The failure of communications, particularly related to interoperability, between police and firefighters responding to dangerous situations has resulted in death or injury to themselves or those they strive to protect. Using Grebner's and Shannon and Weaver's conceptualizations of communications theory as the foundation, the purpose of this general qualitative study was to evaluate, from the perspective of first responders, what barriers exist that may impede opportunities for interoperability of communications systems. Data were collected through semi-structured interviews with a purposive sample of 18 experienced first responders from the states of California, New York, and Texas. Interview data were deductively coded and subjected to a thematic analysis procedure. Key findings indicated that participants perceived differences in technology among agencies as a primary source of frustration and impediment to full interoperability. Further, participants identified policy barriers, a lack of inter-agency training opportunities, and budgetary constraints as frustrating the efforts toward interoperability. The positive social change implications of this study include recommendations to policy makers and first responder agency leadership to support policy change, including appropriations, that encourage increased interoperability among first responder agencies to foster a more expeditious response to large scale emergencies.

This thesis examines the responses of one hundred and seventy three nurses who work in emergency departments in New South Wales to the psychological tenets of stress, support and burnout. Several tools were utilised the Maslach Burnout Inventory, the Jalowiec Coping Scale and the Bailey Stress Scale. The respondents were grouped according to their place of work and numerous variables were analysed for both similarities and significant differences. Overall nurses who work in emergency departments in NSW reported that the lack of in-patient beds or exit block was the most significant stressor in their work, followed by interruptions by telephones and uncontrolled volumes of patients. Although a variety of formal support systems available to emergency nurses were identified in this study a there was not universal agreement about their usefulness. Support from colleagues however was identified as sustaining and helpful. Reported coping styles of the respondents in this study were constructive, self reliant and professional. There was a very small number of respondents who can be classified as burnt out. / Master of Science (Hons.) Health

Patienter kommer till akutmottagningar med stora variationer av sjukdomar, skador, ålder och psykologiska tillstånd. Arbetet på akutmottagningen är ofta mer inriktat på de medicinska aspekterna av omvårdnad. Det är patientens upplevelser av omvårdnaden som fungerar som en bedömning av hur bra omvårdnaden utförs. Syftet med denna studie är att beskriva patientens upplevelser av omvårdnaden på akutmottagningen. Den metod som använts är en litteraturöversikt av tolv artiklar med kvalitativ eller kvantitativ metod. Studien resulterade i tre huvudkategorier som patienterna upplevde som omvårdnad. Huvudkategorierna var: Kommunikation mellan vårdgivare och vårdtagare, sjuksköterskans professionalism och vårdmiljön. Resultatet visar även att patienter har olika behov av omvårdnad, beroende på hur sjuka eller skadade de är. Det är dock viktigt att utgå från varje patients livsvärld för att kunna erbjuda en personligt anpassad omvårdnad vilket skapar en trygghet för patienten. Studien visar även att det i framtida studier finns ett behov av att klargöra hur patienters upplevelser av omvårdnaden på akutmottagningen relateras till hur skadade och sjuka patienterna är. / Patients arrive at emergency departments with large variations of diseases, injuries, age and psychological states. The work at the emergency department is often more focused on the medical aspects of nursing care. It is the patient´s experiences of the care that act as an estimation for how well the care is performed. The aim of this study is to investigate the patient’s experiences of care at the emergency department. The method used is a literature review of twelve articles which have a qualitative or quantitative approach. The study resulted in three major categories that patients experienced as caring. The categories were: communication between caregiver and caretaker, the nurse´s professionalism and the care environment. The results of this literature review also showed that patients have different needs of care depending on how sick or hurt they are. It is however important to build on each patient's life world to offer a personalized care which creates a sense of security for the patient. The study also shows that future studies needs to clarify how patients' experiences of care in emergency departments are related to the injured and sick patients are.

With the outbreak of the 2009 pandemic influenza A (H1N1) comes the need to evaluate the preparedness level of government entities that had preparedness plans. This study looks at the preparedness level for pandemic influenza among key leaders in Brazos County according to their Brazos County Pandemic Influenza Preparedness Plan. Ten key leaders were recruited to participate in interviews. Interviews were transcribed and analyzed for salient themes. Main themes that emerged from interviews were categorized into vaccinations, communication, logistical issues, and the need for evaluations and feedback. Recommendations for increasing preparedness include addressing contingency plans, increasing education through public health efforts, addressing biosecurity, increasing use of technology, and increasing funding and research.

The purposes of this study were to understand emergency physicians¡¦ perception, attitude and application of evidence-based medicine(EBM). This cross-sectional study employed quantitative methods. Regarding the quantitative method, the study population included emergency physicians in southern Taiwan of 32 participating hospitals. Structured questionnaires were sent to emergency physicians, a total of 214 questionnaires were distributed with 189 questionnaires being returned. The response rate was 88.32%. Descriptive statistics was used in data analysis. The major findings were: 1. Emergency physician¡¦s perception of EBM: The average score in Physicians¡¦ understanding EBM terminologies were from 1.88 to 2.79(score ranged from 1 to 4, 1 represented fully understand). 2. Emergency physician¡¦s attitude of EBM: a. There were over a half (57.7%) emergency physicians had taken EBM training courses, while 93.1% expressed their willingness to attend EBM activities in the future. b. Most emergency physicians(86.7%) agreed that application of EBM was useful in clinical practice. c. The major barriers of emergency physicians to apply EBM were lack of time(57.1%), lack of EBM knowledge(50.3%), lack of research methodology knowledge(45.5%) and hardness of critical appraisal(40.7%). d. In general, emergency physicians hold positive attitudes toward EBM, the average score was from 1.79 to 3.09 (score ranged from 1 to 5, 1 represented the most agree). 3. Emergency physician¡¦s application of EBM: a. The average proportion of EBM application in emergency physicians¡¦ clinical practice was 54.42% . b. Emergency physician¡¦s choice of clinical problem-treating was diverse, only little clinical problem may have uniform opinions.

<p>Patienter kommer till akutmottagningar med stora variationer av sjukdomar, skador, ålder och psykologiska tillstånd. Arbetet på akutmottagningen är ofta mer inriktat på de medicinska aspekterna av omvårdnad. Det är patientens upplevelser av omvårdnaden som fungerar som en bedömning av hur bra omvårdnaden utförs. Syftet med denna studie är att beskriva patientens upplevelser av omvårdnaden på akutmottagningen. Den metod som använts är en litteraturöversikt av tolv artiklar med kvalitativ eller kvantitativ metod. Studien resulterade i tre huvudkategorier som patienterna upplevde som omvårdnad. Huvudkategorierna var: Kommunikation mellan vårdgivare och vårdtagare, sjuksköterskans professionalism och vårdmiljön. Resultatet visar även att patienter har olika behov av omvårdnad, beroende på hur sjuka eller skadade de är. Det är dock viktigt att utgå från varje patients livsvärld för att kunna erbjuda en personligt anpassad omvårdnad vilket skapar en trygghet för patienten. Studien visar även att det i framtida studier finns ett behov av att klargöra hur patienters upplevelser av omvårdnaden på akutmottagningen relateras till hur skadade och sjuka patienterna är.</p> / <p>Patients arrive at emergency departments with large variations of diseases, injuries, age and psychological states. The work at the emergency department is often more focused on the medical aspects of nursing care. It is the patient´s experiences of the care that act as an estimation for how well the care is performed. The aim of this study is to investigate the patient’s experiences of care at the emergency department. The method used is a literature review of twelve articles which have a qualitative or quantitative approach. The study resulted in three major categories that patients experienced as caring. The categories were: communication between caregiver and caretaker, the nurse´s professionalism and the care environment. The results of this literature review also showed that patients have different needs of care depending on how sick or hurt they are. It is however important to build on each patient's life world to offer a personalized care which creates a sense of security for the patient. The study also shows that future studies needs to clarify how patients' experiences of care in emergency departments are related to the injured and sick patients are.</p>

Thesis (M.A.) -- University of Texas at Arlington, 2008.

Thesis (D.P.A.)--University of Oklahoma, 1991. / Includes bibliographical references (leaves 294-300).

published_or_final_version / Public Health / Master / Master of Public Health

Emergency contraception is an effective backup for contraceptive failure. In Hong Kong, levonorgestrel emergency contraceptive pill is a prescription drug. In most developed countries, it is provided in advance or over-the-counter to eliminate the barrier to access. The objective of this thesis is to evaluate the feasibility and acceptability of these novel delivery modes in Hong Kong. Four studies were conducted to study pertinent subject matters. A retrospective review on 11014 clinical records of The Family Planning Association of Hong Kong on emergency contraception prescription between 2006 and 2008 was performed to delineate the characteristics of emergency contraceptive users. One-year follow-up data was available in 4728 records, with 89.4% used emergency contraception once and 8.5% used it twice. The proportion of subjects not using ongoing contraceptives reduced from 20.6% at the emergency contraception visit to 4.5% at post-treatment follow-up, 3.9% at 6th month and 3.3% at 12th month. Young age was not associated with not using ongoing contraceptives and repeat use of emergency contraceptives. A randomized controlled trial with 1030 women was conducted to compare the behavior of those given three courses of levonorgestrel emergency contraceptive pills in advance against those who had to get them from clinics when needed. After one year, 29.9% of women in the advanced provision group had used the pills versus 12.9% in the control group (odds ratio 2.87, 95% confidence interval 2.07-3.97). The advanced provision group used three times more pills than the control group (278 versus 95 courses, p<0.001). The median coitus-treatment interval in the advanced provision group was significantly shorter than the control group (11 h versus 20 h; p<0.001). Most women used condoms before (90%) and during (89%) the study. In both groups, consistency of use was higher after emergency contraception (65%) than before (60%) (p<0.001). This study confirmed that advanced provision increased the utilization of emergency contraceptive pill, facilitated its early use and did not hamper ongoing contraceptive use. A questionnaire survey was conducted to evaluate the acceptability of novel use of emergency contraceptive pill among women practicing contraception. Of the 1405 questionnaires analyzed, 46.3% of women supported more advertising on emergency contraception; 48.7% supported advanced provision of emergency contraceptive pill and 25.7% supported over-the-counter provision. Another questionnaire survey assessed the attitude of physicians who provide family planning services. Half (54.2%) of them supported advanced provision of emergency contraceptive pill; 32.5% supported advanced provision to girls aged 16 and below and 40.2% supported over-thecounter provision. Among 352 physicians who provided emergency contraception, only 21.7% of private family physicians and 15.9% of private obstetrician-gynaecologists prescribed emergency contraceptive pills in advance. In conclusion, local women used emergency contraception responsibly and remained vigilant with ongoing contraception even when they got pills in advance. Minority of physicians practice advanced provision. The acceptance of advanced provision, among women and physicians who do not know much about it, is around 50%. It is thus possible to improve when more education on advanced provision is provided. The support for over-the-counter provision was too weak to boost. / published_or_final_version / Medicine / Master / Doctor of Medicine