bluuebunny/crossref_metadata_2025_split huggingface dataset:
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.
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.
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.