Aims The Hunter-8 and the ACT-FAST are stroke scales used in Australia for the pre-hospital identification of large vessel occlusion (LVO) stroke but have not previously been compared. Moreover, their use in identifying distal arterial occlusions has not previously been assessed. We therefore aimed to describe the area under the receiver operating curve (AUC) of the Hunter-8 versus the ACT-FAST for the detection of classic LVO. Methods Both scales were performed on consecutive patients presenting with stroke-like symptoms within 24 hours of symptom onset presenting to the emergency department at a tertiary referral hospital between June 2018 and January 2019. The AUC of the Hunter-8 and the ACT-FAST was calculated for the detection of LVO using different definitions [classic LVO (proximal segment of the middle cerebral artery (MCA-M1), terminal internal carotid artery (T-ICA), or tandem occlusions) and extended LVO (classic LVO plus proximal MCA-M2 and basilar occlusions)]. Results Of 126 suspected stroke patients, there were 24 classic LVO and 34 extended LVO. For detection of classic LVO, the Hunter-8 had an AUC of 0.79 and the ACT-FAST had an AUC of 0.77. For extended LVO, the AUC was 0.71 and 0.70 respectively. Conclusion Both scales represent a significant opportunity to identify patients with proven potential benefit from thrombectomy (classic LVO), however M2 and basilar occlusions may be more challenging to identify with these scales.

Introduction There are 10 emergency paramedic services in Australia and New Zealand (Australasia), referred to as jurisdictional ambulance services (JASs). All 10 of the JASs in Australasia produce their own clinical practice guidelines (CPGs). With differing approaches to their review and implementation of new evidence, there is opportunity for differences to arise between guidelines. This article outlines a new series that will aim to identify interjurisdictional differences in CPGs and paramedic scopes of practice, and consequently differences in patient treatment depending on which jurisdiction a patient is geographically located within at the time of their complaint. Methods The current CPGs of each JAS will be obtained from each JAS, and content extracted by registered paramedics. The scope of practice for each intervention presented in the guideline will be classified as being at the level of ‘paramedic’, ‘intensive care paramedic’ (or equivalent, as titles vary by jurisdiction), or ‘restricted’. Each paper will be provided to each JAS for optional verification of content before publication, and the results of this will be stated. Conclusion This series will aim to provide a contemporary overview of Australasian JAS clinical practice guidelines and scopes of practice.

Introduction The outbreak of the novel coronavirus (COVID-19) has overwhelmed healthcare systems and exposed healthcare providers (and their families) to a high risk of infection and death. This study aimed to assess the willingness of healthcare providers in Jordan to report for duty and provide care to COVID-19 patients. Methods An online questionnaire was developed including questions about demographics, willingness to report to work and provide care to COVID-19 patients, and potential associated factors. Results A total of 253 participants completed the survey (mean age 33.8 years, 58.6% male). The sample included physicians (14.9%), nurses (61.1%) and paramedics (23%). Most participants (96.4%) were willing to come to work during the pandemic, although only 64.7% showed a willingness to provide care to COVID-19 patients. Being male (OR 3.21; 95% CI: 1.75-5.90) or having adequate training on COVID-19 (OR 5.16; 95% CI: 2.32-11.46) were the major predictors for willingness to care for COVID-19 patients, whereas concerns for family safety (OR 0.25; 95% CI: 0.14-0.47) or lack of information about COVID-19 (OR 0.43; 95% CI: 0.23-0.80) were the major predicting barriers for willingness to care for COVID-19 patients. Conclusion Although most participants were willing to report for duty, less than two-thirds were willing to care for COVID-19 patients. Being male and receiving training are associated with willingness; whereas concern for family is associated with less willingness to care for COVID-19 patients.

Introduction The scope of paramedic practice is being redefined and expanded. Professional development and clinical expertise are not only necessary for paramedics to perform their clinical functions and operational responsibilities, they are at the very core of their professionalisation. Professionalisation is a complex process, and the degree to which it can accomplished will impact society's perception of the profession – and its trust in it – for years to come. This study investigated ways to enhance professional practice, from the point of view of the main healthcare providers in a rural area of Ontario, Canada. Methods A qualitative analysis informed by action research methodology was used. The research design was staged and consisted of focus groups and a World Café. The data were coded and organised into themes, using thematic analysis, and were triangulated with the literature. Results Three key themes emerged from the World Café and focus group conversations including current enablers of professionalisation; system components that promote professionalism; and community of practice to support professional development and clinical expertise. Conclusion Paramedic practice is evolving. This should be reflected in clinical practice and education, and more paramedic-led research. Paramedic training may need to move from the college to the university environment to reflect equal standing with colleagues in the broader healthcare system. This study shows strong motivation among paramedics and management to enhance professional practice and professionalism. To achieve this, a culture of trust, developing engagement and communication strategies and establishing a community of practice are crucial.

Autism Spectrum Disorder (ASD) has generated much research interest in recent times due to a soaring increase in diagnosis rates and a movement to recognise ASD as a cognitive style, rather than a cognitive deficit. Psychologists are responsible for the timely and accurate diagnosis of ASD and supporting clients on the spectrum with general mental health care. Undergraduate psychology students may go on to further study to become registered psychologists or choose to pursue other careers in mental health care and support work in which they will likely have contact with members of the autistic community. However, little research into the attitudes towards and knowledge of autism in psychology students in Australia has been conducted. In this exploratory study, 1st year (n=23) and 3rd year (n=64) undergraduate psychology students were surveyed, and the results compared to see if a significant difference exists between cohorts. That is, to ascertain if attitudes towards and knowledge of autism improved in students studying an undergraduate psychology major. Results indicated that there was no significant difference in knowledge and attitudes towards autism between the 1st and 3rd year student cohorts. Implications for psychology students, universities, the autistic population, and the future direction of research in this area are discussed.

Introduction It has been well established that if a person is aware that they are being monitored their commitment and effort will be maximised (the Hawthorne effect), which then leads to efficiency increase and optimal workflow. Objective Our aim was to evaluate the efficacy of instant feedback and the Hawthorne effect of this intervention on pre-hospital time indexes during emergency medical service (EMS) missions. Methods This is a cross-sectional auditing study on the missions of the Tehran EMS Center (performed over a 12-month period) in three phases: pre-intervention, instant feedback, and monitoring without feedback. The measured time indexes were the different parts of mission times. To collect data, a pre-prepared checklist was set up. For the first phase, data were extracted from the database of the Tehran EMS Center. In the second and third phases, the data were entered into the relevant forms for each mission by the researcher and executive colleagues. Results The data of 229,847 missions were analysed. In the instant feedback phase, compared to the pre-intervention phase, the mean activation time, response time, scene time, transfer time and hospital delay time were decreased. When we compared the mean time indexes in the monitoring phase compared to the instant feedback phase, we saw that the average activation time, response time and transfer time were increased but they were still less than that in the pre-intervention phase. However, the scene time and hospital delay time were not changed compared to the instant feedback phase but were lower than that in the pre-intervention phase. Conclusion Auditing was effective in reducing the total time of missions and this effect was largely maintained in the monitoring phase under the Hawthorne effect.

This volume focuses on very young children’s (aged 0-8) rights in a digital world. It gathers current research from around the globe that focuses on young children’s rights as agental citizens to the provision of and participation in digital devices and content—as well as their right to protection from harm. The UN Digital Rights Framework of 2014 addresses children’s needs, agency and vulnerability to harm in today’s digital world and implies roles and responsibilities for a variety of social actors including the state, families, schools, commercial entities, researchers and children themselves. This volume presents a broad range of research, including chapters on parental supervision and control, the changing forms of play, early childhood education, media and cultural studies, law, design, health, special-needs education, and engineering. Implicit within this book is the acknowledgement that children of various ages, abilities, socioeconomic and geographic backgrounds should have equal access to, and positive / non-harmful experiences with, new digital technologies and content—as well as adult support and expertise that enhances these experiences.

Ransomware is increasingly posing a threat to the security of information resources. Millions of dollars of monetary loss have been afflicted on end-users and corporations alike through unlawful deployment of ransomware. Through malware injection into end-user devices and subsequent extortion of their system or data, ransomware has emerged as a threat requiring immediate attention and containment by the cyber-security community. We conduct a detailed analysis of the steps of execution involved in ransomware deployment to facilitate readiness of the cyber-security community in containing the rapid proliferation of ransomware. This paper examines the evolution of malware over a period of 26 years and the emergence of ransomware in the cyber-threat landscape. Key findings on the evolution of ransomware and its use of emerging technologies are presented.

This is the coreflood data we measured during the different experiments

These are pre-hospital care and prehospital care education related abstracts from the Abstracts from the 4th International Conference on Nursing (ICON) held in Malang, East Java, Indonesia.