bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of Six-Month Aerobic Exercise Intervention on Sleep in Healthy Older Adults in the Brain in Motion Study: A Pilot Study
Authors: Guadagni Veronica , Clark Cameron M. , Tyndall Amanda , Raneri Jill K. , Parboosingh Jillian S. , Hogan David B. , Hanly Patrick J. , Poulin Marc J. 
Published: December 2018

Background: Sleep disturbances have been shown to be associated with the presence of the apolipoprotein ( APOE) ɛ4 allele, the well-known genetic risk factor for late-onset sporadic Alzheimer’s disease (AD). Objective: This study quantifies the effects of a six-month aerobic exercise intervention on objective and subjective sleep quality in middle-aged to older individuals including those at increased genetic risk for late-onset sporadic Alzheimer’s disease (AD), who carry the apolipoprotein ( APOE) ɛ4 risk allele. Methods: 199 sedentary men and women without significant cognitive impairments were enrolled in the Brain in Motion study, a quasi-experimental single group pre-test/post-test study with no control group. Participants completed a six-month aerobic exercise intervention and consented to genetic testing. Genotyping of APOE confirmed that 54 individuals were carriers of the ɛ4 allele. Participants’ subjective quality of sleep was assessed with the Pittsburgh Sleep Quality Index (PSQI) pre- and post-intervention. A convenience sample of participants ( n = 29, APOE ɛ4+ = 7) consented to undergo two nights of in-home polysomnography (PSG) pre- and post intervention. Sleep architecture and respiratory variables were assessed. Results: The six-month aerobic exercise intervention significantly improved participants’ total PSQI score, sleep efficiency, and sleep latency in the full sample ( n = 199). PSG results showed that total sleep time and sleep onset latency significantly improved over the course of the exercise intervention only in individuals who carried the APOE ɛ4 allele. These results are, however, exploratory and need to be carefully interpreted due to the rather small number of APOE ɛ4+ in the PSG subgroup. Conclusions: The six-month aerobic exercise intervention significantly improved participants’ sleep quality with beneficial effects on PSG shown in individuals at increased genetic risk for late-onset sporadic AD.
Testing of a 100 kW oil-free high-speed permanent-magnet synchronous motor
Authors: Sheng Feng , Geng Haipeng , Zhang Bo , Yang Baisong , Xia Kai , Yu Lie , Cheng Wenjie 
Published: December 2018

This paper describes a program development in testing a 100 kW Permanent Magnet Synchronous Motor (PMSM) using multi-leaf foil bearings with bump foils. The testing program includes the motor speed up to 43000 rpm, and then slow down to zero speed. The orbit of the rotor and the electrical parameters of the motor are obtained. The success in the experiments shows that the design and fabrication of the compliant gas foil bearings and motor can provide a useful guide to the development of an advanced high speed rotating machinery.
METODE SIMULASI DALAM OPTIMALISASI KINERJA TERMAL RUMAH VERNAKULAR DI DAERAH DATARAN RENDAH
Authors: Sibyan Hidayatus , Asnawi Muhamat Fuat 
Published: December 2018

Energi menjadi permasalahan krusial yang selalu dicari solusi penyelesaiannya dalam semua bidang. Bidang Teknik Informatika atau komputer sangat berkaitan erat dengan bidang lain seperti adanya software komputer untuk mensimulasikan kinerja bangunan dalam melakukan penghematan energi.
Metode simulasi dengan penggunaan software komputer untuk bangunan banyak berkembang. Salah satu metode yang senantiasa berkembang adalah Program Revit. Penelitian ini akan melihat optimalisasi kinerja termal bangunan dengan menggunakan Software Revit.
Target khusus penelitian ini adalah membandingkan kinerja termal rumah tinggal lokal tersebut dengan metode simulasi khususnya dalam penghematan energi. Penelitian akan mengambil fokus rumah lokal di daerah dataran rendah (pantai). Penelitian akan menggunakan variabel iklim yaitu suhu udara, kelembaban udara, kecepatan angin dan suhu radiasi matahari rata-rata. Sebelum masuk ke metode simulasi, dilakukan survey lapangan untuk mengetahui data-data variabel iklim yang riil.
Data rumah tinggal dan hasil pengukuran akan dimasukkan ke dalam software simulasi. Hasil simulasi analisa energi Rumah tinggal dengan penggunaan total energi tahunan terkecil (total EUI) adalah rumah Bapak Pujiono rumah tinggal berdinding kayu dengan total EUI sebesar 727 MJ/sm/yr. Penggunaan energi listrik tahunan (Electricity EUI) 168 kWh/sm/yr dengan biaya sekitar $10.08 (Rp134.033.65). Penggunaan energi bahan bakar tahunan (Fuel EUI) 123 MJ/sm/yr dengan biaya sekitar $13.53 (Rp179.908.27)
The Prehospital Community-Volunteer Model Has a Place in Rural Australia
Authors: O'Meara Peter 
Published: December 2018

Objectives Australian ambulance services rely on the community-volunteer model of prehospital care in many rural areas. The aim of this study was to conceptually describe the model as it operates in rural settings. Methods Soft Systems Methodology (SSM) was used to describe and critically appraise an abstract prehospital community-volunteer model within the context of rural Australia. The philosophical starting point was that local prehospital services should be self-reliant and autonomous. SSM was used to structure the elements of prehospital systems and the relationships between them into metaphors and pictures for analysis. Results The major characteristic of the prehospital community-volunteer model is the relatively uncomplicated processes used to deliver services. Key elements are a knowledgeable and empowered community, a dispatch system with local knowledge, adequate physical resources to meet community expectations, a volunteer-based staffing system, and direct communication with local health professionals. Culturally, the community-volunteer model has a very strong rural character, with opportunity for health professional, emergency worker and local community member involvement. This may be as a volunteer ambulance officer or as a participant in the local governance of the service. Conclusion The prehospital community-volunteer model is a strong and resilient model in communities where the relationship between the ambulance service and the community is based on a socially constructed framework. Advanced technology, rules, systems, procedures and policies are unable to sustain a community-volunteer ambulance service. In contrast to other models, it is held together through stories of the past, rituals and myths. Prehospital community-volunteer models will continue to be important providers of prehospital services in rural Australia. Successful community-volunteer ambulance services need to be integrated into a local urgent care system.
Paramedic Knowledge of Infectious Disease Aetiology and Transmission in An Australian Emergency Medical System
Authors: Shaban Ramon Z. , Creedy Debra K. , Clark Michele J. 
Published: December 2018

Introduction Paramedics and other emergency health workers are exposed to infectious disease particularly when undertaking exposure-prone procedures as a component of their everyday practice. This study examined paramedic knowledge of infectious disease aetiology and transmission in the pre-hospital care environment. Methods A mail survey of paramedics from an Australian ambulance service (n=2274) was conducted. Results With a response rate of 55.3% (1258/2274), the study demonstrated that paramedic knowledge of infectious disease aetiology and modes of transmission was poor. Of the 25 infectious diseases included in the survey, only three aetiological agents were correctly identified by at least 80% of respondents. The most accurate responses for aetiology of individual infectious diseases were for HIV/AIDS (91.4%), influenza (87.4%), and hepatitis B (85.7%). Poorest results were observed for pertussis, infectious mononucleosis, leprosy, dengue fever, Japanese B encephalitis and vancomycin resistant enterococcus (VRE), all with less than half the sample providing a correct response. Modes of transmission of significant infectious diseases were also assessed. Most accurate responses were found for HIV/AIDS (85.8%), salmonella (81.9%) and influenza (80.1%). Poorest results were observed for infectious mononucleosis, diphtheria, shigella, Japanese B encephalitis, vancomycin resistant enterococcus, meningococcal meningitis, rubella and infectious mononucleosis, with less than a third of the sample providing a correct response. Conclusion Results suggest that knowledge of aetiology and transmission of infectious disease is generally poor amongst paramedics. A comprehensive in-service education infection control programs for paramedics with emphasis on infectious disease aetiology and transmission is recommended.
Use of Simulators in Teaching and Learning: Paramedics’ Evaluation of a Patient Simulator?
Authors: Wyatt Andrea , Archer Frank , Fallows Brian 
Published: December 2018

Objectives This study was undertaken as a precursor to a larger study investigating the benefits of simulation in reducing management and technique errors in the prehospital management of trauma patients. However, prior to this it was considered necessary to conduct a preliminary study to address the following: Undertake a structured evaluation of the Laerdal™ SimMan™ Patient Simulator. Determine the “functional fidelity” of the Laerdal™ SimMan™ Patient Simulator that was used in this project from the Paramedic perspective. Methods Participants taking part in the study were invited to complete an evaluation form that examined the various components of the simulator. A second evaluation form examined both the features of the simulator and their applicability to Paramedic practice. The simulator capabilities were assessed through an evaluation of the simulator features, and, with a qualitative element included, provided a descriptive analysis of simulator functional fidelity. Results Analysis identified 36 of 54 features (66%) of the simulator were rated by the respondents as at least ‘average physiological accuracy’. An analysis of applicability to practice identified 41 of 54 features (75%) were rated at least beneficial to practice by greater than 80% of respondents. In combining these results, only 5 features considered applicable to Paramedic practice demonstrated a below average level of physiological accuracy. These findings indicate that, as a general concept, the use of this particular simulator as an educational experience was held in high regard within this cohort of participants. Conclusion Previous studies in related health disciplines have identified an acceptance of a patient simulator as a learning tool by students. This study supports these findings, with Paramedic students evaluating the Laerdal™ SimMan™ Patient Simulator as having high functional fidelity, using the criteria outlined for this study. The findings from this study afford the opportunity for ongoing educational initiatives and research in the training of Paramedics utilising the Patient Simulator.
Surveys of Cultural Competency in Health Professional Education: A Literature Review
Authors: Spencer Caroline , Macdonald Rhona , Archer Frank 
Published: December 2018

A literature review, in advance of designing a survey of cultural competency in Australian and New Zealand paramedic education courses, provides the focus of this paper. The review sought to explore the extent to which other health professions include cultural competency in their undergraduate curriculum. The literature review identified specific research papers that used survey methods to determine the status of cultural competency training in other health professions. With no paramedic specific information available to inform paramedic education, these research papers formed a basis for designing a survey that would examine the extent to which paramedic education includes cultural competency in its curricula. This paper is timely for informing paramedic education about surveys on cultural competency in health professional education. It is particularly timely for the paramedic profession, which is currently in transition from a vocationally based occupation to a professionally based discipline within a university setting; and, at a time when a small number of student paramedics are opting to take advantage of an Honours degree. Similarly, experienced paramedics are undertaking Masters and Doctoral research programs in prehospital and paramedic related issues. Such opportunities enable paramedics to extend their career prospects into academic research, an opportunity that was previously untenable. The process of reviewing the literature to develop a paramedic specific survey provides useful information for paramedics who may want to undertake similar research projects to examine other aspects of the curriculum. This paper, therefore, contributes to both developing an appreciation of the complex issues which arise from this process, and establishes an evidence base foundation for the paramedic discipline as it emerges within an academic and research orientated environment. The lessons learned in reviewing surveys might be useful for other health professions and emergency service researchers.
Patient Decision Making in Prehospital Health Emergencies: Determinants and Predictors of Patient Delay
Authors: Morgans Amee , Archer Frank , Allen Felicity 
Published: December 2018

Background Previous research has identified that cardiac patients tend to delay seeking help for chest pain. This study examined whether help-seeking delay occurred in all health emergencies, and explored what people are doing while they delay. This study also explored patient decision making processes and behaviours that determine how long it takes patients to seek emergency help. Methods This study used a self administered survey, including the Coping Responses Inventory. Participants were a random sample of emergency department attendees, stratified for urgency (high vs medium–low) and mode of transport to the hospital emergency department (ambulance vs other). Additional in-depth patient interviews were also conducted. Results Survey responses showed the median delay from symptom onset to arrival at health care was 4.6 hours. Discriminant Function Analysis identified that gender, pain and coping style predicted delay. Conclusion This study identified that delay is not unique to cardiac emergencies. A process of decision making was undertaken which was common to many health emergencies involving a conscious patient, the outcome of which determined how long each patient took to seek help. Psychosocial, normative and affective factors such as coping style drove patient decisions during a health emergency. The knowledge that patients make decisions in a health emergency based on what they feel, not on what they know is a breakthrough in the understanding of patient motivations to seek medical help in health emergencies, and may explain why traditional patient education using an informative approach has had only limited success.
Procedural Sedation and Analgesia Facilitator – Expanded Scope Role for Paramedics in the Emergency Department
Authors: Campbell SG , Petrie DA , MacKinley RP , Froese P , Etsell G , Warren DA , Kovacs GJ , Urquhart DG , Magee KD 
Published: December 2018

Introduction Procedural sedation and analgesia (PSA) is accepted as a standard of care in emergency departments (ED). PSA requires careful monitoring of a patient‟s cardio-respiratory status, and an ability to act immediately and appropriately in the event of any untoward event. The knowledge and skills necessary for this are a natural extension of the expertise of Advanced Care Paramedics (ACP). We report a series of PSA‟s conducted by ACPs over a 19 month period at a busy teaching hospital. Methods This is a retrospective descriptive study presenting data from a registry recording details of all cases of ACP-facilitated PSA conducted in our ED between August 1, 2004 and February 28, 2006. Baseline characteristics, indication for the procedure, medications used and adverse events are reported. Results 1334 ACP-facilitated PSAs were conducted during the period. According to definitions used by this study, „desaturation‟- a SaO2 of < 90% at any time during the procedure in patients with an initial SaO2 of > 95% occurred in only 11 (0.9%) patients, and „hypotension‟ – systolic blood pressure (SBP) < 85 mm Hg in patients with an initial SBP > 100 mm Hg occurred in 0.6% of patients. One significant adverse event was recorded, that of pulmonary aspiration. Medications used for PSA included fentanyl (94.1%of cases), propofol (65.5%), midazolam (36.7%) and ketamine (2.2%). Conclusion PSA conducted in the ED by specifically trained ACPs is not associated with a significant number of adverse effects. This role should be recognized and subjected to further study.
Exploration of Attitudes and Barriers to Bringing Patient's Own Medications to the Emergency Department: A Survey of Paramedics
Authors: Chan Esther , Taylor Simone , Marriott Jennifer , Barger Bill 
Published: December 2018

Background Previous research has demonstrated that when ambulance paramedics facilitate patient‟s own medications (POM) being brought in to the Emergency Department (ED), the number of prescribing errors on the hospital admission medication chart was significantly decreased, thereby increasing admission prescribing accuracy. Aim We aimed to examine paramedics‟ attitudes to bringing POM to the ED and explore the associated barriers. Methods This was a cross-sectional survey of a convenience sample of ambulance paramedics bringing patients to the ED of a tertiary-referral metropolitan teaching hospital. The questionnaire consisted of 5 questions and took approximately 2 minutes to complete. Results The response rate for the survey was 81.9% (50/61). The study demonstrated a general agreement that bringing POM to the ED was important. Most highly rated barriers noted by respondents to bringing POM included time limitations (60%), location of patient pick up (44%), fear of losing patient‟s medications (24%) and patient‟s refusal (18%). Conclusion Overall, paramedics perceived bringing POM to ED as being important. There are identifiable barriers to paramedics bringing POM to the Emergency Department on admission. Resolution of such barriers may increase the frequency with which POM is brought to hospital, leading to a positive impact on prescribing accuracy.
Out-of-Hospital Administration of Corticosteroids to Patients with Acute Asthma: A Case Study and Literature Review
Authors: Long David , Bendal Jason , Bower Andrew 
Published: December 2018

Objectives Asthma is an important health problem in Australia with more than 2.2. million Australians currently diagnosed with Asthma. Asthma is associated with significant mortality and frequent use of emergency medical services. The objectives of this paper were to: a) present a case study of a near-fatal episode of severe acute asthma in which the patient was administered corticosteroids by an Ambulance Service of New South Wales Extended Care Paramedic; b) review the epidemiology and pathophysiology of acute asthma as well as current pharmacotherapy in asthma management; and c) conduct a literature search and critical appraisal of existing evidence supporting the out-of-hospital administration of corticosteroids for acute asthma by paramedics. Methods The purpose of the literature search was to identify comparative studies of adult patients with “acute” asthma treated by paramedics with corticosteroids prior to arrival at the emergency department (ED) to evaluate whether this intervention is associated with improved outcomes. A literature search of databases included the Cochrane Database of Systematic Reviews (Cochrane Reviews Issue 4 2008), Cochrane Central Register of Controlled Trials (Clinical Trials), Medline (1950- November 2008), EMBASE and CINAHL. A pre-hospital filter was applied to increase the sensitivity of the searches as appropriate. MeSH headings included exp/asthma, exp/hydrocortisone, exp/prednisone, exp/prednisolone and exp/glucocorticoids. Searched text words included asthma, hydrocortisone, prednisone and prednisolone. Titles and abstracts of interest were inspected to identify relevant articles with the full text of selected articles retrieved. Identified papers were independently appraised by two reviewers. Results Only two original studies were identified. The first was a retrospective comparative study of adult patients with moderate to severe asthma who received 125 mg methylprednisolone prior to transport to hospital or after arrival in the ED. The second study was a retrospective chart review to determine whether the out-of-hospital administration of systemic steroids to asthmatic patients had any effect on hospital admission rates. Conclusion Corticosteroids have been widely used in the hospital setting for many years in the treatment of acute asthma and there is good evidence to support their early administration in an ED setting. Out-of-hospital studies provide only weak evidence of benefit. There is insufficient evidence of adequate quality to determine if corticosteroids should be routinely used by paramedics. A prospective randomised controlled trial is needed to determine the true value of early corticosteroid administration in the ambulance setting.
A Cellulitis Guideline at a Community Hospital – We Can Reduce Costs by Standardizing Care
Authors: Campbell Samuel G. , Burton-MacLeod Rebecca , Howlett Todd 
Published: December 2018

Objectives To assess whether there is: a) a clinical difference between patients with cellulitis treated according to the recommendations of a clinical cellulitis guideline, and those treated otherwise and b) a difference in the cost of antibiotic treatment of the two groups Methods Emergency Department (ED) patients diagnosed with cellulitis at a community hospital were graded using a 4-point scale, and physicians were encouraged to treat based on an established practice guideline. Patients were contacted 5 days after their ED visit, and again at 10 days if they had not improved by 5 days. Physician ‘compliance’ was defined as having followed three or more of the five elements of the guideline. Results Of the 272 patients, 147 (54.1%) were classified as Grade I, 53 (19.5%) Grade II, 33(12.1%) Grade III, and 6 (2.2%) Grade IV. In 12.1% the grade was not assigned. 43.5% were treated in compliance with the guidelines, of which 83.3% reported improvement at 5 days, compared to 87.7% of those treated otherwise. At 10 days, 98.8% of the patients treated in compliance with the protocol had improved compared to 94.7% of those treated otherwise. Average antibiotic cost/patient was: Grade 1: $8.48, Grade II: $16.65, Grade II: $96.53 in the ‘compliance’ group, and $35.68, $51.28, and $150.18 respectively in the ‘non-compliance’ group. Conclusion Patients treated in accordance with the cellulitis guideline had similar outcomes to those treated otherwise, at significantly lower cost. Efforts to encourage compliance with the guideline are indicated.