Problématique : Le rôle des paramédics se transforme partout dans le monde. Les besoins des aînés et des malades chroniques entraînent une forte proportion d’interventions préhospitalières non urgentes. La confrontation entre la perception et l’expérience du rôle peut entraîner un conflit correspondant à un stress organisationnel modéré et chronique chez ces travailleurs. Pour y faire face, différentes stratégies d’adaptation peuvent être adoptées. Objectifs : Cette étude vise à dépeindre la réalité des interventions préhospitalières non urgentes des paramédics québécois et à explorer son influence sur leur perception du rôle et les manifestations de cynisme et de désengagement. Méthode : Les données qualitatives obtenues en entrevues semi-structurées ont été codifiées et analysées à partir d’un modèle adapté des théories en psychosociologie du travail et d’administration de la santé (n=13, 3 régions, intervenants de - de 3 à + de 20 ans de carrière). Résultats : Les paramédics reconnaissent vivre un conflit de rôle alors que la formation et la définition de leur pratique se rapportent exclusivement à l’urgence, au contraire de leur expérience. Ils manifestent des attitudes de cynisme et de désengagement affectant la qualité des services, précisant qu’il s’agit d’une réalité inhérente à leur expérience professionnelle intimement reliée à l’épuisement professionnel, plus qu’à un manque fondamental de professionnalisme. Conclusion : Les paramédics décrivent différents mécanismes à instaurer qui visent à reconnaître la dualité conflictuelle de leur pratique dont, la mise en valeur de leur aptitude clinique à intervenir en première ligne dans un cadre préhospitalier non urgent ainsi que l’ajustement et le rehaussement des programmes de formation. / Problem: The paramedic’s role has been steadily evolving internationally. Elderly and chronically ill user’s demands have lead to an increase in prehospital non urgent interventions. Confronting the conflict between the perceived role of a paramedic and the shifting reality toward non urgent care may result in a role conflict that manifests as chronic-moderate organizational stress. Mechanisms of coping related to this stress may be adopted. Objectives: The objectives of this study are to depict the Quebec paramedic’s experience related to non urgent interventions and explore their role perception and resulting attitudes of cynicism and disengagement. Method: Qualitative data from semi-structured interviews have been codified and analyzed based on a model adapted from the literature on works in socio-psychology and health administration theories. (n=13, 3 administrative regions, less than 3 years to more than 20 years of career) Results: Paramedics acknowledge experiencing role conflict as they explain the formation of their work and field of practice as being exclusively oriented toward emergency response, contrary to their pervasive work reality. They demonstrate cynicism and disengagement, and specify it as being inherent to the professional experience and intimately linked with burnout, affecting quality of care despite fundamental professional intentions. Conclusion: Paramedics described different professional coping mechanisms aimed at acknowledging the conflicting duality of their practice, amongst them, showcasing their clinical capability to play an active role in primary health care in the prehospital, non urgent setting and adjusting and enhancing the training programs.

Paramedics are exposed to high levels of stress and trauma in their working environment. Research has its focus on the coping mechanisms and trauma incidents escalating into Posttraumatic Stress Disorder. This study examines the paramedics’ working environment in relation to the help available, and suggests a pastoral counselling method which may be utilized as an effective method of assisting in the coping process and prevention of PTSD. Emergency Medical Services as a helping profession is mainly concerned with the welfare of their patients. This study has its focus on helping the helper, with the main focus on assisting the paramedic to cope with his working environment. Implications of the research include kerugmatik counselling and narrative therapy, incorporated in a pastoral counselling method to assist the paramedic with the healing process. The main findings were that stress and coping of the paramedic in his working environment was a reality which was often overlooked, as these paramedics had their focus on caring for their patients. In most cases there is help available, but the paramedic is hesitant to seek it out. Paramedics are mostly self-reliant in their coping mechanisms as their understanding and relationship with God and with the church had been damaged. The researcher followed the four tasks of practical theology as theoretical framework, as explained by Osmer: Descriptive-empirical Task – Priestly listening Interpretive Task – Sagely wisdom Normative Task – Prophetic discernment Pragmatic Task – Servant Leadership / Thesis (MA (Pastoral Studies))--North-West University, Potchefstroom Campus, 2013.

Paramedics are exposed to high levels of stress and trauma in their working environment. Research has its focus on the coping mechanisms and trauma incidents escalating into Posttraumatic Stress Disorder. This study examines the paramedics’ working environment in relation to the help available, and suggests a pastoral counselling method which may be utilized as an effective method of assisting in the coping process and prevention of PTSD. Emergency Medical Services as a helping profession is mainly concerned with the welfare of their patients. This study has its focus on helping the helper, with the main focus on assisting the paramedic to cope with his working environment. Implications of the research include kerugmatik counselling and narrative therapy, incorporated in a pastoral counselling method to assist the paramedic with the healing process. The main findings were that stress and coping of the paramedic in his working environment was a reality which was often overlooked, as these paramedics had their focus on caring for their patients. In most cases there is help available, but the paramedic is hesitant to seek it out. Paramedics are mostly self-reliant in their coping mechanisms as their understanding and relationship with God and with the church had been damaged. The researcher followed the four tasks of practical theology as theoretical framework, as explained by Osmer: Descriptive-empirical Task – Priestly listening Interpretive Task – Sagely wisdom Normative Task – Prophetic discernment Pragmatic Task – Servant Leadership / Thesis (MA (Pastoral Studies))--North-West University, Potchefstroom Campus, 2013.

This paper brings critical sociological analysis of contemporary situation on the EMS field in Czech Republic and discovers several topics which seemed to be less emphasized at that time. The result of the study is complex description of the EMT's personality, particular types, the population as a whole, specific relationships between variables and a few problems identified during the survey. Using mixed design research methods, the author deals with the emergency medical services in Czech Republic and it's employees. Based on the narrative data collected in speeches with the EMS staff, the typology of EMT's was created, considering their work attitudes, and a set of hypothesis was created as well. On this basis the continuing quantitative research was designed, verifying the validity of previous findings. The paper offers possible directions, how to continue in forthcoming research.

Reflective practice, though ill-defined, has become an accepted educational concept within many health care disciplines particularly in nursing. Subsequently it has become benchmarked within Paramedic Sciences as a professional requirement for continuing education and clinical practice. However, despite the vast literature in nursing and the increasing growth of reflective practice in paramedic curricula it is unclear how it influences the students’ learning in preparation for graduate practice as future reflective practitioners. This research explored ‘to what extent does reflective practice in the paramedic curriculum influence the students’ academic and clinical learning leading to graduate practice’? A mixed methods approach with cohort samples of undergraduate health care students comprised four studies including surveys and non-participant observations of clinical simulation that were conducted in a university learning environment. The results showed overall that Paramedic students believed that they understood reflective practice and perceived it to be useful for their academic studies and clinical practice; although this is probably influenced more by formal teaching rather than the result of their own views. Students were able to describe reflective practice in ideal theoretical terms and were positive towards it regardless of their individual learning styles. However, in a clinical context, they applied it differently with significant emphasis on technical reflection. Evidence of the nature of reflective practice as it occurred during and after clinical simulation scenarios highlights a need for revised approaches to existing learning/teaching strategies with paramedic students. An extended understanding and refinement of reflective practice concepts including a new pedagogic framework to promote enhanced reflectivity are proposed. This theoretical framework is designed to accommodate reflective learning for both personal and collaborative learning related to curriculum outcomes. The use of clinical simulation for the development of reflective practice in the paramedic curriculum is supported with recommendations for further studies in academic and clinical settings.

The diploma thesis deals with the experiences of emergency medical workers when going to patients in an unfavorable social situation. Medical rescue service according to Act No. 374/2011 Coll. on emergency medical services, should provide pre-hospital emergency care to patients in acute life-threatening conditions. Nevertheless, the crews of the ambulance service go to patients whose problems fall more into the social field. These patients do not primarily need medical intervention, yet rescuers in the field have to deal with these situations. The aim of the diploma thesis was to find out and compare the experience of rescuers when going to patients in an unfavorable social situation. Find out how rescuers experience and interpret these situations, what situations they encounter during these trips and how they understand the concept of an unfavorable social situation. The theoretical part of this work deals with the definition of basic concepts in the field of emergency medical services and social work. The empirical part is devoted to qualitative research. It contains a description of the research methodology, analysis of interviews with rescuers and their evaluation. The result of the research is evidence that on an almost daily basis, lifeguards deal with these situations with clients...

This thesis explores the heat transfer characteristics of a packed bed thermal energy storage device through the development of a 3D model in COMSOL Multiphysics. The model is based on a laboratory-scale device consisting of an aluminum box filled with sand, which acts as the thermal storage medium. The medium is heated using two resistance heaters that are embedded into the sand. The heaters are raised to approximately 500°C during the experiment. Three thermocouples placed in the sand record the temperature during charging, thus generating a time-dependent temperature curve at three points. The model simulates this experimental system, and the resulting temperature distribution is compared to the experimental data to assess the model validity. To determine the temperature throughout the storage system at all times, the model solves the heat equation. The density and heat capacity of the sand are measured and added to the model. The model uses the effective medium technique to estimate the thermal conductivity of the sand. A secondary model is developed in Excel to calculate the effective thermal conductivity using twelve different correlations, and the results are compared. The Zehner-Bauer correlation with an added Damköhler radiation term predicted an effective thermal conductivity of 0.218 W/(m·K) at 25°C and 0.451 W/(m·K) at 500°C, with slightly exponential growth due to the influence of thermal radiation. When these values for conductivity are applied to the COMSOL model, there is strong agreement (average percent error < 5%) with the experimental temperature distributions. A parametric study is performed, and shows that increasing grain size and emissivity could increase the thermal conductivity by making use of the exponential growth of thermal radiation. The model serves as a design and learning tool, and a starting point for improving the performance of the thermal energy storage system. / Detta examensarbete undersöker värmeöverföringsegenskaperna hos en termisk energilagringsenhet med packad bädd genom utveckling av en 3D-modell i COMSOL Multiphysics. Modellen är baserad på en enhet i laboratorieskala som består av en aluminiumlåda fylld med sand, som fungerar som det termiska lagringsmediet. Mediet värms upp med hjälp av två motståndsvärmare som är inbäddade i sanden. Värmeelementen höjs till ca 500°C under experimentet. Tre termoelement placerade i sanden registrerar temperaturen under laddningen och genererar på så sätt en tidsberoende temperaturkurva i tre punkter. Modellen simulerar detta experimentella system, och den resulterande temperaturfördelningen jämförs med experimentella data för att bedöma modellens giltighet. För att bestämma temperaturen i hela lagringssystemet vid alla tidpunkter löser modellen värmeekvationen. Sandens densitet och värmekapacitet mäts och läggs till i modellen. Modellen använder den effektiva mediumtekniken för att uppskatta sandens värmeledningsförmåga. En sekundär modell utvecklas i Excel för att beräkna den effektiva värmeledningsförmågan med hjälp av tolv olika korrelationer, och resultaten jämförs. Zehner-Bauer korrelationen med en tillagd Damköhler strålningsterm förutsade en effektiv värmeledningsförmåga på 0,218 W/(m·K) vid 25°C och 0,451 W/(m·K) vid 500°C, med en något exponentiell tillväxt på grund av påverkan från värmestrålning. När dessa värden för konduktivitet tillämpas på COMSOL-modellen finns det en stark överensstämmelse (genomsnittligt procentuellt fel < 5%) med de experimentella temperaturfördelningarna. En parametrisk studie har utförts som visar att ökad kornstorlek ock emissivitet kan öka värmeledningsförmågan genom att utnyttja den exponentiella tillväxten av värmestrålning. Modellen fungerar som ett design- och inlärningsverktyg och som en utgångspunkt för att förbättra prestandan hos det termiska energilagringssystemet.