervention and treatment approaches were often not known. The results indicate that there is a need for educators and curriculum builders to include additional coverage of topics of toxicological importance such as the anion gap and toxic alcohol assessment, pathophysiology and treatment.
New Zealand Paramedics are Ready for An Autonomous Pre-Hospital Thrombolysis Protocol
Authors: Davis Paul , Howie Graham , Dicker Bridget
Published: December 2018

Introduction

Internationally, autonomous paramedic-delivered pre-hospital thrombolysis (PHT) administration for ST-elevation myocardial infarction patients has proven to be a highly effective strategy in facilitating expedited delivery of this treatment modality. However, current New Zealand models rely on physician authorised telemetry-based systems which have proved problematic, particularly due to technological failings. The aim of this study is to establish whether current paramedic education in New Zealand is sufficient for the introduction of an autonomous paramedic clinical decision-making model of PHT.

Methods

A one-hour workshop introduced a new PHT protocol to 81 self-selected paramedic participants – both rural and metropolitan based – from New Zealand. Paramedics were then tested in protocol application through completion of a scenario-based standardised written test. Four written scenarios constructed from actual field cases assessed 12-lead electrocardiogram interpretation, understanding of protocol inclusion/exclusion criteria, and treatment rationale. Ten multiple-choice questions further tested cardiac and pharmacology knowledge as well as protocol application.

Results

Overall clinical decision-making showed a sensitivity of 92.0% (95% CI: 84.8–96.5), and a specificity of 95.6% (95% CI: 89.1–98.8). Electrocardiogram misinterpretation was the most common error. University educated paramedics (n=44) were significantly better at clinical decision-making than in-house industry trained paramedics (n=37) (p=0.001), as were advanced life support paramedics (n=36) compared to paramedics of lesser practice levels (n=45) (p=0.006).

Conclusion

Our New Zealand paramedic sample demonstrated an overall clinical decision-making capacity sufficient to support the introduction of a new autonomous paramedic PHT protocol. Recent changes in paramedic education toward university degree programs are supported.
Four Dimensions of Paramedic Practice in Canada: Defining and Describing the Profession
Authors: Bowles Ron R , van Beek Catherina , Anderson Gregory S
Published: December 2018

Introduction

This article presents a framework for describing four dimensions of paramedic practice: Practitioners, Practice Setting, Care and Patient Disposition. The framework emerged from a qualitative study conducted to identify potential research directions and opportunities to advance paramedicine and paramedic education at Justice Institute of British Columbia in Canada.

Methods

Researchers conducted semi-structured interviews with 17 stakeholders in Canadian paramedicine to explore the current state and emerging expectations of paramedic practice and paramedic education.

Results

The study found no consensus, and little agreement, on what term or terms best describe the profession. Participants agreed that the core of paramedic practice involves an advanced care paramedic responding by ambulance to the patient's side in an emergency to assess and treat urgent medical and traumatic conditions, then transport the patient to further medical care – most often an emergency physician at an emergency department. However, participants also described paramedics as healthcare providers who are increasingly taking on varied operational roles to improve patient care and address gaps in an evolving and stressed healthcare system. Four dimensions emerged for describing key characteristics of paramedic practice: the Practitioners, Practice Settings, Care and Patient Disposition.

Discussion

The framework described in this article may be useful for examining and better understanding both traditional and evolving paramedic roles. This, in turn, informs the efforts of paramedic educators, regulators, employers, and professional associations to support practitioners in the field. The article uses the framework to contrast two distinctly different community paramedic programs.
Undergraduate Paramedic Students’ Perceptions of a Community Volunteer Placement
Authors: Johnston Tania , Acker Joe , MacQuarrie Alexander
Published: December 2018

Objective

This study aimed to explore first year university paramedic students’ perceptions of volunteerism during a community placement.

Methods

In this exploratory study we employed a cross-sectional methodology utilising a convenience sample of first year undergraduate students. Administering a paper-based survey, we measured students’ perceptions of their experience of a 50-hour placement as a volunteer within a community organisation.

Results

Of the 191 students available to participate in the study, 88 completed the survey yielding a 46.1% response rate. Survey results were positive overall and indicated that students view volunteering in a community placement as a good experience. The majority of students signalled that they had a positive impact during their placement and were inclined towards future volunteering including as paramedic volunteers.

Conclusion

Our results suggest that paramedic students positively perceive volunteering during a community placement and may be predisposed to future volunteer opportunities.
Improving Paramedic Confidence with Paediatric Patients: A Scoping Review
Authors: Fowler James , Beovich Bronwyn , Williams Brett
Published: December 2018

Introduction

Paediatric patients comprise a reasonable minority of paramedic workload, but cases involving children often evoke anxiety and discomfort. Subsequent feelings of low confidence and self-efficacy have been linked with a reluctance to initiate treatment and possibly, poorer care. It is unknown to what extent these apprehension-producing perceptions are held by paramedics and what educational strategies can improve them. This study aims to fill this gap by reporting on a scoping review that examined and mapped the effectiveness of educational interventions on improving paramedic perceptions of caring for paediatric patients.

Methods

Arksey and O'Malley's scoping methodology was used. CINAHL, AMED, EMBASE, MEDLINE and PsychINFO databases were searched, alongside several networks and grey literature services. The search strategy was validated by a subject research-librarian. Two reviewers independently reviewed retrieved articles against inclusion and exclusion criteria determined in advance.

Results

Seventeen articles were included in the review, comprising six conference abstracts, one letter to the editor and 10 journal articles. These articles were categorised into three themes: identifying educational needs and preferences, novel education programs and evaluating education delivery methods.

Conclusion

Paramedics feel uncomfortable treating paediatric patients and desire more paediatric training, particularly simulation and exposure to children. There is insufficient evidence to demonstrate superior effectiveness of any particular training program. While the most effective education delivery method is unclear, it seems web-based learning can be as effective as traditional teaching. The efficacy of existing pre-established paediatric training programs needs to be investigated, alongside paediatric education in the initial training curriculum. Further research, particularly from outside the United States of America, is needed to identify and develop the most effective educational intervention to improve paramedic confidence with paediatric patients.
The Knowledge, Attitudes and Preparedness of Australian Paramedics to Manage Intimate Partner Violence Patients – a Pilot Study
Authors: Sawyer Simon , Williams Angela , Rotheram Auston , Williams Brett
Published: December 2018

Introduction

Australian ambulance services are currently attempting to improve their capacity to respond to intimate partner violence (IPV) patients, which is a significant contributing factor to the morbidity and mortality of women. Leading health organisations have called for increased training for frontline health care workers, however there is a paucity of literature on the current preparedness of Australian paramedics. A description of the preparedness of Australian paramedics to manage IPV patients has the potential to inform curricula and practice development.

Methods

We surveyed a cohort of qualified Australian paramedics using the modified Physician Readiness to Manage Intimate Partner Violence Survey.

Results

We received 28 completed surveys (16.5% response rate), that revealed most respondents (89.3%) believed they had encountered IPV patients while working as a paramedic, yet only one participant reported comprehensive education or training on the management of such patients. Participants reported low knowledge and preparedness to manage IPV patients. Participant attitudes were poor for self-efficacy, confidence and preparation, and generally neutral for items regarding attitudes toward women and IPV patients.

Conclusions

This study adds to mounting evidence that paramedics frequently encounter IPV patients, have insufficient education and training, and are not prepared to manage such patients. While the results of this study should be interpreted with caution due to a low response rate and small sample, it appears that Australian paramedics would benefit from targeted educational packages that provide the necessary knowledge to recognise and refer patients, modify inappropriate or insufficient attitudes, and prepare paramedics to effectively manage IPV patients.
Coronial Consideration of Patient Deaths in Paramedicine
Authors: Moritz Dominique Lee
Published: December 2018

During the course of a paramedic's duties, it is inevitable that they will deal with patient death in some way. Australia's coronial system is a safeguard to ensure deaths are investigated where their cause is not immediately known, or the circumstances surrounding the death is unusual.

This article considers three recent coronial inquests involving paramedic care in Australia; identifies the significant observations that can be made from analysing the paramedics’ actions during patient treatment; and comments on how the coronial system can be used to improve patient outcomes.
Life after Bushfire: Post-Traumatic Stress, Coping, Post-Traumatic Growth
Authors: Hooper Jackie , Magor-Blatch Lynne , Bhullar Navjot
Published: December 2018

Introduction

Research suggests that post-traumatic stress (PTS) symptoms are common after the experience of bushfire. However, the ways in which individuals cope with, positively grow from, and find benefit in the adverse circumstances of bushfire in Australia has not been adequately explored. The main objective of this study is to assess the relationship between PTS, coping strategies and post-traumatic growth, in a sample of Australian community members affected by a bushfire event.

Methods

Sixty-five participants (mean age 40.66 years, SD=13.57), who had previously experienced a bushfire event in Australia, responded to an anonymous online survey.

Results

Results indicated that greater PTS was associated with the use of all coping strategies, as well as higher levels of post-traumatic growth. The use of coping strategies was associated with higher levels of post-traumatic growth. Hierarchical regression analyses found that post-traumatic growth and avoidant coping explained significant amounts of unique variance in PTS, whereas PTS and emotion-focussed coping explained significant amounts of unique variance in post-traumatic growth.

Conclusion

In communities that are seasonally threatened by bushfires, our findings suggest that not only are post-disaster stress reduction interventions required, but so too are preparedness programs that include strategies for promoting growth and positive adaptation. It is suggested further research should address implications for strength-based preparedness and recovery programs in bushfire prone areas.
Working towards wellness: Lessons from 9/11 paramedics and emergency medical technicians for Australian ambulance services
Authors: Smith Erin Claire , Burkle Jr Frederick M
Published: December 2018

IntroductionThe September 11, 2001 terrorist attacks, otherwise known as 9/11, on the World Trade Center in New York City killed 2753 people, including approximately 413 first responders. Some 7000 responders are currently enrolled in the World Trade Center Health Program with illnesses related to their exposure to 9/11, and over 2000 have had to retire on 9/11-related disability. The impact of 9/11 is extensive and ongoing.MethodsThis research used qualitative methods to interview a cohort of 54 paramedics and emergency medical technicians who responded to 9/11. These interviews occurred around the 15-year anniversary of the terrorist attacks. The objective of the research was to explore the long-term physical and mental health impact on the responding paramedics and emergency medical technicians and to investigate key influences on wellness. Information pertaining to ongoing impact, wellness and ideas for effective ambulance wellness programs were extrapolated through thematic analysis.ResultsSeven key lessons for paramedic wellness were identified. These included: the need to understand the paramedic workforce and the key influences on their health and wellbeing; the importance of engaging staff in the development-phase of wellness strategies; avoiding silo-approaches to physical and mental health; providing ongoing professional development opportunities; providing tools for effective peer-to-peer communication; including family members in wellness initiatives; and not forgetting the retiring workforce.ConclusionThis research makes an important new contribution to the existing knowledge base at a time when Australian ambulance services are currently developing wellness strategies to improve the physical and psychosocial wellness of the pre-hospital workforce.
Enhancing the Quality of Cpr Performed by Laypeople
Authors: Lerjestam Kerstin , Willman Anna , Andersson Ingrid , Abelsson Anna
Published: December 2018

Introduction

The prognosis of survival for a person suffering from cardiac arrest increases when a layperson performs cardiopulmonary resuscitation (CPR) on-site. In Sweden, providing CPR training to people working in public places is considered a social benefit.

Objective

The aim of this study was to investigate the effect of a 3-hour CPR intervention for electricians.

Methods

Data were collected through an intervention by means of simulation and consisted of a pre- and post-assessment of the participants’ CPR performance.

Results

The results show a statistically significant improvement in ventilation (41%) and quality of compression (36%).

Conclusion

With short rehearsal training, the layperson can significantly improve the quality of CPR given. In a situation of cardiac arrest, this can be crucial for the patient's survival and continued quality of life.
Timing approaches toward scientific organization of webinars in libraries
Authors: Sokolova Yu. V. , Kolchin P. A.
Published: December 2018

Due to advancing information and communication technologies webinars have become a means of continuing education which demands methodological support and standardization. The authors analyze the methods of labor rating, in particular, timing of technological and organizational processes. The factors of time input for webinar organization are defined: i. e. number of lecturers, including those remote ones, various formats and number of demonstrated materials (presentations, video, audio, texts, links), scenario multitasking (for example, polling, displaying related materials, linking, etc.), simultaneous broadcasting to another videohosting  (i.e YouTube). The list of technological processes for webinar organization is presented along with the findings of labor rating as exemplified by the NPLS&T’s experience. The calculations of real time consumed are obtained through the judgment-based method as well as through the continuous timing method. The authors conclude on the rate between real-life and typical timing of webinar organization and the proportion of this time within working hours in NPLS&T.
A scientist, pedagogue, innovator. To the jubilee of Yury Stolyarov
Authors: Dvorkina V. Ya.
Published: December 2018

The author speculates on the life, scientific, pedagogic and social activities of Russian prominent library scientist Yury Nikolaevich Stolyarov and his contribution into the library studies. His publications embrace the problems of library collections development, general library studies, library profession and education, documentology, document resources, document communication, book culture, theory of information, library ethics, bibliopsychology by Nikolas Rubakin, information resources, efficiency of library activities, methodology, library statistics, bibliography, history of librarianship, etc. The key works by Stolyarov are listed. The importance of several works by Stolyarov is revealed: “Library: The structural and functional approach”, “The evolution of library collections studies”, ”The origins of book culture”, textbooks and learning aids in library collections studies, etc.

Yury Stolyarov’s childhood years and environment, stages of his professional career, his work for Kaluga Regional Library, army service, work for Moscow State Institute of Culture and job positions, engagement in dissertation boards and IFLA activities are discussed. His pedagogical and social activities are characterized, awards are mentioned, too.