Justice Institute of British Columbia

New Westminster, Canada

Justice Institute of British Columbia

New Westminster, Canada
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Kowalski K.,University of Victoria | Tuokko H.,University of Victoria | Tallman K.,Justice Institute of British Columbia
Physical and Occupational Therapy in Geriatrics | Year: 2010

On-road assessment is an essential component of a comprehensive older driver evaluation. However, based on a systematic review of the older driver literature, it appears that the importance of specific elements within an on-road assessment differs depending on the following intended purpose of the evaluation: (a) the detection of impaired drivers; or (b) driver retraining. Moreover, driving rehabilitation specialists identify additional components as important. Directions for future research include the design of an on-road evaluation protocol that incorporates retraining as an integral part of the evaluation process. Through this approach, it may become clear which driving behaviors are amenable to retraining. © 2010 Informa Healthcare USA, Inc. All rights reserved.

Bowles R.R.,Justice Institute of British Columbia | van Beet C.,Justice Institute of British Columbia | Anderson G.S.,Justice Institute of British Columbia
Australasian Journal of Paramedicine | Year: 2017

Introduction This article presents a framework for describing four dimensions of paramedic practice: Practitioners, Practice Setting, Care and Patient Disposition. The framework emerged from a qualitative study conducted to identify potential research directions and opportunities to advance paramedicine and paramedic education at Justice Institute of British Columbia in Canada. Methods Researchers conducted semi-structured interviews with 17 stakeholders in Canadian paramedicine to explore the current state and emerging expectations of paramedic practice and paramedic education. Results The study found no consensus, and little agreement, on what term or terms best describe the profession. Participants agreed that the core of paramedic practice involves an advanced medical provider responding by ambulance to the patient’s side in an emergency to assess and treat urgent medical and traumatic conditions, then transport the patient to further medical care – most often an emergency physician at an emergency department. However, participants also described paramedics as healthcare providers who are increasingly taking on varied operational roles to improve patient care and address gaps in an evolving and stressed healthcare system. Four dimensions emerged for describing key characteristics of paramedic practice: the Practitioners, Practice Settings, Care and Patient Disposition. Discussion The framework described in this article may be useful for examining and better understanding both traditional and evolving paramedic roles. This, in turn, informs the efforts of paramedic educators, regulators, employers, and professional associations to support practitioners in the field. The article uses the framework to contrast two distinctly different community paramedic programs. © 2017, Paramedics Australasia. All Rights Reserved.

PubMed | University of British Columbia, London School of Hygiene and Tropical Medicine, University of Canberra, Flinders University and Justice Institute of British Columbia
Type: Journal Article | Journal: Prehospital and disaster medicine | Year: 2016

Mass gatherings (MGs) occur worldwide on any given day, yet mass-gathering health (MGH) is a relatively new field of scientific inquiry. As the science underpinning the study of MGH continues to develop, there will be increasing opportunities to improve health and safety of those attending events. The emerging body of MG literature demonstrates considerable variation in the collection and reporting of data. This complicates comparison across settings and limits the value and utility of these reported data. Standardization of data points and/or reporting in relation to events would aid in creating a robust evidence base from which governments, researchers, clinicians, and event planners could benefit. Moving towards international consensus on any topic is a complex undertaking. This report describes a collaborative initiative to develop consensus on key concepts and data definitions for a MGH Minimum Data Set. This report makes transparent the process undertaken, demonstrates a pragmatic way of managing international collaboration, and proposes a number of steps for progressing international consensus. The process included correspondence through a journal, face-to-face meetings at a conference, then a four-day working meeting; virtual meetings over a two-year period supported by online project management tools; consultation with an international group of MGH researchers via an online Delphi process; and a workshop delivered at the 19thWorld Congress on Disaster and Emergency Medicine held in Cape Town, South Africa in April 2015. This resulted in an agreement by workshop participants that there is a need for international consensus on key concepts and data definitions.

Anderson G.S.,Justice Institute of British Columbia | Gaetz M.,University of the Fraser Valley | Statz C.,University of the Fraser Valley
Prehospital and Disaster Medicine | Year: 2012

Introduction Immediate resuscitation is necessary in order to achieve conscious survival for persons who have lost airways or pulses. However, current literature suggests that even in medically-trained personnel, CPR skills are forgotten shortly after certification. Hypothesis/Problem The purpose of this study was to determine the CPR skill and knowledge decay in those who are paid to respond to emergency situations within the workplace. Methods Using an unconscious victim scenario, the sequence and accuracy of CPR events were observed and recorded in 244 participants paid to act as first responders in large industrial or service industry settings. Results A significant negative correlation was observed between days since training and a pre-CPR safety check variable, periodic checks for breathing and positioning. Many of the knowledge-related assessment skills (e.g., scene safety, emergency medical system (EMS) activation) appeared to deteriorate with time, although they could be contaminated by the repetition of training in those who had recertified one or more times. Skill-based components such as landmarking for chest compressions and controlling the airway declined in a more predictable fashion. Conclusion The results of this study suggest that repetition may be more important than days since last trained for skill and knowledge retention, and methods of refreshing skills should be examined. While skills deteriorate rapidly, changing frequency of certification is not necessarily the best way to increase retention of skill and knowledge. © 2012 World Association for Disaster and Emergency Medicine.

Cox R.S.,Royal Roads University | Perry K.-M.E.,Justice Institute of British Columbia
American Journal of Community Psychology | Year: 2011

In this paper we draw on the findings of a critical, multi-sited ethnographic study of two rural communities affected by a wildfire in British Columbia, Canada to examine the salience of place, identity, and social capital to the disaster recovery process and community disaster resilience. We argue that a reconfiguration of disaster recovery is required that more meaningfully considers the role of place in the disaster recovery process and opens up the space for a more reflective and intentional consideration of the disorientation and disruption associated with disasters and our organized response to that disorientation. We describe a social-psychological process, reorientation, in which affected individuals and communities navigate the psychological, social and emotional responses to the symbolic and material changes to social and geographic place that result from the fire's destruction. The reorientation process emphasizes the critical importance of place not only as an orienting framework in recovery but also as the ground upon which social capital and community disaster resilience are built. This approach to understanding and responding to the disorientation of disasters has implications for community psychologists and other service providers engaged in supporting disaster survivors. This includes the need to consider the complex dynamic of contextual and cultural factors that influence the disaster recovery process. © 2011 Society for Community Research and Action.

PubMed | University of the Fraser Valley, University of Bologna and Justice Institute of British Columbia
Type: Journal Article | Journal: Journal of bodywork and movement therapies | Year: 2016

This study examined improvements in static balance and muscle electromyographic (EMG) activity following a four week progressive training program in 16 middle aged females (mean age = 46.9 8.7 yrs; height 161.1 6.0 cm; weight 65.4 11.2 kg). Participants trained 3 times per week for 4 weeks, for 50 min per session, progressing base of support, stability, vision, resistance and torque in each of six basic exercises. Pre and post training measures of balance included feet together standing, a tandem stance and a one-leg stand (unsupported leg in the saggital plane) performed with the eyes closed, and a Stork Stand (unsupported leg in the frontal plane) with both eyes open and closed. In each position postural deviations were tallied for each individual while muscle recruitment was determined using root mean squared (RMS) EMG activity for the soleus, biceps femoris, erector spinae, rectus abdominis and internal oblique muscles of the dominant foot side. Balance scores were significantly improved post training in both the Balance Error Score System (p < 0.05) and stork stand positions (p < 0.01). Muscle activity was reduced post-training in all muscles in each condition except the soleus in the tandem position, although not all significantly. Reduced biceps femoris activity suggest that improved core stability allowed participants to move from a hip to an ankle postural control strategy through improved coordination of muscles involved in balance and reduced body sway. The core muscles were able to control body position with less activity post training suggesting improved muscle coordination and efficiency. These results suggest that short term progressive floor to BOSU balance training can improve standing balance in middle aged women.

Lund A.,Royal Columbian Hospital | Turris S.A.,University of British Columbia | Bowles R.,Justice Institute of British Columbia
Prehospital and Disaster Medicine | Year: 2014

Mass gatherings (MG) impact their host and surrounding communities and with inadequate planning, may impair baseline emergency health services. Mass gatherings do not occur in a vacuum; they have both consumptive and disruptive effects that extend beyond the event itself. Mass gatherings occur in real geographic locations that include not only the event site, but also the surrounding neighborhoods and communities. In addition, the impact of small, medium, or large special events may be felt for days, or even months, prior to and following the actual events. Current MG reports tend to focus on the events themselves during published event dates and may underestimate the full impact of a given MG on its host community. In order to account for, and mitigate, the full effects of MGs on community health services, researchers would benefit from a common model of community impact. Using an operations lens, two concepts are presented, the vortex and the ripple, as metaphors and a theoretical model for exploring the broader impact of MGs on host communities. Special events and MGs impact host communities by drawing upon resources (vortex) and by disrupting normal, baseline services (ripple). These effects are felt with diminishing impact as one moves geographically further from the event center, and can be felt before, during, and after the event dates. Well executed medical and safety plans for events with appropriate, comprehensive risk assessments and stakeholder engagement have the best chance of ameliorating the potential negative impact of MGs on communities. Copyright © World Association for Disaster and Emergency Medicine 2014.

Turris S.A.,University of British Columbia | Turris S.A.,University of Vic | Lund A.,University of British Columbia | Bowles R.R.,Justice Institute of British Columbia
Disaster Medicine and Public Health Preparedness | Year: 2014

Objectives Mass gatherings (MGs) and special events typically involve large numbers of people in unfamiliar settings, potentially creating unpredictable situations. To assess the information available to guide emergency services and onsite medical teams in planning and preparing for potential mass casualty incidents (MCIs), we analyzed the literature for the past 30 years. Methods A search of the literature for MCIs at MGs from 1982 to 2012 was conducted and analyzed. Results Of the 290 MCIs included in this study, the most frequently reported mechanism of injury involved the movement of people under crowded conditions (162; 55.9%), followed by special hazards (eg, airplane crashes, pyrotechnic displays, car crashes, boat collisions: 57; 19.6%), structural failures (eg, building code violations, balcony collapses: 38; 13.1%), deliberate events (26; 9%), and toxic exposures (7; 2.4%). Incidents occurred in Asia (71; 24%), Europe (69; 24%), Africa (48; 17%), North America (48; 27%), South America (27; 9%), the Middle East (25; 9%), and Australasia (2; 1%). A minimum of 12 877 deaths and 27 184 injuries resulted. Conclusions Based on our findings, we recommend that a centralized database be created. With this database, researchers can further develop evidence to guide prevention efforts and mitigate the effects of MCIs during MGs. Copyright © 2014 Society for Disaster Medicine and Public Health, Inc.

Anderson G.S.,Justice Institute of British Columbia | Bowles R.,Justice Institute of British Columbia
Road and Transport Research | Year: 2015

Background: Data from around the world would suggest that attention to safety during work-related driving should be a priority as traffic accidents are the leading cause of work-related injury, death and absence from work in many countries. Purpose: This study examines the characteristics of the grey fleet (those who drive personal vehicles for the purposes of work), and the road safety programs that are presently in place in British Columbia. Method: A 'Grey Fleet Employer Survey' was distributed via email to a random sample of 15% of all employers in British Columbia Of 5023 emails delivered successfully 531 respondents were captured in the data (10.6% response), of which 104 declined participation leaving 427 who completed surveys (8.4% response rate). Results: Of those companies responding 64.4% of them reported having a grey fleet with 36.6% of employees from small companies (4-19 employees), 21.0% of the employees from medium (20-99 employees) and 12.2% of employees from large (100+ employees) companies driving personal vehicles for work-related purposes. Of those employers reporting a grey fleet 75.2% checked to make sure employees who drove had a valid drivers' licence, typically at the time of hire (70.5), with 39% checking on an annual basis. Few companies (17.8%) required employees to inspect their own vehicles before starting each trip. The majority of employers (74.6%) believed it was the employee's responsibility to inspect their own private vehicles, and this was true across small (73.6%), medium (73.6%) and large (77.8%) employers. Conclusion: Employers who use grey fleets are not certain of their legal requirements under Worker's Compensation Act (duty of care), and education and training is required concerning the employer and employee responsibilities concerning driving safety.

Monteith R.G.,Justice Institute of British Columbia | Pearce L.D.R.,Justice Institute of British Columbia
Prehospital and Disaster Medicine | Year: 2015

Growing awareness and concern for the increasing frequency of incidents involving hazardous materials (HazMat) across a broad spectrum of contaminants from chemical, biological, radiological, and nuclear (CBRN) sources indicates a clear need to refine the capability to respond successfully to mass-casualty contamination incidents. Best results for decontamination from a chemical agent will be achieved if done within minutes following exposure, and delays in decontamination will increase the length of time a casualty is in contact with the contaminate. The findings presented in this report indicate that casualties involved in a HazMat/CBRN mass-casualty incident (MCI) in a typical community would not receive sufficient on-scene care because of operational delays that are integral to a standard HazMat/CBRN first response. This delay in response will mean that casualty care will shift away from the incident scene into already over-tasked health care facilities as casualties seek aid on their own. The self-care decontamination protocols recommended here present a viable option to ensure decontamination is completed in the field, at the incident scene, and that casualties are cared for more quickly and less traumatically than they would be otherwise. Introducing self-care decontamination procedures as a standard first response within the response community will improve the level of care significantly and provide essential, self-care decontamination to casualties. The process involves three distinct stages which should not be delayed; these are summarized by the acronym MADE: Move/Assist, Disrobe/Decontaminate, Evaluate/Evacuate. © World Association for Disaster and Emergency Medicine 2015.

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