Social support, self-efficacy, trauma and well-being in emergency medical dispatchers

Emergency Medical Dispatchers (EMDs) respond to crisis calls for ambulance; they dispatch paramedics and provide emotional and medical assistance to callers. Despite the stressful nature and exposure to potentially traumatising events in this role, there has been no published research specifically investigating well-being or posttraumatic growth among EMDs. Extrapolating from research conducted among other emergency services workers (e. g., paramedics, police), literature attests to the importance of self efficacy and social support in promoting mental health in emergency service workers. Therefore, this study assessed the impact of self efficacy, and giving and receiving social support on psychological well-being, posttraumatic growth (PTG), and symptoms of posttraumatic stress disorder (PTSD). Sixty EMDs (50% response rate) completed an online questionnaire. Three hierarchical multiple regression analyses were conducted to ascertain predictors of well-being, PTG and PTSD. Receiving social support emerged as a significant positive predictor of well-being and PTG, and a significant negative predictor of PTSD. Self efficacy was found to significantly and positively predict well-being, and shift-work was found to significantly and negatively predict PTSD. These results highlight that self efficacy and receiving social support are likely to be important for enhancing well-being within this population, and that receiving social support is also likely to facilitate positive post-trauma responses. Such findings have implications for the way emergency service personnel are educated with reference to aspects of mental health and how best to support personnel in order to achieve optimal mental health outcomes for all.

Informatics to support patient choice between diverse medical systems

Culturally, philosophically and religiously diverse medical systems including Western medicine, Traditional Chinese Medicine, Ayurvedic Medicine and Homeopathic Medicine, once situated in places and times relatively unconnected from each other, currently co-exist to a point where patients must choose which system to consult. These decisions require comparative analyses, yet the divergence in key underpinning assumptions is so great that comparisons cannot easily be made. However, diverse medical systems can be meaningfully juxtaposed for the purpose of making practical decisions if relevant information is presented appropriately. Information regarding privacy provisions inherent in the typical practice of each medical system is an important element in this juxtaposition. In this paper the information needs of patients making decisions regarding the selection of a medical system are examined.

Ethical values in emergency medical services: A pilot study

Background Ambulance professionals often address conflicts between ethical values. As individuals’ values represent basic convictions of what is right or good and motivate behaviour, research is needed to understand their value profiles. Objectives To translate and adapt the Managerial Values Profile to Spanish and Swedish, and measure the presence of utilitarianism, moral rights and/or social justice in ambulance professionals’ value profiles in Spain and Sweden. Methods The instrument was translated and culturally adapted. A content validity index was calculated. Pilot tests were carried out with 46 participants. Ethical considerations This study conforms to the ethical principles for research involving human subjects and adheres to national laws and regulations concerning informed consent and confidentiality. Findings Spanish professionals favoured justice and Swedish professionals’ rights in their ambulance organizations. Both countries favoured utilitarianism least. Gender differences across countries showed that males favoured rights. Spanish female professionals favoured justice most strongly of all. Discussion Swedes favour rights while Spaniards favour justice. Both contexts scored low on utilitarianism focusing on total population effect, preferring the opposite, individualized approach of the rights and justice perspectives. Organizational investment in a utilitarian perspective might jeopardize ambulance professionals’ moral right to make individual assessments based on the needs of the patient at hand. Utilitarianism and a caring ethos appear as stark opposites. However, a caring ethos in its turn might well involve unreasonable demands on the individual carer’s professional role. Since both the justice and rights perspectives portrayed in the survey mainly concern relationship to the organization and peers within the organization, this relationship might at worst be given priority over the equal treatment and moral rights of the patient. Conclusion A balanced view on ethical perspectives is needed to make professionals observant and ready to act optimally – especially if these perspectives are used in patient care. Research is needed to clarify how justice and rights are prioritized by ambulance services and whether or not these organization-related values are also implemented in patient care.

Children and consent to medical treatment

This chapter provides a comprehensive and up-to-date treatment of legislative provisions and common law principles regarding children and the law of consent to medical treatment. When can children provide their own consent? Can parents consent on behalf of their children, and if so, under what circumstances and why? Is court authority ever required, and if so, when, and why? What new contexts are providing fresh challenges to legal principles, parents, medical practitioners, and most importantly, children?

Acute injuries in track and field athletes: A 3-year observational study at the Penn Relays Carnival with epidemiology and medical coverage implications

Background Few studies have examined acute injuries in track and field in both elite and sub-elite athletes. Purpose To observe the absolute and relative rates of injury in track and field athletes across a wide range of competition levels and ages during three years of the Penn Relays Carnival to assist with future medical coverage planning and injury prevention strategies. Study design: Descriptive epidemiology study. Methods Over a 3-year period all injuries treated by the medical staff were recorded on a standardised injury report form. Absolute injury rates (absolute number of injuries) and relative injury rates (number of injuries per 1000 participants) were determined and odds ratios (OR) of injury rates were calculated between sexes, competition levels and events. Injuries were also broken down into major or minor medical or orthopedic injuries. Results Throughout the study period 48,473 competing athletes participated in the Penn Relays Carnival, and 436 injuries were sustained. For medical coverage purposes, the relative rate of injury subtypes was greatest for minor orthopedic injuries (5.71 injuries per 1000 participants), followed by minor medical injuries (3.42 injuries per 1000 participants), major medical injuries (0.69 injuries per 1000 participants) and major orthopedic injuries (0.18 injuries per 1000 participants). College/elite level athletes displayed the lowest relative injury rate (7.99 injuries per 1000 participants), which was significantly less than high school (9.87 injuries per 1000 participants) and masters level athletes (16.33 injuries per 1000 participants). Males displayed a greater likelihood of suffering a minor orthopedic injury compared to females (OR = 1.36, 95% CI = 1.06 to 1.75; χ2 = 5.73, p = 0.017) but were less likely to sustain a major medical injury (OR = 0.33, 95% CI = 0.15 to 0.75; χ2 = 7.75, p = 0.005). Of the three most heavily participated in events, the 4 x 400m relay displayed the greatest relative injury rate (13.6 injuries per 1000 participants) compared to the 4 x 100 and 4 x 200m relay. Conclusions Medical coverage teams for future large scale track and field events need to plan for at least two major orthopedic and seven major medical injuries per 1000 participants. Male track and field athletes, particularly masters level male athletes, are at greater risk of injury compared to other genders and competition levels.

Profiling : an application assignment approach for green data centers

In the past few years, there has been a steady increase in the attention, importance and focus of green initiatives related to data centers. While various energy aware measures have been developed for data centers, the requirement of improving the performance efficiency of application assignment at the same time has yet to be fulfilled. For instance, many energy aware measures applied to data centers maintain a trade-off between energy consumption and Quality of Service (QoS). To address this problem, this paper presents a novel concept of profiling to facilitate offline optimization for a deterministic application assignment to virtual machines. Then, a profile-based model is established for obtaining near-optimal allocations of applications to virtual machines with consideration of three major objectives: energy cost, CPU utilization efficiency and application completion time. From this model, a profile-based and scalable matching algorithm is developed to solve the profile-based model. The assignment efficiency of our algorithm is then compared with that of the Hungarian algorithm, which does not scale well though giving the optimal solution.

Impact of simulated hyperopia on academic-related performance in children

Purpose: To investigate the impact of simulated hyperopia and sustained near work on children’s ability to perform a range of academic-related tasks. Methods: Fifteen visually normal children (mean age: 10.9 ± 0.8 years; 10 males and 5 females) were recruited. Performance on a range of standardised academic-related outcome measures was assessed with and without 2.50 D of simulated bilateral hyperopia (administered in a randomised order), before and after 20 minutes of sustained near work, at two separate testing sessions. Academic-related measures included a standardised reading test (the Neale Analysis of Reading Ability), visual information processing tests (Coding and Symbol Search subtests from the Wechsler Intelligence Scale for Children) and a reading-related eye movement test (the Developmental Eye Movement test). Results: Simulated bilateral hyperopia and sustained near work each independently impaired reading, visual information processing and reading-related eye movement performance (p<0.001). A significant interaction was also demonstrated between these factors (p<0.001), with the greatest decrement in performance observed when simulated hyperopia was combined with sustained near work. This combination resulted in performance reductions of between 5% and 24% across the range of academic-related measures. A significant moderate correlation was also found between the change in horizontal near heterophoria and the change in several of the academic-related outcome measures, following the addition of simulated hyperopia. Conclusions: A relatively low level of simulated bilateral hyperopia impaired children’s performance on a range of academic–related outcome measures, with sustained near work further exacerbating this effect. Further investigations are required to determine the impact of correcting low levels of hyperopia on academic performance in children.

Simulated astigmatism impairs academic-related performance in children

Purpose: Astigmatism is an important refractive condition in children. However, the functional impact of uncorrected astigmatism in this population is not well established, particularly with regard to academic performance. This study investigated the impact of simulated bilateral astigmatism on academic-related tasks before and after sustained near work in children. Methods: Twenty visually normal children (mean age: 10.8 ± 0.7 years; 6 males and 14 females) completed a range of standardised academic-related tests with and without 1.50 D of simulated bilateral astigmatism (with both academic-related tests and the visual condition administered in a randomised order). The simulated astigmatism was induced using a positive cylindrical lens while maintaining a plano spherical equivalent. Performance was assessed before and after 20 minutes of sustained near work, during two separate testing sessions. Academic-related measures included a standardised reading test (the Neale Analysis of Reading Ability), visual information processing tests (Coding and Symbol Search subtests from the Wechsler Intelligence Scale for Children) and a reading-related eye movement test (the Developmental Eye Movement test). Each participant was systematically assigned either with-the-rule (WTR, axis 180°) or against-the-rule (ATR, axis 90°) simulated astigmatism to evaluate the influence of axis orientation on any decrements in performance. Results: Reading, visual information processing and reading-related eye movement performance were all significantly impaired by both simulated bilateral astigmatism (p<0.001) and sustained near work (p<0.001), however, there was no significant interaction between these factors (p>0.05). Simulated astigmatism led to a reduction of between 5% and 12% in performance across the academic-related outcome measures, but there was no significant effect of the axis (WTR or ATR) of astigmatism (p>0.05). Conclusion: Simulated bilateral astigmatism impaired children’s performance on a range of academic–related outcome measures irrespective of the orientation of the astigmatism. These findings have implications for the clinical management of non-amblyogenic levels of astigmatism in relation to academic performance in children. Correction of low to moderate levels of astigmatism may improve the functional performance of children in the classroom.

Academic honors and performance

Despite the social importance of awards, they have been largely disregarded by academic research in economics. This paper investigates whether receiving prestigious academic awards—the John Bates Clark Medal and the Fellowship of the Econometric Society—is associated with higher subsequent research productivity and status compared to a synthetic control group of non-recipient scholars with similar previous research performance. Our results suggest statistically significant positive publication and citation differences after award receipt.

Going live : building academic capacity in blended learning using web-conferencing technologies

This paper reports on a current initiative at Queensland University of Technology to provide timely, flexible and sustainable training and support to academic staff in blended learning and associated techno-pedagogies via a web-conferencing classroom and collaboration tool, Elluminate Live!. This technology was first introduced to QUT in 2008 as part of the university‘s ongoing commitment to meeting the learning needs of diverse student cohorts. The centralised Learning Design team, in collaboration with the university‘s department of eLearning Services, was given the task of providing training and support to academic staff in the effective use of the technology for teaching and learning, as part of the team‘s ongoing brief to support and enhance the provision of blended learning throughout the university. The resulting program, ―Learning Design Live‖ (LDL) is informed by Rogers‘ theory of innovation and diffusion (2003) and structured according to Wilson‘s framework for faculty development (2007). This paper discusses the program‘s design and structure, considers the program‘s impact on academic capacity in blended learning within the institution, and reflects on future directions for the program and emerging insights into blended learning and participant engagement for both staff and students.

Designing for collaborative learning spaces : an academic staff development pilot program

To prepare for the delivery of new Bachelor of Science units in collaborative learning spaces, academic and professional staff at Queensland University of Technology piloted an academic development program over the period of a semester. The program was informed by Rogers’ theory of innovation and diffusion (2003) and structured according to Wilson’s framework for faculty development (2007). Through a series of workshops and group mentoring activities, the program modelled inquiry-based learning in a collaborative learning space, and the participants designed and practiced the delivery of teaching activities. This paper provides a preliminary evaluation of the effectiveness of the pilot based on survey responses from participants, notes from the development team who coordinated the program and audience feedback from the final showcase session. The design and structure of the program is discussed as well as possible future directions.