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We are very pleased to publish five original papers in our second issue of the sixth volume of International Journal of Emergency Services. Four articles in this issue focus on the management of ambulance services and issues pertaining to prehospital care. One paper touches on the important theme of stress and copying mechanism for emergency response officers (ERO) and the police in particular. All the articles reflect the theme and international perspective of the journal while making an important contribution to advancement of the field of emergency management.
In our first paper, Scott Somers and Anthony LoGiudice investigate the spatial patterns of out-of-hospital cardiac arrest (OHCA) incidence in a large American city in order to identify neighborhoods and public occupancies with highest risk for developing an evidence-based strategy to promote cardiac health and improve survival. A bivariate analysis was conducted using Spearman correlation coefficient to check the covariance of census variables that were expected to relate to OHCA incidence. The study found clusters of OHCA events in neighborhoods with socially isolated older persons, as well as low-income minority populations unlike the previous reported cases of high-risk OHCA locations in such community. Evidence from this study highlights the importance of using local data to develop public health policies in ensuring that scarce resources and public outreach efforts are targeted at populations of greatest risk. The paper concludes with a recommendation that identification and management of major causes of premature death and understanding the causes of health disparities is critical to developing effective EMS prevention programes.
Our second paper is a practitioner piece co-authored by Joanna M. Blodgett, Duncan Robertson, David Ratcliffe, and Kenneth Rockwood. It provides an evaluation of the non-conveyance of patients transported by the National Health Service ambulance trusts in the UK to emergency departments (ED). Due to a rise in 999 calls for non-emergency reasons coupled with an ageing population, conveyance of patients directly to the ED is no longer the default decision for paramedics on scene and providing safer care close to home is becoming a priority. Using an example from one of the ambulance trusts in England, the authors evaluate one such scheme developed in their organization which enables paramedics to safely refer appropriate patients to a dedicated General Practitioner Acute Visiting Service. Their study demonstrated positive preliminary results but the authors recommend a rigorous cost effective analysis to identify the cost savings of the scheme and inform future policy decisions. They further argue for collaborative effort across different ambulance trusts with specific inquiries to examine the data exploring patient presentation, pathway and outcome to identify any potential benefits or harms for the patient which could be confirmed in larger follow-up studies.
Mike Brady in our third paper provides a critical review of the complaints procedure in the UK ambulance services. Complaints are an integral element of the quality control and clinical governance process and form a valid and reliable way of identifying areas of practice that require improvement. This review aims to assess to what extent such complaints and their possible causes are researched and to identify any possible areas of practice requiring further investigation. Based upon a Freedom of Information request to the ambulance services, three main areas of complaints are identified, namely, response times improvement strategies, ambulance staff attitudes, and educational assessments of errors. This review highlights that complaints made to the UK ambulance services relating to the three main themes are underrepresented in the current literature. Implications for further research follow from this analysis.
In their paper exploring the daily stress and coping among ERO in Portugal, authors Susana Rodrigues, Mariana Kaiseler, Cristina Queirós, and Miguel Basto-Pereira provide interesting insights from their case study. Considering that daily stress and limited coping skills can result in detrimental consequences for officers´ health and society welfare, they carried out their study among police personnel in Portugal using a daily diary. The study used the theoretical framework proposed by Lazarus and Folkman in describing coping as either problem-focused (PF) or emotion-focused (EF). Evidence from the study indicated that EROs experienced a variety of stressors and “operational stressors” were more commonly reported. In particular, “gun situations” was recorded as most stressful. When analyzing coping, EROs tended to use more EF coping, particularly the “peer support.” However, despite variation in coping effectiveness in accordance to stress experienced, the study findings suggested that PF coping seems to be more effective. The authors make a strong case for further research using longitudinal designs and through ecological research methods in different contexts.
Our final paper authored by Nualnong Wongtongkam explores the prevalence of incidences of violence, burnout and post-traumatic stress disorder witnessed by the paramedics in two Australian ambulance services. The paper argues that violence at work is considered a major occupational hazard worldwide and is of particular concern in the healthcare sector where it accounted for almost one-quarter of all workplace violence incidents. Drawing from a sample of paramedics in the two ambulance services, the study did not record significant differences between sites in timing of violent incidents, consequences of traumatic events or organizational provision. There was, however, a statistically significant difference between genders for being yelled at or verbally abused. When considering burnout, female paramedics showed significantly higher levels of emotional exhaustion and lower levels of career satisfaction than their male counterparts. Future research using bigger data sets can build upon the findings of this study but policy interventions to encourage female paramedics to display their professional identities and steps to enhance well-being and safety while on duty clearly follow from this study.
We are very pleased to share that IJES has been approved for inclusion in the American Sociological Association Publishing Options database. This will give greater visibility in North America and beyond. The new 2016 CiteScore metrics have now been released by Scopus and the journal score are available on our website. This comes after IJES was included in the Australian Business Deans Council’s list of approved journals last year.
We would also like to announce that our next issue will be focusing on policing and people leadership and is being guest edited by Dr Jonathan Smith (UK) and Dr Ginger Charles (USA). In recent times, there has been considerable investment in looking at future requirements for leadership in the police service and in developing these attributes. The editors wish to bring together both academics and practitioners in providing as series of thoughtful pieces which explore the people leadership qualities required of leaders in the police community over the next few years.
We again thank all of our authors, peer reviewers, and readers for supporting IJES over the last six years. We also value your feedback and are also particularly interested in your suggestions for future themes, topics, and expressions of interests for special issues. We hope you will enjoy reading this issue.
Paresh Wankhade and DeMond S. Miller