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Introduction As registered health professionals, Australian paramedics are required to abide by professional registration standards including the maintenance of continuing professional development (CPD). The broader health literature identifies facilitators, barriers and motivators for engaging in CPD, however the body of knowledge specific to paramedicine is weak. This research seeks to address this gap in the paramedicine body of knowledge. Methods This study adopts a constructivist grounded theory methodology. Data were collected through semi-structured interviews, and analysed using first and second cycle coding techniques. Paramedics from various state-based Australasian ambulance services and private industry (N=10) discussed their experiences specific to their attitudes, perceptions and engagement about CPD. Results Paramedic CPD goes beyond the traditional approach to mandatory training. Paramedics are motivated by factors such as modality of delivery, professional expectations, clinical/professional improvement and, sometimes, fear. Facilitators included organisational support, improved clinical knowledge, practitioner confidence, self-directed learning opportunities and perceived relevance of content. Barriers include cost, workload/fatigue, location, rostering, lack of incentive to engage, lack of employer support and technological problems. Conclusion By understanding what facilitates or motivates engagement in CPD activities, paramedics can navigate their CPD in conjunction with regulatory requirements. Although paramedics report some similar experiences to other health professionals, there are nuances that appear specific to the discipline of paramedicine. Of interest, a unique finding related to fear influencing paramedic CPD engagement. The results of this study informs paramedic employers and paramedic CPD providers with insights to assist in the development of positive CPD experiences and interactions.

Introduction This study explores the career intentions of undergraduate university paramedic students. Other like studies have been completed before paramedicine registration, and this is the first career intentions study to focus on the Queensland perspective. Methods Second year Queensland University of Technology (QUT) undergraduate paramedic students (n=182) were invited to participate. Ethics approval was gained and consent to participate was implied by the completion of a mixed methods questionnaire developed from the extant literature. Data were coded and analysed using Stata 15.1 and NVIVO 12. Results The response rate was 47.3% (n=86). Findings indicated 82.35% of participants intend to pursue paramedic employment after graduating. Queensland Ambulance Service is the preferred choice of employer (78.05%), however 67.07% intended to apply to multiple services for employment, 62.2% are considering private industry employment and 59.76% are contemplating overseas work. Intended paramedicine career length revealed 39.5% of participants plan to work for 20 years or more, 29% for 6–10 years and 18.4% for 11–15 years. Qualitative findings suggest students are concerned about employment opportunities, dislocation from support networks, and feeling unprepared to work in other paramedic jurisdictions. Furthermore, the employer's reputation, culture, internship program and career development opportunities impact on employment decisions. Conclusion The paramedic landscape in Australia appears to be changing. Although the majority of participants intend to work for jurisdictional ambulance services, students are exploring a range of employment opportunities. Understanding the career intentions of undergraduate paramedic students is essential for universities when preparing students for the transition to a globally evolving profession.

Despite being one of the largest carbon emitters in the world, the United States has little direct emphasis on climate change in its schools. Even where there is desire to teach climate change, the politicization of climate change sees school leaders steering teachers away from the topic. This piece examines what we know about climate change education in the U.S., what types of curriculum we have had, what historical conditions saw the U.S. curriculum change, and asks whether and how climate change can and should be a superordinate concern of U.S. schooling. As U.S. schools on whole have never been a site of equity concerning matters of race, class, gender, and many other issues, we ask whether climate change will be subsumed or taken up as a concern. We pose two alternate futures: one in which the scale of climate change as a problem sees changes in how we educate our young and affect the future, or another where the potential for a healthy climate becomes a prime concern of burgeoning revanchist, fascistic leaning governments worldwide and ecofascist social movements within them.

This commentary discusses two valuable extracurricular opportunities that exist for undergraduate paramedic students to further develop the attributes and capabilities necessary for becoming more competitive in gaining graduate employment in Australian ambulance services. The authors propose that participation in peer programs and CPD while at university offer a relatively simple, cost-effective and equitable opportunity for students to improve their competitiveness for employment with Australian ambulance services.

The term ‘paramedicine’ is an ever-increasing part of the lexicon in numerous ambulance services and stakeholder organisations across the globe. However, it is unclear if a consensus exists on the definition of paramedicine that transects international boundaries. This editorial intends to stimulate a robust discussion to find an international consensus on the definition of paramedicine.

IN A RECENT PAPER, ROBERT KAGAN(1) argued that the current transatlantic drift can be attributed to the fact that Americans and Europeans see the world in fundamentally different ways. Kagan suggests that Europeans are from Venus and Americans from Mars; the point being that Europeans tend to look for peaceful settlement, processes of accommodation and compromise, while Americans are goal oriented and much more likely to resort to the use of force in the pursuit of those goals.(2) He further claims that attitudinal differences between the US and Europe are not simply the product of cultural factors and states of mind, but rather are a response to the surfeit of power and influence in the US and the relative weakness of the states of the European Union. The point is, then, that the EU is accommodating because it has to be, and the US more assertive because it can be.Kagan's paper has had the impact it has had because of the current context of transatlantic relations. While overdrawn and exaggerated, Kagan's caricature hit a nerve both in the US and, more importantly, in Europe, and seems to have gained extra points given the seriousness of the disputes within NATO regarding the Iraq War.(3) If there is agreement that there is a crisis in transatlantic relations, there is disagreement among IR scholars as to its cause. Kagan points to differences of world views regarding power and attitudes to its use. Meanwhile, Europeans are fond of blaming the current US administration, and there is a kernel of truth to this, at least insofar as American foreign policy has appeared quite (consistently) unilateralist of late. Not so long ago, however, John Mearsheimer(4) claimed that we would long for the days of the Cold War because of the certainties and the alignments that it gave us. Structural realist theory, starkly presented by Mearsheimer, predicts that alliances like NATO will disintegrate in the absence of their raison d'etre, the threat from the Soviet Union. Such predictions depend on an assumption regarding the key purpose of an organization like NATO. Canadians, in particular, might want to point to the transatlantic identity aspect of NATO. The territorial defence of western Europe was poured into the mould of this identity in the dire emergency of the growing chill in east-west relations after the end of the Second World War. Another theoretical framework suggests that NATO might persist because of the value of the functions it fulfills as an organization, rather than as a single purpose defensive alliance. This institutionalist view states that organizations are valued by their members for creating certainty in international relations and because organizations are harder and more costly to create than to maintain (politically, at any rate). As a result, this approach suggests we should expect that NATO will persist long past its sell-by date (that is, the end of the Cold War, the end of the Soviet Union or the end of a meaningful Russian military threat). So long as members find it useful, an organization will continue to survive.(5)Unfortunately, every theoretical approach (even the reputedly optimistic constructivists) seems to indicate that transatlantic relations are in trouble. This is because the bond that has kept transatlantic relations has loosened. And this is true whether the bond was thought to be based on security, utility or identity. NATO is now useful rather than necessary. And the centrality of European security has been transcended by 9/11, which has set a new global security agenda, and by the (near) completion of the project of enlargement. What does this mean for Canada and what should Canadian foreign policy look like with respect to transatlantic relations? If we return briefly to Kagan's metaphors, Canadians might ask whether we are Martians or Venusians. Some observers appear to want us to be American and hope that Canada will adopt, in Kagan's terms, a Martian approach to international affairs. …

This article describes how microsimulation analysis was used to help design a social experiment currently being conducted in two provinces in Canada. To the authors' knowledge, microsimu lation has never been used before for this purpose, although the technique has been used to assist development of a couple of nonexperimental demonstration programs. For the Canadian experiment, the microsimulation analysis was used primarily for choosing among alternative program models and for refining the selected model, but it had other important uses, such as helping to project the potential financial liability to the Canadian government. The authors conclude that microsimulation should be given serious consideration in the design of future experiments, whenever an appropriate simulation model is available.

This chapter advances a critique of an increasingly dominant school in international relations: the Harvard School of Liberal International Theory.The academics who make up this school are joined in a common project of creating an alternative to realism and neorealism in international theory, and draw explicitly or silently on liberal premises, theories and/or ideas to advance this project. The focus of this chapter is on two authors, Robert O. Keohane and Andrew Moravcsik, who exemplify the Harvard School of Liberal International Theory.

Ferritin concentrations in blood are a good indicator of iron stores1 and can be measured in plasma or serum with commercial kits. We have measured plasma ferritin content in infants ranging from 3 to 15 months of age. During the first three years of a four-year study, plasma samples drawn from these infants were shipped to Abbott Laboratories in Chicago and assayed using the Ferrizyme immunoassay technique (Abbott Laboratories, Chicago, Illinois). For the last year of the study, we analyzed the remaining samples in St. John's using the radioimmunoassay GammaDab 125I Kit (Baxter Travenol Diagnostics, Inc., Cambridge, Massachusetts). Both kit manufacturers report inter-and intra-assay variability of ≤ 5 %. Results for samples analyzed by the second method were higher than earlier results from infants of the same age with the same intakes of iron; thus, we decided to analyze subsequent samples with both kits.

THE ARTICLE, "Practicing Radical Pedagogy: Balancing Ideals with Institutional Constraints," initially brought to mind Richard Bach's (1977) comment that "We teach best what we need to learn most." In a sense, the article gives flesh to Bach's insight by taking seriously the assumption that being and becoming the "best" teacher one can be demands an openness to scrutinizing one's own pedagogical philosophy and practice with a critical eye. Moreover, in good sociological fashion, the author reminds us that "good" teachers also reflect critically on the relationship between the contexts and circumstances in which they teach and the sometimes uncomfortable pedagogical compromises they make. That teachers need to be reminded of this struggle from time to time is illustrated by way of a personal anecdote that recounts Sweet's experience of being challenged by a student who asked the simple and always disarming question, "Why don't you practice what you preach?" While I appreciate Sweet's concern over this question, I believe that Sweet and I view this basic dilemma of radical teaching somewhat differently. Prior to suggesting how I think the radical teacher ought to engage this dilemma, some preliminary comments are in order.

L'A. expose sa conception selon laquelle l'enseignement de la sociologie devrait etre une experience liberatrice pour les etudiants comme pour les enseignants. Il pose la question d'une pedagogie de la liberation pour la sociologie. Dans ce but il convient, d'une part, de comprendre pourquoi et comment les chercheurs s'interessent a certaines theories et a certaines perspectives et, d'autre part, de communiquer cette comprehension. L'A. presente un certain nombre d'exemples de ce modele d'enseignement

Most accounts of the development of the functional approach in international relations begin with a brief tribute to some of the precursors, such as Arthur Salter, Paul S. Reinsch, Leonard Woolf, the Fabians, Guild Socialists, and Pluralists. They then move swiftly on to David Mitrany's A Working Peace System and a logical evaluation and an assessment in light of subsequent experience in the realm of international organization.1 This

Most quality assurance professionals can rightly claim that their units and the laboratories they inspect work in compliance with good laboratory practice (GLP) regulations. However, compliance itself is only the beginning. Quality assurance (QA) should now turn its attention to the process of optimizing operations in the industry by identifying weak links in the quality chain and working to remove the likelihood of failures and wasted time. Part of this process involves measuring QA impact. Impact can be evaluated in terms of effectiveness or efficiency. The difference between effectiveness and efficiency is discussed here. Measuring effectiveness involves quantifying effects; measuring efficiency involves quantifying the relationship between effect and effort. Some practical approaches to the collection of suitable data are outlined. There are no clear-cut rules for measuring QA impact. So far, the techniques available for assessing impact are rudimentary. However, it is important that all quality assurance professionals tackle the problems of evaluating their impact in order to strive toward higher standards of performance and toward greater understanding of the role of QA within the industry.

A patient with embolic occlusion of the right femoral artery and the left tibial arteries received streptokinase as treatment to lyse the emboli. Blood flow in both lower extremities improved with streptokinase administration. On the fourth day of therapy, however, the patient developed pain and swelling of the right calf. A venogram confirmed the presence of a clot obstructing the right popliteal vein. Streptokinase infusion was stopped, and urokinase infusion was started. Pain and swelling in the right calf disappeared and venous blood flow was greatly improved during urokinase therapy. Urokinase infusion was stopped after sixty hours, and heparin therapy was started. The patient was discharged from the hospital one month after admission. Patients should be closely monitored during thrombolytic therapy to detect any signs of complica tions, including new thrombotic episodes.