Paramedics' perceptions of their role in palliative care : analysis of focus group transcripts

Paramedics play an important role in out-of-hospital health care. They provide unscheduled care, assisting both patients with minor injuries and those experiencing life-threatening emergencies. Increasingly, paramedics are called on to manage chronic and complex health needs, including symptom relief for patients at the end of life. However, paramedics may not be well prepared to offer palliative care, as practice guidelines and education tend to focus on the management of acute medical emergencies and major trauma. Emergency medical services that employ paramedics rarely have practice guidelines or protocols that deal specifically with palliative care.

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.

O trafico da escravatura, e o Bill de Lord Palmerston

Ex-secretário de Estado dos Negócios Estrangeiros de Portugal, o autor analisa as medidas tomadas por Portugal e Inglaterra em relação à abolição do tráfico de escravos. O Parlamento britânico adotou, em 1840, uma lei proposta por Lord Palmerston, autorizando os navios de guerra britânicos a "capturar, em todos os mares, as embarcações que, com bandeira portuguesa, se empreguem ou sejam suspeitas de empregar-se no tráfico da escravatura. O visconde de Sá da Bandeira, que havia negociado com o governo inglês vários acordos e projetos de tratados, escreveu um livro sobre o assunto, onde há informações históricas importantes não só a respeito da escravidão nas colônias portuguesas como nas inglesas, nas dinamarquesas, francesas, espanholas e nos Estados Unidos

The lord advocates of Scotland from the close of the fifteenth century to the passing of the reform bill.

Mode of access: Internet.

The social, educational and religious state of the manufacturing districts; with statistical returns of the means of education and religious instruction in the manufacturing districts of Yorkshire, Lancashire and Cheshire; in two letters to the Right Hon. Sir Robt. Peel, bart., with an appendix containing a letter to the Right Hon. Lord Wharncliffe, on Sir Jas. Graham's factory education bill; also the objections to the amended bill.

Includes tables.

Notes on Lord John Russell's Marriage Bill.

Mode of access: Internet.

Letter to the Right Hon. Lord Ashley, on the cotton factory system, and the ten hours' factory bill ...

Mode of access: Internet.

Letter to the Right Hon. Lord Ashley, on the cotton factory question, and the ten hours' factory bill : with an appendix, containing an abstract of the bill /

Goldsmiths'-Kress no. 28307.9.

Speech of the Right Honourable Lord Brougham, lord high chancellor of England, on the second reading of the Reform bill, delivered in the House of lords ... the 7th of October, 1831 ...

Mode of access: Internet.

[The] most important transactions of the sixth session of the First Parliament of His Majesty King George II. anno domini, MDCCXXXIII : containing ... also in this pamphlet are inserted, The Lords protests in the said session of Parliament : and a compleat list of all those gentlemen of the House of Commons as voted for or against the late excise-bill ... .

Goldsmiths'-Kress no. 07160.0-4.

The digital economy bill and the UK’s creative industries : a perspective from China

The Digital Economy Bill has been heavily criticized by consumer organizations, internet service providers and technology experts on the grounds that it will reduce the public’s ability to access politically sensitive information, impinge on citizens’ rights to privacy, threaten freedom of expression and have a chilling effect on digital innovation. Its passage in spite of these criticisms reflects, among other things, the power of the rhetoric that has been employed by its proponents. This paper examines economic arguments surrounding the digital economy debate in light of lessons from one of the world's fastest growing economies: China.