Initial paramedic education must have sufficient rigor and appropriate resources to prepare graduates to provide lifesaving prehospital care. Despite required national paramedic accreditation, there ...is substantial variability in paramedic pass rates that may be related to program infrastructure and clinical support. Our objective was to evaluate US paramedic program resources and identify common deficiencies that may affect program completion.
We conducted a cross-sectional mixed methods analysis of the 2018 Committee on Accreditation of Educational Programs for the Emergency Medical Services Professions annual report, focusing on program Resource Assessment Matrices (RAM). The RAM is a 360-degree evaluation completed by program personnel, advisory committee members, and currently enrolled students to identify program resource deficiencies affecting educational delivery. The analysis included all paramedic programs that reported graduating students in 2018. Resource deficiencies were categorized into ten categories: faculty, medical director, support personnel, curriculum, financial resources, facilities, clinical resources, field resources, learning resources, and physician interaction. Descriptive statistics of resource deficiency categories were conducted, followed by a thematic analysis of deficiencies to identify commonalities. Themes were generated from evaluating individual deficiencies, paired with program-reported analysis and action plans for each entry.
Data from 626 programs were included (response rate = 100%), with 143 programs reporting at least one resource deficiency (23%). A total of 406 deficiencies were identified in the ten categories. The largest categories (
= 406) were medical director (14%), facilities (13%), financial resources (13%), support personnel (11%), and physician interaction (11%). The thematic analysis demonstrated that a lack of medical director engagement in educational activities, inadequate facility resources, and a lack of available financial resources affected the educational environment. Additionally, programs reported poor data collection due to program director turnover.
Resource deficiencies were frequent for programs graduating paramedic students in 2018. Common themes identified were a need for medical director engagement, facility problems, and financial resources. Considering the pivotal role of EMS physicians in prehospital care, a consistent theme throughout the analysis involved challenges with medical director and physician interactions. Future work is needed to determine best practices for paramedic programs to ensure adequate resource availability for initial paramedic education.
DHA, the main n-3 PUFA in the brain, is synthesized from n-3 PUFA precursors by astrocytes. To assess the potential of this process to supply DHA for the brain, we investigated whether the synthesis ...in astrocytes is dependent on DHA availability. Rat brain astrocytes differentiated with dibutyryl cAMP and incubated in media containing 10% fetal bovine serum synthesized DHA from alpha-linolenic acid (1-(14)C18:3n-3), docosapentaenoic acid (3-(14)C22:5n-3), tetracosapentaenoic acid (3-(14)C24:5n-3), and tetracosahexaenoic acid (3-(14)C24:6n-3). When DHA was added to media containing a 5 microM concentration of these (14)C-labeled n-3 PUFA, radiolabeled DHA synthesis was reduced but not completely suppressed even when the DHA concentration was increased to 15 microM. Radiolabeled DHA synthesis also was reduced but not completely suppressed when the astrocytes were treated with 30 microM DHA for 24 h before incubation with 5 microM 1-(14)C18:3n-3.These findings indicate that although the DHA synthesis in astrocytes is dependent on DHA availability, some synthesis continues even when the cells have access to substantial amounts of DHA. This suggests that DHA synthesis from n-3 PUFA precursors is a constitutive process in the brain and, therefore, is likely to have an essential function.
The present research continues to test the hypothesis from Akers’ Social Structure-Social Learning Theory (
1998
) that the effects of structural variables will be mediated by social learning ...processes. The present research uses Core Alcohol and Drug Survey data from eight diverse college campuses throughout the United States to study binge drinking. This research examines 13 structural features for a full range of college students. The results indicate the social learning variables (rewards, punishments and definitions) mediated most of the structural effects of binge drinking. There were significant interactions, which are not predicted by Akers. The paper discusses the implication of these findings for Akers’ mediation hypothesis.
Pediatric patients who were transported by the participating agencies were included, and their prehospital patient care record was linked to their hospital care record. ...if a pain score of 8 was ...documented, but no pain medication was administered, that was classified as an error with mild temporary harm. ...23 of 118IV placements were noted as an ASE, with the most frequent cause being multiple attempts to perform the procedure.
Liquor Is Quicker Lanza-Kaduce, Lonn; Capece, Michael; Alden, Helena
Criminal justice policy review,
06/2006, Letnik:
17, Številka:
2
Journal Article
Recenzirano
Akers’s Social Structure-Social Learning Theory (SS-SL) has recently been criticized for dealing with social structural factors as exogenous variables rather than integrating them into propositions ...that specify the learning processes better. For example, Morash has argued that SS-SL has largely ignored the ways in which gender structures institutions, interactions, and behaviors and takes Akers to task for ignoring feminist theories. This research uses Core Alcohol and Drug Survey data from a subsample of White unmarried college students from eight diverse campuses throughout the United States to examine how conflict structured by gender affects differences in the use of alcohol before sex. The research specifically examines Akers’s claim that social learning variables (in this case, anticipated reward and risk of harm) will substantially mediate the effects of structural variables rather than modulate or moderate them. The policy implications of the research are discussed.
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