The impact of patient sex on paramedic pain management in the prehospital setting

Objective: The aim of this study was to establish the impact of patient sex on the provision of analgesia by paramedics for patients reporting pain in the prehospital setting.
Methods: This retrospective cohort study of paramedic patient care records included all adult patients with a Glasgow Coma Score higher than 12 transported to hospital by ambulance in a major metropolitan area over a 7-day period in 2005. Data collected included demographics, patient report of pain and its type and severity, provision of analgesia by paramedics, and type of analgesia provided. The outcomes of interest were sex differences in the provision of analgesia. Data analysis was by descriptive statistics, χ2 test, and logistic regression.
Results: Of the 3357 patients transported in the study period, 1766 (53%) reported pain; this forms the study sample. Fifty-two percent were female, median age was 61 years, and median initial pain score (on a 0-10 verbal numeric rating scale) was 6. Forty-five percent of patients reporting pain did not receive analgesia (791/1766) (95% confidence interval [CI], 43%-47%), with no significant difference between sexes (P = .93). There were, however, significant sex differences in the type of analgesia administered, with males more likely to receive morphine (17%; 95% CI, 15%-20%) than females (13%; 95% CI, 11%-15%) (P = .01). The difference remains significant when controlled for type of pain, age, and pain severity (odds ratio, 0.61, 95% CI, 0.44-0.84).
Conclusion: Sex is not associated with the rate of paramedic-initiated analgesia, but is associated with differences in the type of analgesia administered.

Expert in my pocket: creating first person POV videos to enhance mobile learning

Worldwide, there has been a rapid increase in both the use of mobile technologies as a conduit for student learning and the use of wearable cameras to record sporting and recreational activities. The Expert in My Pocket project (EiMP) has combined these two technologies to produce a repository of freely available short videos and supporting materials to enhance student development of psychomotor clinical skills. The videos are presented from a first person point of view (1PPOV) with expert health professionals ‘thinking aloud’ as they demonstrate selected skills. Research indicates that students and educators overwhelmingly support the concept of EiMP videos and more importantly value the 1PPOV as an authentic view. This paper demonstrates the techniques and equipment employed to produce these videos, which consisted of a chest or head mounted GoPro camera operated via an iPad. Additionally, the paper explains another innovative feature, Quick Response (QR) Codes, that when linked to the videos placed on equipment assists with “just in time” mobile learning.

Use of videos to support teaching and learning of clinical skills in nursing education: A review

Information and communications technology is influencing the delivery of education in tertiary institutions. In particular, the increased use of videos for teaching and learning clinical skills in nursing may be a promising direction to pursue, yet we need to better document the current research in this area of inquiry. The aim of this paper was to explore and document the current areas of research into the use of videos to support teaching and learning of clinical skills in nursing education. The four main areas of current and future research are effectiveness, efficiency, usage, and quality of videos as teaching and learning materials. While there is a clear need for additional research in the area, the use of videos seems to be a promising, relevant, and increasingly used instructional strategy that could enhance the quality of clinical skills education.

Taking parliamentary sovereignty seriously within a Bill of Rights framework

The Victorian Government has made a commitment to consult with the community on how best to protect and promote human rights in Victoria. To this end, it has established a Human Rights Consultation Committee to undertake this consultation and to report on the desirability or otherwise of enacting a Bill of Rights. The government has, however, indicated its preference for a statutory Bill of Rights and one that preserves the 'sovereignty of Parliament'. This article takes those two government preferences as its baseline and then explores what might follow if the preservation of parliamentary sovereignty is taken seriously within a Victorian rights framework.

In the wake of hospital inquiries : impact on staff and safety

Mishandled concerns about clinical standards resulted in whistleblowing in four Australian hospitals. Official inquiries followed with recommendations to improve patient safety. In the aftermath of the inquiries, common themes included loss of trust in management and among clinical colleagues, and loss of trust from patients and the community. Without first rebuilding trust, staff will not report mistakes or other concerns about safety. Successful implementation of patient safety procedures requires policies to stress the professional duty of staff to report concerns about colleagues when they believe there is a risk to patients.

Sexing little penguins eudyptula minor using bill measurements

In Little Penguins Eudyptula minor there are no reliable plumage or body size differences that can be used visually to distinguish the sex of individuals. However, sexual dimorphism of morphometric measures has been noted, with males always being a little larger than females. In this study, differences between E. minor sexes at eight colonies in south-eastern Australia were determined statistically via discriminant function analysis (DFA) and through the utilization of DNA-based techniques developed for non-ratite birds. The DFA correctly determined gender in 91.1% of cases and molecular methods were 100% accurate. Our DFA success rate of classification is similar to that previously published for Little Penguins in Victoria. In this study statistically significant differences in mean bill depths and lengths were found between Little Penguin colonies at St Kilda, Phillip Island and Gabo Island, compared to colonies at Kangaroo Island, Granite Island, Middle Island and London Bridge. As birds in eastern populations (St Kilda, Phillip Island, Gabo Island) exhibit statistically significantly smaller beaks (bill depth and bill length), separate discriminant functions were investigated for each phenotypically distinct geo-spatial cohort. Interestingly, cluster analysis for bill length identified three groups: western (Kangaroo Island and Granite Island), eastern (St Kilda, Phillip Island and Middle Island) and the London Bridge Little Penguin colony, which constituted a separate group. We conclude that while there is a slight increase in DF power for colonies west of Cape Otway and for some specific colonies, colony-specific DFA is not required to identify the sex of Little Penguins in south-eastern Australia.

My life / Bill Clinton

Described as a 'diary dump' and as a monstrous ego trip, Bill Clinton's 957-page autobiography My Life is packed with the names of nearly everyone he's met since he started school, in chronological order. David Palmer teaches American Studies at Flinders University, Scott Burchill lectures in International Relations at Deakin University. On this week's Book Talk they talk with Jill Kitson about Clinton's book and agree on its historical importance.

TPA bill fails small business

Proposed legislation before federal parliament continues to come under fire from legal experts for not doing enough to protect small businesses against cartels and the misuse of market power.