scholarly journals Advanced care or advanced life support – what are we providing?

2021 ◽  
Vol 18 ◽  
Author(s):  
Timothy Makrides ◽  
Leon Baranowski ◽  
Lucas` Hawkes-Frost ◽  
Jennie Helmer
Keyword(s):  
Crucial Role ◽  
Life Support ◽  
Empirical Studies ◽  
Advanced Life Support ◽  
Advanced Practice ◽  
New Paradigm ◽  
The Past ◽  
Anglo American ◽  
Different Levels ◽  
The Way

The field of paramedicine has undergone significant change and modernisation over the past 50 years. Presently there are no consistent terms or lexicon used across the profession to describe different levels of advanced practice. This inconsistency risks creating confusion as the professionalisation of paramedic practice continues. As well, many empirical studies support the claim that communication and the importance of managing language actively plays a crucial role in supporting change and in shaping the new paradigm. Therefore, the way one uses communication, and the deliberate choice of words to describe advance practice, will support change in the desired direction. This article explores these terms and their attendant influences on perceptions of practice to argue for change towards the standardised use of the term ‘advanced care paramedic’ across the Anglo-American paramedic system.  

scholarly journals Cognitive linguistics and metaphor research: past successes, skeptical questions, future challenges

2006 ◽  
Vol 22 (spe) ◽  
pp. 1-20 ◽  
Author(s):  
Raymond W. Gibbs, Jr
Keyword(s):  
Cognitive Linguistics ◽  
Empirical Studies ◽  
The Past ◽  
Linguistic Research ◽  
Fundamental Part ◽  
Cognitive Linguistic ◽  
Future Challenges ◽  
Future Work ◽  
The Way

An important reason for the tremendous interest in metaphor over the past 20 years stems from cognitive linguistic research. Cognitive linguists embrace the idea that metaphor is not merely a part of language, but reflects a fundamental part of the way people think, reason, and imagine. A large number of empirical studies in cognitive linguistics have, in different ways, supported this claim. My aim in this paper is to describe the empirical foundations for cognitive linguistic work on metaphor, acknowledge various skeptical reactions to this work, and respond to some of these questions/criticisms. I also outline several challenges that cognitive linguists should try to address in future work on metaphor in language, thought, and culture.

BUILDING THE PAST: MONUMENTS AND MEMORY IN THE FORUM ROMANUM

2006 ◽  
Vol 3 (1) ◽  
pp. 157-192 ◽  
Author(s):  
Carlos Machado
Keyword(s):  
Crucial Role ◽  
Political Consciousness ◽  
Social Transformations ◽  
The Past ◽  
Imperial Court ◽  
The City ◽  
The Way ◽  
Late Roman

Memory played a crucial role in the shaping of Late Roman political consciousness and identity. This is clear in the case of the city of Rome, where political, religious, and social transformations affected the way that the city’s inhabitants defined their relationship between themselves and with the imperial court. The area of the forum Romanum was intimately related to Rome’s history, and was therefore particularly appropriate for the construction of different ‘Roman memories’. The aim of this article is to discuss how the monuments built or restored in this area helped to define these memories and turn the past into a political argument.

scholarly journals PREPAREDNESS OF CANADIAN PHYSICIAN OFFICES FOR PAEDIATRIC EMERGENCIES

2018 ◽  
Vol 23 (suppl_1) ◽  
pp. e5-e5
Author(s):  
Anushka Weeraratne ◽  
Dayae Jeong ◽  
Suhrata Verma ◽  
Marina Atalla ◽  
Mohammed Hassan-Ali ◽  
...  
Keyword(s):  
Emergency Preparedness ◽  
Life Support ◽  
Advanced Life Support ◽  
Family Physicians ◽  
Care Staff ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
The Past ◽  
Paediatric Emergency ◽  
The Impact

Abstract BACKGROUND Studies in the US have demonstrated that many primary care staff and offices are inadequately prepared for paediatric emergencies. Although the Canadian Paediatric Society (CPS) recently reaffirmed their “Guidelines for Paediatric Emergency Equipment and Supplies for a Physician’s Office”, no evaluation has been made regarding the impact of publishing these recommendations, or on the state of preparedness for paediatric emergencies in family physician offices. OBJECTIVES The aim of this study was to evaluate awareness of and adherence of family physicians in Ontario to the CPS guidelines on preparedness for paediatric emergencies. DESIGN/METHODS We conducted a province-wide, cross-sectional survey of 749 randomly selected family physicians. Participants were asked to complete a 14-question survey regarding clinic characteristics, incidence of paediatric emergencies, and preparedness of the clinic in the case of a paediatric emergency. Ethics approval was obtained from the regional Ethics Review Board. RESULTS 94 physicians responded to our survey (response rate of 13.1%). 68.1% of respondents reported seeing more than 10 children per week, and 59.6% and had experienced at least one paediatric emergency in the past year. The proportion of physicians reporting paediatric emergencies within the last year increased with the number of children seen - 37.9% of physicians who saw fewer than 10 children per week reported an emergency, compared to 100.0% of those who saw more than 40 children per week. Only 4.3% respondents reported that they were unaware of the CPS guidelines on paediatric emergency preparedness. Although 85.1% of respondents were aware of the guidelines, only 10.6% of respondents had read them. Of the physicians who were aware of but had not read the guidelines, 2.5% engaged in mock code sessions, 27.8% were up-to-date on Paediatric Advanced Life Support (PALS), 1.3% had written protocols outlining safe transport of children to hospitals, and 41.8% stocked half or more of the recommended supplies. In comparison, of the physicians who had read the guidelines, 20.0% engaged in mock code sessions, 50.0% were up-to-date on PALS, 10.0% had written protocols, and 70.0% stocked half or more of the recommended supplies. CONCLUSION A large proportion of respondents had experienced at least one paediatric emergency in the past year, but were overall underprepared. There was a discrepancy between physicians who were aware of the CPS guidelines on emergency preparedness (85.1%), and those who have actually read them (10.6%), though offices with the latter were more adherent to the guidelines’ recommendations. It will be important for CPS to consider how to further advocate for paediatric emergency preparedness in clinics that see children regularly.

Review and Recommended Best Practices for Measuring and Modeling Organizational Citizenship Behavior

2016 ◽  
Author(s):  
Christopher C. Rosen ◽  
Eric J. Yochum ◽  
Liana G. Passantino ◽  
Russell E. Johnson ◽  
Chu-Hsiang Chang
Keyword(s):  
Best Practices ◽  
Organizational Citizenship ◽  
Organizational Citizenship Behavior ◽  
Empirical Studies ◽  
Citizenship Behavior ◽  
Citizenship Behaviors ◽  
Measurement Issues ◽  
Source Effects ◽  
The Past ◽  
Different Levels

Organizational citizenship behaviors (OCBs) have been assessed in a variety of ways. We conducted a thorough review of this literature, and we provide a comprehensive discussion of how OCBs have been measured and modeled, with a focus on identifying trends and providing guidelines for future researchers. Our review, which included all empirical studies published in eight top-tier management journals over the past 30 years, is organized around four themes: (1) operational inconsistencies, which include utilizing different levels of specificity, sets of dimensions and facets, and response scales when assessing OCBs across studies; (2) rating source effects, in terms of the appropriateness of self versus nonself (i.e., supervisors and coworkers) sources of OCB ratings; (3) differences in how the higher order multidimensional OCB construct has been modeled across studies; and (4) emerging methodological and measurement issues, including nonindependence, multilevel treatments of OCB, and the utilization of control variables in OCB research.

The Effect of Ambulance Staffing Models in a Metropolitan, Fire-Based EMS System

2017 ◽  
Vol 32 (2) ◽  
pp. 175-179 ◽  
Author(s):  
Eric J. Cortez ◽  
Ashish R. Panchal ◽  
James E. Davis ◽  
David P. Keseg
Keyword(s):  
Success Rate ◽  
Life Support ◽  
Advanced Life Support ◽  
Emergency Medical Technician ◽  
Publication Type ◽  
Protocol Violation ◽  
Difficult Decision ◽  
Emergency Medical ◽  
Different Levels ◽  
Medical Technician

AbstractIntroductionThe staffing of ambulances with different levels of Emergency Medical Service (EMS) providers is a difficult decision with evidence being mixed on the benefit of each model.Hypothesis/ProblemThe objective of this study was to describe a pilot program evaluating alternative staffing on two ambulances utilizing the paramedic-basic (PB) model (staffed with one paramedic and one emergency medical technician[EMT]).MethodsThis was a retrospective study conducted from September 17, 2013 through December 31, 2013. The PB ambulances were compared to geographically matched ambulances staffed with paramedic-paramedic (PP ambulances). One PP and one PB ambulance were based at Station A; one PP and one PB ambulance were based at Station B. The primary outcome was total on-scene time. Secondary outcomes included time-to-electrocardiogram (EKG), time-to-intravenous (IV) line insertion, IV-line success rate, and percentage of protocol violations. Inclusion criteria were all patients requesting prehospital services that were attended to by these teams. Patients were excluded if they were not attended to by the study ambulance vehicles. Descriptive statistics were reported as medians and interquartile ranges (IQR). Proportions were reported with 95% confidence intervals (CI). The Mann-Whitley U test was used for significance testing (P<.05).ResultsMedian on-scene times at Station A for the PP ambulance were shorter than the PB ambulance team (PP: 10.1 minutes, IQR 6.0-15; PB: 13.0 minutes, IQR 8.1-18; P=.01). This finding also was noted at Station B (PP: 13.5 minutes, IQR 8.5-19; PB: 14.3 minutes, IQR 9.9-20; P=.01). There were no differences between PP and PB ambulance teams at Station A or Station B in time-to-EKG, time-to-IV insertion, IV success rate, and protocol violation rates.ConclusionIn the setting of a well-developed EMS system utilizing an all-Advanced Life Support (ALS) response, this study suggests that PB ambulance teams may function well when compared to PP ambulances. Though longer scene times were observed, differences in time to ALS interventions and protocol violation rates were not different. Hybrid ambulance teams may be an effective staffing alternative, but decisions to use this model must address clinical and operational concerns.CortezEJ, PanchalAR, DavisJE, KesegDP. The effect of ambulance staffing models in a metropolitan, fire-based EMS system. Prehosp Disaster Med. 2017;32(2):175–179.

scholarly journals The Place of e-learning in ALS Teaching

2021 ◽  
Vol 66 (3) ◽  
pp. 617-624
Author(s):  
Małgorzata Grześkowiak ◽  
Piotr Rzeźniczek ◽  
Adam Pytliński ◽  
Jacek Stańdo ◽  
Magdalena Roszak
Keyword(s):  
Life Support ◽  
Advanced Life Support ◽  
Medical Procedures ◽  
Learning Methods ◽  
Electronic Learning ◽  
The Past ◽  
E Learning ◽  
Second Year ◽  
The Moment ◽  
Site Classes

Abstract This paper presents the place of e-learning methods in the teaching of Advanced Life Support (ALS) to second year medical students. The described course lasts 30 hours and consists of lectures, seminars, and classes. Numerous modifications of the course were introduced in the past and at the moment electronic learning methods are being improved with new ones being added as well. The following have been implemented: 1. e-learning presentations instead of lectures; 2. recording own instructional movie demonstrating advanced cardiopulmonary resuscitation; 3. a change in the method of conducting practical classes consisting in recording the medical procedures performed by students with a camera. Although e-learning plays an important role in ALS teaching, it cannot completely replace on-site classes. Thus, ALS without any practice to acquire resuscitation skills is impossible.

scholarly journals P153: Preparedness of Canadian physician offices for paediatric emergencies

CJEM ◽  
2018 ◽  
Vol 20 (S1) ◽  
pp. S111-S112
Author(s):  
S. S. Verma ◽  
A. Weeraratne ◽  
D. Jeong ◽  
M. Atalla ◽  
M. Hassan-Ali ◽  
...  
Keyword(s):  
Emergency Preparedness ◽  
Life Support ◽  
Advanced Life Support ◽  
Family Physicians ◽  
Care Staff ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
The Past ◽  
Paediatric Emergency ◽  
The Impact

Introduction: Background: Studies in the US have demonstrated that many primary care staff and offices are inadequately prepared for paediatric emergencies. Although the Canadian Paediatric Society (CPS) recently reaffirmed their Guidelines for Paediatric Emergency Equipment and Supplies for a Physicians Office, no evaluation has been made regarding the impact of publishing these recommendations, or on the state of preparedness for paediatric emergencies in family physician offices. Objectives: The aim of this study was to evaluate awareness and adherence of family physicians in Ontario to the CPS guidelines on preparedness for paediatric emergencies. Methods: We conducted a province-wide, cross-sectional survey of 749 randomly selected family physicians. Participants were asked to complete a 14-question survey regarding clinic characteristics, incidence of paediatric emergencies, and preparedness of the clinic in the case of a paediatric emergency. Ethics approval was obtained from the regional Ethics Review Board. Results: 104 physicians responded to our Ontario survey (response rate of 14.8%). 71.2% of respondents reported seeing more than 10 children per week, and 58.7% and had experienced at least one paediatric emergency in the past year. The proportion of physicians reporting paediatric emergencies within the last year increased with the number of children seen - 37.9% of physicians who saw fewer than 10 children per week reported an emergency, compared to 85.7% of those who saw more than 40 children per week. 85.6% of respondents reported that they were unaware of the CPS guidelines on paediatric emergency preparedness. Only 9.6% of respondents were aware of the guidelines, and even fewer, 3.8% had read them. Of the physicians who were unaware of the guidelines, 4.5% [CI=0.2, -0.09] engaged in mock code sessions, 29.2% [CI=0.2, 0.2] were up-to-date on Paediatric Advanced Life Support (PALS), 1.1% [CI=0.03, -0.01] had written protocols outlining safe transport of children to hospitals, and 50.6% [CI=0.4, 0.6] stocked half or more of the recommended supplies. In comparison, of the physicians who were aware of the guidelines, 14.3% [CI=0.3, -0.04] engaged in mock code sessions, 35.7% [CI=0.1, 0.6] were up-to-date on PALS, 7.1% [CI=0.2, -0.06] had written protocols, and 78.6% [CI=0.8, 0.8] stocked half or more of the recommended supplies. Conclusion: A large proportion of respondents had experienced at least one paediatric emergency in the past year, but were overall underprepared. The majority of respondents, 85.6%, were not aware of the guidelines, compared to 9.6% who were aware of them. However, offices with the latter were more adherent to the guidelines recommendations. It will be important for CPS to consider how to further advocate for paediatric emergency preparedness in clinics that see children regularly.

scholarly journals (A310) Academic Training for Paramedics - A Unique University Based Model

2011 ◽  
Vol 26 (S1) ◽  
pp. s87-s87
Author(s):  
D. Schwartz ◽  
L. Aronson ◽  
B. Adini ◽  
L. Nesher
Keyword(s):  
Life Support ◽  
Task Complexity ◽  
Advanced Life Support ◽  
First Year ◽  
First Semester ◽  
Anglo American ◽  
National Emergency ◽  
University Degree ◽  
Certificate Training ◽  
Hospital Wards

IntroductionThe paramedic profession is relatively new, dating to the 1970's. In Israel, it was introduced in 1980 and paralleled the introduction of advanced life support units (ALS) to Israel's national emergency medical services (EMS), Magen David Adom (MDA).The curriculum and assigned roles were adopted with minor changes from Anglo-American systems. Initially, paramedics were assigned alongside physicians, but in recent years a growing percentage of units operate without an on-board physician. Despite the increasing complexity of required tasks and the move toward paramedic-led crews, paramedic training has changed little. Most are trained through a non-academic, certificate granting tracts. In 1998, a fully academic bachelor's degree program was launched at the Ben-Gurion University (BGU).MethodsThe programs aims, curriculum, and experience are described, based on past and current curriculum and on interviews with past and current staff and students.ResultsThe BGU program is a three year program that grants its graduates both a University BA and professional paramedic certification. The program is housed as a university department within the Faculty of Health Sciences. First year courses center on basic sciences. The second year centers on classroom and simulation-based learning of the clinical topics. The third is devoted mostly to clinical clerkships, in hospital wards in the first semester and on MDA ALS units in the second. To date, the program boasts more than 300 graduates, many attaining higher academic degrees in healthcare sciences and many who work in Israel's national EMS.DiscussionThe BGU academic paramedic training program is the only such program in Israel and one of a few worldwide. Questions regarding the increasing responsibility and task complexity require a move from certificate training to University degree granting learning and the possible contribution of such

Migration as a Theologizing Experience

2014 ◽  
Vol 31 (1) ◽  
pp. 9-21 ◽  
Author(s):  
John Corrie
Keyword(s):  
Religious Identity ◽  
New Paradigm ◽  
The West ◽  
The Past ◽  
Secular Culture ◽  
Starting Point ◽  
Migrant People ◽  
The Way ◽  
At Home

Abstract The suggestion by Hanciles that migration is a “theologizing experience” is the starting point for exploring the way in which mission in a western context, in partnership with non-western migrants, can be a mutually transforming experience. Hanciles suggests that non-western migrant people bring a new paradigm of mission which is radically different from the way Western mission has been done in the past because it offers itself in weakness, risk, diversity, and dependency. However, theologically and experientially, migration brings with it many ambiguities and creative tensions, which means that Hanciles’ analysis may need to be more nuanced. In particular the notion that migrants are involved in a “reverse mission” to the West “from below” which characterizes the new paradigm has a number of problems in reality. This is explored particularly in a British context, in which we find that the contribution of migrants to mission, though sometimes encouraging, is varied, and that issues which have mired western mission in the past are re-appearing “in reverse”. It is therefore suggested that a mutual inter culturality between migrants and indigenous Western churches from the very beginning of the encounter may provide the promise of a more transformative mission experience. They have more in common than they realize: the irony is that the western church finds itself also in a situation of “exile”, though in a very different sense. Marginalized, alien to the secular culture, in decline, with their religious identity no longer “at home”, the Western Christian experience of exile resonates with the migrant experience of exile, which is ground for a genuine partnership in mission. It is concluded that mission as a theologizing experience can work for transformative mission where there is genuine interculturality, and that this could mitigate the problems of thinking of migrant mission purely in terms of “reverse mission”.

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