bluuebunny/crossref_metadata_2025_split huggingface dataset:
Editorial VMIDEA 3
Authors: López Galeano Andrés 
Published: December 2018

Hablar de Latinoamérica refiere a debates, posturas y múltiples tensiones evidenciados en los acontecimientos que allí se han dado a lo largo de la historia. Posterior al proceso de colonización, Latinoamérica ha sido lugar de constantes debates políticos, sociales y culturales enmarcados en variados temas que van desde el desarrollo, el populismo, la dependencia a países del Norte, hasta la cuestión indígena que resalta la importancia de rescatar valores y técnicas propios de esta. Con la expansión de un mundo cada día más globalizado, retornar al pasado, dar voz a aquellos no reconocidos o a la reconstrucción de posturas antiguas, toma un gran valor desde la social y del patrimonio cultural. Esto, ha generado campos de tensión que, desde la misma academia, constituyen el núcleo de un pensamiento hibrido, implícito en todos los procesos de la cotidianidad latinoamericana relacionada con el diseño y las bellas artes. La intención crítica que emerge desde Latinoamérica es ahora más palpable y latente pues parte del cuestionamiento actual por el estado de las cosas.
Forma y supraforma
Authors: Comba Leonardo 
Published: December 2018

En la ejecución de su oficio, el comunicador visual “informa”, esto es, le da forma a lo informe, a lo que aún no tiene forma, mediante el uso consciente e intencionado del lenguaje visual. Evidentemente debe preexistir una información de base organizada y coherente, definida desde el uso adecuado del lenguaje alfabético, oral o escrito, un discurso específico que se debe “configurar”, lo cual significa precisamente “dar determinada forma a algo” (RAE, 2017). Según el criterio estricto y concreto de Wucius Wong “las formas son contornos compactos y positivos que ocupan un espacio y se diferencian del fondo” (1995, p.138) y relaciona el concepto con “todo lo que pueda ser visto” (p.43) e identificado. En este sentido, ubica la forma como el principal elemento visual, que, según su clasificación, contiene y en algunos casos determina a los demás elementos visuales (tamaño, color y textura) y de relación (dirección y posición), diferenciándolo de los elementos conceptuales, deducibles pero no perceptibles (punto, línea, plano y volumen), que a su vez se convierten en formas cuando pasan a ser visibles y verificables.
La postura crítica y la pesquisa en el Diseño Gráfico
Authors: Vanegas Orozco Luis Henry 
Published: December 2018

El diseño es considerado desde el principio de los siglos como algo necesario en la vida humana, en tanto reúne las vertientes que abrevan en la necesidad y la solución, elementos atinentes al ser desde sus inicios. En medio del potencial abanico de aspectos, se sitúa la gráfica como fenómeno que convive con cada uno de nosotros, necesitados de expresar con otros lenguajes las percepciones acerca de la realidad particular. Sin embargo, ese lenguaje ha superado la expectativa de ser una forma de mostrar las realidades y subjetividades, tendiendo a convertirse en una mediación que la sociedad de consumo ha adoptado utilitariamente, al ofrecer sus productos y servicios.
Resurgence of an Australasian Prehospital Journal
Authors: Boyle Malcolm 
Published: December 2018

As the new editor of the former Journal of Emergency Primary Health Care, now the Australasian Journal of Paramedicine, I welcome you to the first issue of 2013 and a new start for the journal. The Australasian Journal of Paramedicine (AJP) is the official open access, peer-reviewed, international journal of Paramedics Australasia (PA), the peak professional body for paramedics across Australasia.
Facilitating Rapport through Real Patient Encounters in Health Care Professional Education
Authors: Ross Linda 
Published: December 2018

Background Establishing rapport is central to any health care professional-patient encounter. Developing a positive relationship with a patient enables the health care practitioner to elicit pertinent information and make informed clinical decisions about their treatment. This consequently leads to greater patient adherence, satisfaction and ultimately outcomes. As interpersonal communication and building patient rapport is integral to patient care it is imperative that the teaching of these skills be included in undergraduate and continuing health care professional education. The objective of this narrative review was to analyse the literature pertaining to health care professionals learning and developing interpersonal communication and rapport building skills through encounters with ‘real patients’. Methods In April 2013 a search was conducted using the following electronic databases; MEDLINE, PsychINFO, CINAHL and ERIC. The search was limited to articles from peer-reviewed journals, conference papers and abstracts published between 1998 –2013 and written in English. Articles identified were assessed against the inclusion/exclusion criteria. Results An initial search located 6549 articles. Following the application of inclusion and exclusion criteria seven articles were included in this review. A synthesis and subsequent examination of the extracted data revealed positive results in regard to incorporating ‘real patients’ into interpersonal communication skills and practitioner-patient relationship teaching and learning. Some studies measured actual improvement in behaviour and skills whilst others offered self-reported data on participant perceptions of their skills Conclusion Training interventions involving ‘real patients’ that are designed to foster interpersonal communication, interviewing skills, practitioner-patient relationships and rapport building are achievable and beneficial for student and practicing health care professionals. Any conclusions drawn from this review however must remain preliminary until such time as more high-level research becomes available.
Development and Implementation of Victorian Prehospital Clinical Practice Guidelines: The Supraventricular Tachycardia Example
Authors: Smith Gavin , Kenneally Jeff 
Published: December 2018

Introduction In order to provide an evidence-based approach to practice, the Ambulance Victoria (AV) Clinical Practice Development Committee (CPDC) is tasked with periodic review of all of the AV Clinical Practice Guidelines (CPG's). This paper will highlight the framework underpinning CPG development in a Victorian prehospital emergency care system, and explore the development of CPG A0403 (supraventricular tachycardia) as an example of the process. Methods The CPDC applied a newly developed process, based upon national and internationally accepted methods of guideline assessment and development. Literature review, analysis of current practice data and extensive expert consultation were also used to formulate Guidelines. Results The CPDG delivered a revised CPG which removed calcium channel blocker therapy, introduced adenosine, and expanded the use of vagal manoeuvres to all operational paramedics. The VACIS data highlighted low intervention rates using pharmacology and vagal manoeuvres, with accepted reversion rates where applied. No logistic or safety issues were identified for the proposed changes, and expert consultation also supported changes to the guideline. Conclusion The development and implementation of new clinical guidelines in Victoria has evolved to embrace evidence based practice. The paucity of available prehospital-specific evidence means that consensus is still relied upon to complete the process, yet the evolution of further research will help to reduce reliance on this aspect and improve the quality and effectiveness of the process.
Job Satisfaction Level and Its Main Determinants among Iranian Emergency Medical Service Personnel: A Population-Based Survey
Authors: Roshanaei Ghodratollah , Khatiban Mahnaz , Hosseini Saboor , Bikmoradi Ali , Karampourian Arezou 
Published: December 2018

Introduction Few research studies exist regarding the job satisfaction of Iranian emergency medical services personnel. This study aimed to explore job satisfaction levels of these personnel in the two western provinces of Iran. Methods Participants in this study were emergency medical personnel working (n=260) at medical emergency centres in the two western provinces of Iran (Kermanshah and Hamadan) in 2011. Job satisfaction was measured by a self-administered questionnaire consisting of questions about demographic characteristics and job components, as well as verbal or physical violence with other staff and the greater community. There were 10 experts who confirmed the questionnaire content and face validity. A Cronbach's alpha of 0.84 and a Pearson r for test-retest (r=0.88) showed a reasonable reliability. The gathered data was analysed using SPSS 16 software. Results Overall, job satisfaction was found to be at a moderate level (99.3% in Kermanshah and 98.2% in Hamadan). The highest satisfaction score was in the autonomy to provide care to patients. There was verbal and physical violence between personnel and their supervisors, patients and patients’ caregivers, which was perceived as a low to moderate level of satisfaction. Most participants experienced very low verbal and physical violence with their colleagues. Conclusion The majority of the Iranian emergency medical personnel in this study perceived their overall job satisfaction at a moderate level, the autonomy of patient care at the highest level and the fairness of the annual performance appraisal system at the lowest level of satisfaction.
Comparison of Anaphylaxis Diagnostic Criteria and Management Guidelines for the Prehospital Setting
Authors: Chang Yu-Tung , Boyle Malcolm J 
Published: December 2018

Introduction Anaphylaxis is a potentially life-threatening medical emergency and a challenge for emergency healthcare providers. There appears to be a lack of consistency in the international definition and management of anaphylaxis. The objective of this study was to review current international guidelines in diagnostic and management of anaphylaxis in the pre-hospital setting. Methods A literature search was conducted of the medical related electronic databases, Ovid MEDLINE, Cinahl, Cochrane CENTRAL and EMBASE from 1980 to the end of May 2013. A previously published pre-hospital search filter was used in each of the databases including additional keywords, ‘anaphylaxis’, ‘diagnosis’, ‘hypersensitivity’, ‘allergy’, ‘allergic reaction’, ‘adrenaline’, ‘epinephrine’ and ‘antihistamine’. Articles were included if their primary aim was to report of the evidence used to create international guidelines of anaphylaxis diagnosis and management. The references of retrieved articles were also reviewed. Articles were excluded if they were not written in English. Results There were 128 articles located by the search with 18 meeting the inclusion criteria. Of these, three were literature reviews and six reported on the introduction of anaphylaxis guidelines, including medical treatment in different countries. Three retrospective studies evaluated the efficiency of current diagnostic and management in hospital setting. Two questionnaire surveys were conducted internationally. There were two articles proposing diagnostic criteria and a rating method for anaphylaxis. Two were relevant to pre -hospital studies. Conclusion The inconsistency of definition and diagnosis criteria increases the risk of under-diagnosis and under-treatment of patients with anaphylaxis. Emergency healthcare providers need a more explicit set of diagnosis criteria and guidelines for treatment to rapidly relieve patients’ anaphylactic reaction and potentially life-threatening situation.
Reporting MāOri Participation in Paramedic Education and the Ems Workforce in New Zealand
Authors: Morrison Timothy A , Tunnage Bronwyn 
Published: December 2018

Introduction Indigenous people have poorer health outcomes and are under-represented in the general healthcare workforce. This study aims to: i) quantify Māori participation in paramedic education and the Emergency Medical Service (EMS) workforce in New Zealand, ii) compare these with reported Māori participation rates across healthcare education and the general healthcare workforce, and iii) identify factors that may promote or inhibit Māori engagement in the sector. Methods Providers of tertiary paramedic education and EMS systems were surveyed and relevant literature was reviewed. Results Māori averaged 7.5% of total enrolments in tertiary paramedic education over a 5 year period and, in 2013, represented 5% of the total EMS workforce. The literature review included 14 publications. Māori participation across the general healthcare workforce is low. Factors promoting Māori tertiary enrolment include the desires to attain a career, enhance Māori health and have a steady income. Barriers inhibiting academic studies include inadequate support, low academic and socio-economic backgrounds and the absence of a culturally safe learning environment. Aspects promoting workforce engagement include clear career pathways, support for workforce development, having role-models, mentors and leaders in the profession, and working in a culturally supportive environment. Conclusions Māori are significantly under-represented in the EMS sector and further research is required to determine which factors promote and inhibit participation. Recruitment and retention processes should be reviewed by employers and educators and teaching strategies within paramedic programmes reconsidered. Initiatives aimed at engaging Māori in the health workforce should ensure they promote paramedicine as a potential career choice.
Is There An Ideal Prehospital Drug Treatment for Acute Cyanide Poisoning?
Authors: Barraclough Craig B 
Published: December 2018

Introduction Cyanide, due to its toxicity and prevalence in a variety of industries, is a suitable agent for terrorists or disaffected persons to use as a weapon of terror. New Zealand's National Poisons Centre lists five cyanide antidotes. This review aimed to identify whether there is an ideal pre-hospital drug treatment for acute cyanide poisoning. Methods Literature less than 10 years old was selected after a keyword search. The articles were reviewed for specific positive and negative properties of each antidote. Results Thirty-nine articles were reviewed of which four were excluded. Results varied, with hydroxocobalamin scoring highly on effectiveness, with limited negative effects. It also demonstrated positive haemodynamic effects, suitability in cases involving trauma, carbon monoxide (CO), smoke inhalation casualties and was safe for pre-hospital use. Sodium nitrite, followed by dicobalt edetate had the next highest scores for efficacy. However, both scored negatively for their effects on blood, causing hypotension and toxicity, and they are unsuitable for trauma, CO or smoke inhalation casualties. Sodium thiosulphate, with a moderate level of efficiency, remained most effective when co-administered with other antidotes. 4-dimethylaminophenol and amyl nitrite rated the lowest, with negative effects similar to sodium nitrite. Adrenaline was tested as an antidote in one study where two novel antidotes both demonstrated promising results. Conclusion Hydroxocobalamin had the highest success rate and its safety profile make it the most suitable pre-hospital drug treatment for acute cyanide poisoning.
Freedom House: A Rich History and a Continuing Legacy: An Interview with George Mccary
Authors: Williams Brett 
Published: December 2018

This interview with George McCary was conducted by Associate Professor Brett Williams in 2014. I first came to learn about Freedom House from one of my US colleagues Dave Page. I guess what struck me most about this amazing story was that it seemed very little was known about the early work of Freedom House and how this played a part in the professionalisation of the US pre-hospital system. In many ways, it is these types of historical examples that are critical in understanding our discipline as we forge towards becoming a legitimate health care profession. I wonder if there are other similar examples in Australia or other parts in the world? I would like to acknowledge Dave Page for allowing me to meet a number of the original members of Freedom House and being able to arrange an interview with George McCary while I was in Pittsburgh. This interview will be followed by invited commentaries from Professor Walt Stoy, University of Pittsburgh and Professor Peter O'Meara, La Trobe University.
Paramedics and Act Mental Health Legislation
Authors: Bradley Ellen J , Townsend Ruth , Eburn Michael 
Published: December 2018

Introduction On 15 May 2014, the Minister for Health, The Hon Katy Gallagher presented the Mental Health (Treatment and Care) Amendment Bill 2014 (‘the Bill’) to the Australian Capital Territory Legislative Assembly (1). The Bill was subsequently passed on 30 October 2014. One recommendation contained in the proposed Bill is to extend powers of apprehension, which are currently only held by police officers, to approved ACT paramedics. The power may be exercised without regard to the patient's decision making capacity. This paper explores some of the legal and ethical issues associated with the proposed legislation. Methods This paper reviews the Bill in light of underlying legal and ethical principles that are relevant to the treatment of the mentally ill and paramedic practice. Results It is demonstrated that there are arguments both in favour of, and against the proposal to grant paramedics powers of apprehension. Conclusion Whether allowing paramedics to detain a person who is mentally ill will work in the best interests of the patients remains to be seen but caution must be exercised to protect the paramedic/patient relationship.
What Motivates Students to Pursue a Career in Paramedicine?
Authors: Ross Linda , Hannah Julian , Van Huizen Pheona 
Published: December 2018

Introduction This study aimed to determine the motivations behind students’ decisions to enrol in a degree in emergency health (paramedic) or double degree emergency health (paramedic) and nursing. Methods Students were surveyed to determine the importance of different motivations influencing their decision to enrol in their current university course. Results There were 168 surveys returned from 182 students (93% response rate). The most important motivations for students were ‘wanting to help people’, ‘saving lives’ and ‘exciting career’. Older respondents rated ‘giving back to the community’, ‘wearing a uniform’, ‘employment prospects’, ‘pay rate’ and ‘job security’ slightly higher. Males considered ‘ pay rate’, ‘ working environment’ and ‘ job security’ slightly more important than females. Conclusions Findings suggest that like other health professional students, those studying paramedicine do so for intrinsic motives including ‘wanting to help people’, ‘saving lives’ and an ‘exciting career’.
Exploring New Zealand Paramedic Attitudes towards Advance Directives: An Ethical Analysis
Authors: Davey Paul J , Lees Amanda B , Godbold Rosemary 
Published: December 2018

Introduction Advance directives are known to present challenging ethical issues in health care practice, however there is a paucity of research paramedic perspectives. When a cardiac arrest occurs in the community, end of life provisions have often not been considered by patients or the patients are unable to communicate their wishes and these are not usually known to the attending paramedic crew. These factors contribute to an ethically complex decision-making environment. Ethical deliberation contributes to practitioners’ critical thinking skills and helps prepare them for decision-making under uncertainty. This research aims to highlight and explore underlying values present within practice-based decisions. Methods An exploratory, interpretive study, using the Values Exchange, a web-based ethical decision-making tool, explored eighteen urban-based New Zealand paramedics’ deliberative perspectives on an ethically controversial end of life scenario. Results Thematic analysis of participants’ free text responses ascertained the breadth of views on advanced directives, with the emergence of three dominant themes; legal tensions, multiple constructs of dignity and seeking solutions that support clinical practice. Conclusion Findings revealed that when considering situations involving advance directives, participants regarded the duty to uphold patient dignity as paramount. There was a desire for greater legal guidance and a call for increased professional education in law and ethics. This study provides insight into New Zealand urban-based paramedics’ views and experiences of this ethically challenging aspect of patient care.
Use of Supraglottic Airway Devices by Paramedics in the Management of Adult Prehospital Cardiac Arrest Patients
Authors: Barr Stephen , Smith Gavin , Darroch Shaunagh 
Published: December 2018

Introduction Current best practice for paramedic airway management of prehospital cardiac arrest is being continually reviewed following changes to the emphasis on intubation as a primary intervention within international resuscitation guidelines. Subsequently, there is increased enthusiasm for the use of next generation supraglottic airway devices. This review aimed to identify the current evidence for the safety and effectiveness of supraglottic airways for the management of prehospital cardiac arrest. Methods A search of the electronic databases Medline, PubMed, Science Direct and Cochrane Library was conducted. Papers were excluded if they did not examine airway management in the prehospital cardiac arrest setting, involved the use of sedative or paralysing agents, involved paediatric patients, animals or cadavers. Results Of the 689 articles identified, 22 peer-reviewed articles were included for analysis. All 22 articles were from the following countries: United States of America, United States of America and Canada, Australia, Austria, Finland, Germany, Korea, Japan, The Netherlands, Norway, Taiwan and the United Kingdom. Discussion This review revealed large variances in both device effectiveness and patient outcome, particularly between geographical locations. Second-generation supraglottic airway devices demonstrated considerable improvement in effectiveness over their predecessors. Interestingly, the use of bag-valve mask ventilation reported better outcomes than any other form of advanced airway intervention. Studies also highlighted the diversity of airway management techniques and devices across global EMS systems. Conclusion Despite favourable indications of the effectiveness and safety of the next generation supraglottic airway devices, the paucity of pre-hospital specific research (particularly randomised controlled trials) challenges decision-making regarding pre-hospital airway management best practice.