Empathy in paramedic practice: an overview

Background: Although inconsistently defined, empathy is generally considered to be the understanding of another person\u27s reactions, thoughts, feelings and problems and being able to relay this sense of understanding back to the individual. Empathy in healthcare is associated with improved communication, reduced stress, lower complication rates and improved clinical outcomes. Low empathy is associated with decreased patient satisfaction, and provider burnout. Aim: The aim of this article is to provide an overview of empathy in paramedic practice, and to outline several potential solutions to improve empathy levels among paramedics and paramedic students. Methods: We conducted unstructured, non-systematic searches of the literature in order to inform an overview of the literature. An overview is a summary of the literature that attempts to survey the literature and describe its characteristics. We thematically structured the results of these searches under the following headings: empathy in paramedic practice, empathy and burnout, and strategies to improve empathy levels. Discussion: The literature demonstrates that paramedic students have lower empathy scores towards substance users and mental health emergencies, and this may affect future practice as a paramedic. The burden of emotional work in paramedic practice and coping strategies that paramedics develop may also be contributory factors in this lower empathy. There appears to be a relationship between empathy and burnout, with most studies suggesting an inverse relationship. Empathy is an interpersonal skill that can be learned and improved upon through methods such as reflection and simulation. Conclusion: Empathy in paramedic practice is complex, and understudied. Although some evidence exists to suggest that paramedic students have variable empathy levels towards certain patients, and that these empathy scores can decline over time, there is a distinct lack of research into empathy in practicing paramedics, and this requires further attention. In particular, its relationship to patient care, paramedic burnout, and wellbeing require investigation. Several strategies to teach empathy exist and these can be considered by educators

Is spinal stenosis assessment dependent on slice orientation? A magnetic resonance imaging study

Introduction: Lumbar spinal stenosis (LSS) treatment is based primarily on the clinical criteria providing that imaging confirms radiological stenosis. The radiological measurement more commonly used is the dural sac cross-sectional area (DSCA). It has been recently shown that grading stenosis based on the morphology of the dural sac as seen on axial T2 MRI images, better reflects severity of stenosis than DSCA and is of prognostic value. This radiological prospective study investigates the variability of surface measurements and morphological grading of stenosis for varying degrees of angulation of the T2 axial images relative to the disc space as observed in clinical practice. Materials and methods: Lumbar spine TSE T2 three-dimensional (3D) MRI sequences were obtained from 32 consecutive patients presenting with either suspected spinal stenosis or low back pain. Axial reconstructions using the OsiriX software at 0°, 10°, 20° and 30° relative to the disc space orientation were obtained for a total of 97 levels. For each level, DSCA was digitally measured and stenosis was graded according to the 4-point (A-D) morphological grading by two observers. Results: A good interobserver agreement was found in grade evaluation of stenosis (k=0.71). DSCA varied significantly as the slice orientation increased from 0° to +10°, +20° and +30° at each level examined (P<0.0001) (−15 to +32% at 10°, −24 to +143% at 20° and −29 to +231% at 30° of slice orientation). Stenosis definition based on the surface measurements changed in 39 out of the 97 levels studied, whereas the morphology grade was modified only in two levels (P<0.01). Discussion: The need to obtain continuous slices using the classical 2D MRI acquisition technique entails often at least a 10° slice inclination relative to one of the studied discs. Even at this low angulation, we found a significantly statistical difference between surface changes and morphological grading change. In clinical practice, given the above findings, it might therefore not be necessary to align the axial cuts to each individual disc level which could be more time-consuming than obtaining a single series of axial cuts perpendicular to the middle of the lumbar spine or to the most stenotic level. In conclusion, morphological grading seems to offer an alternative means of assessing severity of spinal stenosis that is little affected by image acquisition techniqu

The winter floods of 2015/2016 in the UK - a review

A remarkably persistent and exceptionally mild cyclonic episode beginning in early-November 2015 and lasting around fourteen weeks brought severe, extensive and protracted flooding which impacted most damagingly on northern Britain, Northern Ireland and parts of Wales. Many existing rainfall and seasonal temperature records were eclipsed during this period and, most notably, maximum recorded river flows were exceeded over a substantial proportion of the country. At the national scale, previous maximum daily and monthly outflows were clearly eclipsed and four relatively discrete episodes of extreme runoff can be recognised. In many areas, the magnitude, persistence and repetitive nature of the flooding had major adverse impacts on communities, infrastructure, agriculture and a host of other sectors of the economy. The extent and duration of the flooding has very few close parallels in the historical record and, overall, it was a hydrometeorological episode which ranks alongside the 1975/1976 drought and 1947 floods as the most extreme broad-scale events captured in observational records during the last 100 years at least. The truly exceptional runoff patterns experienced in 1947 and 1976 had a major impact on flood and drought management strategies but occurred before the exacerbating impact of climate change was generally recognised. The 2015/2016 flooding, together with the impact of other protracted flood events in the 21st century thus far, has underlined the need to adapt engineering design and flood management strategies to accommodate the recent extension in the range of recorded runoff variability

Transforming undergraduate education in geriatric medicine:an innovative curriculum at Bristol Medical School

The World Health Organization (WHO) advocates investment in high-quality undergraduate education in geriatric medicine as a means of meeting the future needs of the aging population. However, there is a lack of evidence for the optimal delivery of training in this area. Rigorous pedagogical research is required to determine the most effective way to equip tomorrow’s doctors with the skills and knowledge to care for older adults with complex health and social care needs. The transition between two undergraduate medical curricula meant that Bristol Medical School (BMS) was uniquely positioned to innovate and evaluate undergraduate education in geriatric medicine. This transition marked BMS’ departure from a ‘traditional’ curriculum to case-based learning. The outgoing curriculum included a 4-week unit in geriatrics, whilst the new programme includes an 18-week clerkship titled ‘Complex Medicine in Older People’ (CMOP). CMOP is a clinical clerkship with 18 cases at its core, covering the fundamental aspects of geriatric medicine. The core cases and clinical learning are enhanced with five expert lectures, six tutorials and three journal clubs. Reflective practice is modelled and promoted with Balint groups and a book club. Consolidative workplace-based assessments and clinical portfolio mirror those used in postgraduate training, preparing students for professional practice. CMOP is iteratively improved in real-time using staff and student feedback. This marked shift in mode and duration of teaching affords the opportunity to evaluate the impact of differing education in geriatrics, providing an evidence-based model for teaching on aging. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s41999-022-00690-w

The 'care' of children in need in contemporary Scotland the role of positivism and performance indicators in official imaginings of childhood and wellbeing

Improving the wellbeing of children is an ambition of governments worldwide. This has led to increased activity to measure the implementation of policies intended to achieve this. In this paper, we argue that this is currently limited through the reliance on statistically-driven methods and that there needs to be a fundamental change in how policies are assessed. We examine this within the current policy context for vulnerable children in Scotland

‘It Brings Light to What You Really Put into Your Body’: A Focus Group Study of Reactions to Messages about Nicotine Reduction in Cigarettes

Objective: In 2017, the U.S. Food and Drug Administration (FDA) announced a proposed regulation to lower nicotine in cigarettes to minimally addictive levels to help smokers quit. We sought to explore effective message strategies communicating about nicotine reduction in cigarettes across the different key audiences that the regulation is most likely to influence. Methods: We designed four types of messages: efficacy messages, risk messages, a message about alternative sources of nicotine, and a compensation message. Sixteen virtual focus groups were conducted in Atlanta and San Francisco in April-May 2020. Data were analyzed in NVivo 12.0 using a thematic analysis approach. Findings: Exclusive smokers were receptive to both efficacy messages and risk messages. Dual users were the only group that was open to resorting to alternative sources of nicotine. Former smokers were critical of these messages as promoting the new kinds of cigarettes and potentially encouraging initiation and relapse of smoking. Nonsmokers felt that efficacy messages downplayed the risks of smoking and did not scare people away from smoking. Presenting information that very low nicotine cigarettes (VLNCs) still contain harmful chemicals made smokers question continued smoking in the absence of nicotine and view VLNCs as harmful. Conclusions: Messages communicating about nicotine reduction in cigarettes might help to motivate smokers to quit and can correct the misperceptions that VLNCs are less harmful. The FDA should consider specific target audiences and use different messages that complement each other in communicating about this regulation

Images of Research:An Art Gallery and Puzzle Book

Images of Research is an annual competition that challenges researchers to capture their work in a single image, alongside a short description. This competition has been run at the University of Dundee since 2020 and represents just a handful of the research projects being carried out by postgraduate researchers.The competition celebrates our research and the many original ways it can be expressed. This collection showcases the winning entries, mixed with fun sketches and puzzles to complete