bluuebunny/crossref_metadata_2025_split huggingface dataset:
Willingness to Work during a Terrorist Attack: A Case-Study of First Responders during the 9/11 World Trade Centre Terrorist Attacks
Authors: Smith Erin 
Published: December 2018

Background Terrorist attacks are exceptional events that place first responders in high risk situations. When terrorist attacks occur, first responders will play an integral role in the response to, and management of, these events. Providing a core component of the ‘frontline’ response to terrorism, first responders will potentially be exposed to a variety of health and safety risks, including physical injury, death, exposure, infection, contamination, and psychological effects such as anxiety, post-traumatic stress, and depression. Objectives The objective of this research was to gain an understanding of risk perception and willingness to work during terrorist events. Specifically, this research aimed to investigate willingness to work among paramedics and emergency medical technicians (EMTs) who had responded to the 9/11 World Trade Centre (WTC) terrorist attacks. Methods Focus groups and interviews were conducted with New York based first responders to discuss their willingness to work and response to the 9/11 attacks. Conclusion First responders reported a number of primary risks that concerned them during their response to the 9/11 terrorist attacks. These were injury and death, and potential contamination and exposure. The key concerns reported by first responders with providing the frontline response to the attacks related primarily to health and safety, communication issues, the need for accurate and timely information, and the need for suitable training and education. First responders often reported a difficulty in finding a balance between personal safety and duty of care. Despite these risks and concerns, all study participants reported a willingness to work on the day. Willingness to work during subsequent terrorist and bioterrorist events in the future was influenced by the provision of better personal protective equipment (PPE), communication strategies, and the development of targeted and specialised training and education programmes.
The Quandary of Prehospital Oxygen Administration in Chronic Obstructive Pulmonary Disease - a Review of the Literature
Authors: Perry Elizabeth , Wiliams Brett 
Published: December 2018

Introduction Perpetual debate continues regarding the amount of oxygen that should delivered by paramedics to patients with acute exacerbations of chronic obstructive pulmonary disease (COPD). A number of studies argue that providing excessive levels of oxygen in COPD patients results in hypercapnic respiratory failure. Despite the prevalence of COPD there continues to be a paucity of prehospital literature on this topic. Objective To review and analyse the literature regarding prehospital administration of oxygen therapy in patients with COPD. Design Literature review using a variety of medical databases including Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, MEDLINE, CINAHL and PubMed. The following MeSH terms were used in the search: lung diseases, obstructive; emergency medical services; respiratory therapy. Results Using exclusion and inclusion criteria a total of 9 papers were located. There is a lack of high quality evidence to adequately address the issue of oxygen prescription to COPD patients in the prehospital setting. It is recommended that oxygen flow is titrated in COPD patients to maintain SpO2 between 90-92%. Conclusion There is a need for randomised controlled trials in the prehospital setting to address the issue regarding oxygen prescription for COPD patients. Oxygen can be titrated using pulse oximetry to minimize complications of hypoxia and the risk of hypercapnia from excessively high oxygen concentration.
From Roadside to Hospital: A Pilot Study to Investigate the Factors Influencing the Time Taken to Deliver Trauma Patients to a Regional Hospital
Authors: Boyle Malcolm , O'Meara Peter 
Published: December 2018

Introduction One of the trauma system objectives for the ambulance service is to get the right patient to the right hospital in a timely manner. The Review of Trauma and Emergency Services in Victoria, Australia, identified prolonged prehospital scene times of greater than 20 minutes for non trapped patients as a deficiency that may have adverse outcomes for severely injured trauma patients. The objective of this pilot study was to identify the factors that impact on the timely transfer of trauma patients from the scene of an incident to a regional hospital emergency department and justification for the delays, as the basis for a further detailed study. Methods A retrospective pilot cohort study of trauma patients transported by ambulance to the emergency department of the Latrobe Regional Hospital over a six-month period who had an emergency department triage category of 1, 2 or 3 was undertaken. Data relating to the prehospital care of trauma patients with scene times > 20 minutes and transport times > 30 minutes were extracted from Rural Ambulance Victoria patient care records and hospital patient records. Ethics approval was granted. Results There were 70 trauma patients transported to the hospital during the collection period. Of these 49 patients were available for analysis, 21 cases were excluded due to incomplete time or ED triage details. There were 12 cases where scene times were > 20 minutes. Only one paramedic crew spent an unjustifiably long time at the scene and only one patient had a transport time to hospital > 30 minutes. Conclusion This pilot study confirms that there are prolonged prehospital scene times involving paramedics, however, the study suggests that most of the extended times are explained by factors outside the control of the attending paramedics. There was only one case where the scene time was not justified. One patient had a transport time > 30 minutes which was due to the patient being taken to a higher level of care. Experiences from this pilot study have led to changes in subsequent prehospital trauma studies.
Enhancing An Undergraduate Paramedic Degree through the Introduction of a Health Fact Sheet Assessment Task
Authors: Hryciw Deanne 
Published: December 2018

Aims A component of the Council of Ambulance Authorities Inc. (Australia) guidelines is to facilitate the development of University degree courses which focus on the development of professional behaviour by incorporating educational programs that provide paramedic graduates with workplace skills that will be required for their future careers. Methods A health fact sheet assessment task was introduced to first year Bachelor of Health Sciences (Paramedic) students as a part of their curriculum in bioscience. The aims of the assessment task were to improve their understanding of basic anatomy and physiology, and to enhance essential workplace skills such as communicating scientific concepts to members of the general public (lay people). In addition to the task, a survey was distributed to determine the opinion of the students on the health fact sheet assessment task. Results The 166 students who completed the task achieved a high mean grade of 8.16 out of 10 (± 0.77). Fifty-two students completed the survey (31.32%), with most students strongly believing that learning to communicate more effectively to the general public was a useful skill and that the health fact sheet assessment task achieved this aim. Conclusion The health fact sheet assessment task was a valuable tool in an undergraduate paramedic curriculum, reinforcing skills that are relevant to an allied health career.
Correlation of Paramedic Administration of Furosemide with Emergency Physician Diagnosis of Congestive Heart Failure
Authors: Dobson Thomas , Jensen Jan , Karim Saleema , Travers Andrew 
Published: December 2018

Objective Recent literature has questioned the accuracy of paramedic diagnosis of congestive heart failure and appropriateness of administration of diuretics. This study determined the agreement between paramedic administration of furosemide and emergency physician diagnosis of congestive heart failure. Treatments administered in the pre-hospital and emergency departments and adverse events are also described. Methods This retrospective study included patients treated with furosemide by paramedics from November 1, 2006 to June 1, 2008. Paramedic reports were matched with Emergency Department (ED) charts. Emergency physician diagnosis, prehospital and ED treatments, adverse events and mortality were identified. Results Of 94 patients, emergency physician diagnosis was congestive heart failure (CHF) in 60 cases, indicating agreement of 63.8% of paramedic administration of furosemide for this diagnosis. Leading alternate diagnoses were: pneumonia (n = 14); acute coronary syndrome (n = 8); chronic obstructive pulmonary disease (n = 7). The rate of death was higher in patients not diagnosed with congestive heart failure (6/28 vs. 2/58, p=0.017). Eight non-fatal adverse events were identified, all were patients diagnosed with congestive heart failure by emergency physicians. Conclusion Paramedic administration of furosemide demonstrates moderate agreement with physician diagnosis of congestive heart failure. This adds to the evidence that diagnosing the cause of dyspnea in the prehospital setting is difficult, most often confused with pneumonia. Paramedics should be cautious when administering furosemide, as it may be related to increased mortality.
From Stretcher-Bearer to Paramedic: The Australian Paramedics’ Move towards Professionalisation
Authors: Williams Brett , Onsman Andrys , Brown Ted 
Published: December 2018

Over the last one hundred and twenty years, the Australian paramedic sector has changed dramatically; influenced and informed by a range of social, health, economic, professional, and political forces. However, there has been little reflection of those changes in either the perception of the discipline as a profession or the manner in which its membership is trained, socialised, and educated. This paper explores the links between professionalisation and education in the paramedic field. Paramedics are currently at best seen as a ‘semi-profession’ and a great deal of discussion about whether the discipline actually wants to achieve full professional status exists. Comparisons will be made with the professions of nursing and physiotherapy, outlining how and why they progressed from a semi-professional status to a fully recognised profession, culminating in a discussion about which characteristics the paramedics discipline as yet lacks. A review of common professional traits suggests three areas where the discipline falls short: 1) the delineation of its professional compass, especially in relation to extant recognised cognate (and competitive) professions, 2) National registration and regulation resulting in professional self-control and accreditation, and 3) Higher Education and the development of a unique body of professional knowledge. Finally it will be argued that the recognition and addressing of the gaps by the relevant policymakers, regulators, employers and academics will lead to the formulation of strategies that are most likely to result in professional status for paramedics in Australia.
Designing a Questionnaire to Review Cultural Competency in Australian and New Zealand Paramedic Courses
Authors: Spencer Caroline , Macdonald Rhona , Archer Frank 
Published: December 2018

Designing a questionnaire to review cultural competency in Australian and New Zealand paramedic education courses provides the focus of this paper. The paper emerged from a larger research project, which sought to explore the extent to which health professions include cultural competency in their curricula. The purpose of designing a questionnaire was to review Australian and New Zealand paramedic education courses to discover the presence and coverage of cultural competency in the paramedic curriculum. To the best of our knowledge, no current research explores this theme. The absence of such research provided an opportunity to rectify this gap and contribute to the development of the paramedic curriculum, particularly with the proliferation of cultural competency courses in other health professions. This research makes an important contribution to the new academic discipline of paramedic research. The methods used for designing a questionnaire utilised three statements and guidelines on research practice, in addition to a literature review that informed the design process. The research outcome is a paramedic specific questionnaire based on a carefully constructed design process which education researchers could use or adapt to their needs for exploring other curriculum topics.
Sir Neville Howse (Vc), Private John Simpson Kirkpatrick and Private Martin O'Meara (Vc) and Their Contributions to Australian Military Medicine
Authors: Devenish Scott , O'Meara Peter 
Published: December 2018

Medical personnel serving with the Defence Forces have contributed to the evolution of trauma treatment and the advancement of prehospital care within the military environment. This paper investigates the stories of an Australian Medical Officer, Sir Neville Howse, and two stretcher bearers, Private John Simpson Kirkpatrick and Private Martin O'Meara, In particular it describes the gruelling conditions under which they performed their roles, and reflects on the legacy that they have left behind in Australian society. While it is widely acknowledged that conflicts such as World War One should never have happened, as civilian and defence force paramedics, we should never forget the service and sacrifice of defence force medical personnel and their contribution to the body of knowledge on the treatment of trauma. These men and women bravely provided emergency care in the most harrowing conditions possible. However, men like Martin O'Meara may not have been given the same status in society today as Sir Neville Howse or Simpson and his donkey, due to the public's lack of awareness and acceptance of war neurosis and conditions such as post traumatic stress disorder, reactive psychosis and somatoform disorders which were suffered by many soldiers during their wartime service and on their return home after fighting in war.
A Pilot Study to Determine Whether Undergraduate Paramedics are Able to Retain Basic Resuscitation and Respiratory Physiology Knowledge
Authors: Nehme Ziad , Boyle Malcolm 
Published: December 2018

Introduction While suboptimal bag ventilation has been well documented during cardiopulmonary resuscitation (CPR), we often do not consider how operator knowledge of ventilation guidelines may contribute to this outcome. The objective of this pilot study was to evaluate third year Monash University undergraduate paramedic students’ knowledge of the International Liaison Committee on Resuscitation (ILCOR) ventilation guidelines and basic respiratory physiology. Methods A cross-sectional study was used to elicit responses about ventilation rate, tidal volume and knowledge of lower oesophageal sphincter pressure in normal and cardiac arrest states for third year undergraduate paramedic students at Monash University. Ethics approval was granted Results There were 30 (41%) third year students who participated. Only 8 (27%) of the students who participated could identify the correct ventilation rate for an intubated patient in a cardiac arrest situation, with only 3 (10%) of students identifying the correct tidal volume. Overall, 27 (90%) of students had a poor knowledge of ventilation guidelines while 29 (97%) students were unable to recall basic lower oesophageal sphincter pressure values. Conclusion A greater emphasis on education of current ventilation guidelines, as well as the underpinning knowledge surrounding the guidelines, is needed to ensure students attain appropriate ventilation during CPR.
Which is more Effective for Ventilation in the Prehospital Setting during Cardiopulmonary Resuscitation, the Laryngeal Mask Airway or the Bag-Valve-Mask? - a Review of the Literature
Authors: Flavell Emma , Boyle Malcolm 
Published: December 2018

Background Prehospital care providers are responsible for providing adequate ventilation during cardiopulmonary resuscitation (CPR). Endotracheal intubation (ETI) is widely accepted as the ‘gold standard’ for airway protection and the preferred method for ventilation. However, most Australian paramedics are not trained to perform ETI. Laryngeal Mask Airway (LMA) and Bag-Valve-Mask (BVM) are seen as adequate alternatives to ETI as recommended by the International Liaison Committee of Resuscitation (ILCOR). The objective of this study was to identify which airway device LMA or BVM (with OPA/NPA) is more effective in airway patency and ventilation during cardiopulmonary resuscitation in the prehospital environment. Methods A literature search was conducted using medical electronic databases, MEDLINE CINHAL, EMBASE, Meditext, Cochrane Central Register of Controlled Trials (CENTRAL), and Scopus. These databases were searched from January 1996 until the end of January 2010. Articles were included if the principal objective was to compare ventilation efficiency of the LMA against the BVM in the prehospital setting. References from articles retrieved were reviewed. Results There were 2937 articles located by the search. Of these, 30 articles met the inclusion criteria with twelve relevant to the prehospital environment. In the twelve prehospital studies, two involved the use of mannequins, four were retrospective, five were observational, and there was one a literature review. Conclusion The findings from this review suggest that the LMA is more effective at ventilations over time during CPR in adults, as there is less risk of gastric regurgitation and pulmonary aspiration. The BVM is quicker at performing the first ventilation but there is a loss of effectiveness over time. BVM is considered the best method for ventilating children and neonates.
Personal Alarm Use to Call the Ambulance after a Fall in Older People: Characteristics of Clients and Falls
Authors: Johnston Kylie , Worley Anthea , Grimmer-Somers Karen , Sutherland Michele , Amos Lorraine 
Published: December 2018

Objectives To examine differences in fall characteristics and emergency service response to older fallers (≥ 65 years of age), considering their use, or not, of a personal alarm. Methods A retrospective one month audit of South Australian Ambulance Service records was conducted. Characteristics of ambulance call-outs for falls or alarm activations were described (Sample 1). Alarm-activated services for older fallers were matched (by day and type of service) with fallers who did not use a personal alarm (Sample 2). Results A retrospective one month audit of South Australian Ambulance Service records was conducted. Characteristics of ambulance call-outs for falls or alarm activations were described (Sample 1). Alarm-activated services for older fallers were matched (by day and type of service) with fallers who did not use a personal alarm (Sample 2). Conclusion Older women living alone were the major users of personal alarms for assistance after falling. If activated quickly, alarms enabled most fallers to gain ambulance attention within 15 minutes. However, personal alarm use was also associated with a high incidence of false alarms.
La mécanique de l’action publique
Authors: Surel Yves 
Published: December 2018

Resume L’article, dans le cadre de ce numéro spécial sur le process tracing , entend montrer comment ce (nouveau) protocole de recherche peut s’avérer utile dans l’analyse des politiques publiques et poursuit par là même deux objectifs principaux. Pointer tout d’abord les similitudes et affinités que cette méthode, centrée sur l’identification et le séquençage de mécanismes causaux à l’œuvre dans un processus politique donné, entretient avec certains éléments du kit analytique de la sociologie de l’action publique (analyse séquentielle, néo-institutionnalisme, analyses du changement, etc.). Identifier ensuite par quels moyens, cette méthode parfois discutée de manière très abstraite, peut fournir des outils opérationnels pour une analyse plus systématique et plus fine des trajectoires de politique publique. Pour ce faire, nous défendons l’idée que les mécanismes causaux, qui constituent à nos yeux les éléments centraux de la démarche, peuvent être mieux isolés et articulés à l’aide du modèle des « trois I », le séquençage d’une politique publique pouvant se faire à partir de l’identification de mécanismes attachés aux idées, aux intérêts et aux institutions.
La « cérébration inconsciente ». Imagerie et imaginaire du cerveau dans le récit de fiction (1850-1890)
Authors: Enriquez Romain 
Published: December 2018

Dans la première moitié du xix e siècle, l’anatomie et la physiologie cérébrales formulent des idées audacieuses qu’on réunira sous l’expression « cérébration inconsciente » dans la seconde moitié du siècle. Le rôle moteur du cerveau est contesté, son fonctionnement rattaché à des processus inconscients qui opèrent de façon réflexe. Cet article rappelle les conditions d’émergence de la « cérébration inconsciente » dans le débat, puis confronte aux discours scientifiques la fiction littéraire afin de découvrir l’apport original de cette dernière à trois niveaux – phénoménologie de la cérébration inconsciente, rôle étiologique dans la névrose et conséquences sur l’image de l’artiste. L’apport littéraire s’avère moins addition de connaissance que jeu avec les pratiques d’écriture et les notions des sciences contemporaines, un jeu par lequel elle propose pourtant un savoir concurrent ou alternatif, ouvrant de nouvelles perspectives épistémologiques.
Narrative, Identity and Academic Storytelling
Authors: Hyland Ken 
Published: December 2018

Considérant le récit dans la perspective des histoires que nous racontons à propos de nous-mêmes dans le cadre de nos vies professionnelles d’universitaires, je m’intéresse aux genres qui nous permettent de le faire de manière plus explicite. Mon objectif ici est d’explorer comment se construisent des représentations de soi, ce que j’appellerai des « récits identitaires », dans trois genres académiques peu explorés jusqu’ici, où les exigences d’anonymat et de dépersonnalisation sont moins contraignantes. Les auteurs des pages de remerciements en début des thèses, des pavés bio et des pages web personnelles sont dégagés des contraintes formelles qui régissent l’argumentaire disciplinaire et disposent d’une ouverture qui leur permet de révéler une partie de la façon dont ils souhaiteraient être perçus par autrui. La question se pose, cependant, de savoir comment ces auteurs exploitent les opportunités que ces genres narratifs offrent.
Nurturing the Wealth Beneath Our Feet or Trampling Sacred Grounds? Blog Narratives on Fossil Fuel Development in New Zealand 2010–2016
Authors: Biros Camille 
Published: December 2018

This article explores the role of the narrative sequence in the debate over fossil fuel exploration and exploitation in New Zealand as it appears in a selection of blogs. Since 2008, the New Zealand government has sought to encourage the development of this industry, claiming the existence of many underexplored basins around the two islands. Perceptions on these prospects differ greatly as the blogs considered here exemplify. We first present the wider political, economic and cultural context leading to the production of the blogs, followed by a description of the different types of narrative sequences found in these blogs. We then go on to discuss the argumentative value of these blogs in the heated debate over resource exploitation. Finally, we draw some conclusions about the generic features of blogs.