Certificate Level Research Articles

Structural Design Synthesis of Aircraft Engine Pylons at Certification Level of Detail

Structural optimization technology, as advanced as it has become, is still not used to fully automate the design of airframe components at a level of analysis detail that would be acceptable for certification by regulatory agencies. It is part of the development of certifiable structures but is still just a part, requiring significant manual labor invested by stress engineers working with empirical and semi-empirical methods for detail analysis periodically along the design path. The Paper presents an attempt to apply an integrated model-based systems engineering philosophy, fully automated, to the process of designing and certifying aircraft structures with a level of detail and scope of modeling that would meet certification requirements. The Paper presents comparisons, not available until now, between the cost and time required by current design methods practiced in industry and required for certification and by an integrated model-based design method in the case of a particular and important aerospace structural system: the engine pylon. Weight and the development costs of the resulting designs are compared. It allows for the first time an examination of the benefits of product weight performance of the integrated model-based approach as well as engineering effort in a highly realistic certification-driven structural design case. The Paper also describes technical modeling and design automation innovations required to build the practical certification level integrated design optimization platform used here.

Marine Stewardship Council sustainability certification in developing countries: Certifiability and beyond in Kerala, India and The Gambia, West Africa

The Marine Stewardship Council (MSC) features small-scale and developing country fisheries prominently in promoting its sustainability program, yet the problem of low levels of certification in developing country fisheries is a long-standing and important issue in marine policy. The objective of this paper is to better understand small-scale, developing country fishery experiences with the oldest fisheries certification program globally. It does so primarily through a comparative case study of fisheries that were among the first in their wider regions to engage the program. The paper assesses fisheries in Kerala, India, and The Gambia, West Africa, detailing the evolution of engagement with MSC sustainability certification. Analytically, the paper assesses experiences, successes and frustrations in these cases across ecological, economic, social, and institutional dimensions—categories that have gained widespread appeal in sustainability studies. The paper finds that what makes a fishery certifiable or uncertifiable is not just levels of performance against the sustainability certification standard but also a broader range of relations and interactions that influence paths of development and change in fisheries. We, therefore, call for more explicitly integrated and critical explanatory social science and interdisciplinary evaluations of fisheries certifiability, broadly understood as impacted by diverse ecological, social, economic and political factors and relationships. Technical certifiability, social-ecological certifiability, and uncertifiability will be introduced to broaden our understanding.

Prospective nursing care certification using the 25-question Geriatric Locomotive Function Scale.

The 25-question Geriatric Locomotive Function Scale (hereafter, "GLFS-25") is a simple screening tool to detect elderly individuals at high risk of locomotive syndrome and promote interventions. This cohort study aimed to clarify if it can predict the need for nursing care certification in the near future. Participants were 531 Japanese adults aged ≥65 years who had undergone a healthcare checkup in 2012 and never received nursing care certification until 2012. We collected baseline information and conducted a physical examination in 2012. We investigated the presence of nursing care certification and care need level from 2013 to 2018. Relationships of these factors with nursing care certification after 6 years were assessed. A receiver operating characteristic curve for both the GLFS-25 and physical examination were used to determine optimal threshold value. From 2013 to 2018, 114 volunteers (21.4%) applied for nursing care certification and 29 volunteers died. The group with nursing care certification (over support level 1) had an average age of 79.9 years and a mean score of 17.8 on the scale. Those without nursing care certification had an average age of 74.1 years and a mean score of 8.7. When the GLFS-25 score was 12.5, sensitivity was 0.658 and specificity was 0.760. The area under the curve was 0.736 (95% confidence interval 0.682-0.789). The GLFS-25 has enabled early detection of individuals with locomotive syndrome who are more likely to need nursing care certification in the near future. We propose using a cutoff score of 13 for the scale. Geriatr Gerontol Int 2021; 21: 492-497.

Psychiatric Nurses' Perceptions of Therapeutic Alliance With Individuals With Schizophrenia: A Survey Study.

Research on nurse-patient relationships with the schizophrenia population is sparse. The current study piloted a survey to explore therapeutic relationships. Fifty-one psychiatric nurses completed an online survey on therapeutic relationships with the schizophrenia population. Factor and chi-square analysis yielded preliminary findings. Fifteen of 16 survey items loaded onto four factors at ≥0.4. A significant association between level of education and professional certification and comfort working with patients with schizophrenia was found. Survey modifications and a larger sample size may generate useful information and clarify the relationship among education, certification, and comfort. [Journal of Psychosocial Nursing and Mental Health Services, 59(4), 21-29.].

Learning Transfer Exploration Model from Skill Institute to Workplace, PLS-SEM Approach

Skills and job mismatch issues have become common and recurring issues in Technical and Vocational Education Training (TVET). This issue is associated with the transfer of learning that involves various factors such as the area of training, certification level, curriculum, instructors, facilities and resources and industry recognition. In line with the Baldwin & Ford model, learning transfer involves three major factors such as the trainee’s characteristics, the training design and working environment. Therefore, identify the factors which contribute to the effective transfer of learning is necessary. This study attempts to identify which factors are contributing to learning transfer based on National Occupational Skill Standard (NOSS) system in skill institutes in Malaysia to workplace. This is because the lack of relevant studies related to the learning transfer on the NOSS system and at once makes it difficult to emphasize the factors to be considered for effective transfer of learning. The design of the survey study through the distribution of questionnaires to 309 Malaysian Skills Certificate trainees was done to generalize the study findings. This study used the Partial Least Squares-Structural Equation Modeling (PLS-SEM) tool to validate the model. PLS-SEM is choose because it can predict and explain constructs target. Then it can explore the relationship between the construct. Besides that, PLS SEM is chosen because this method can be done on complex structure equation model that consists more constructs and indicators. PLS-SEM can also control both a reflective and formative constructs. Findings indicate that work environment and training design positively influences learning transfer be represented by generalization and retention construct. The findings provide useful insight and information regarding the learning transfer that correlate with mismatch issues that policy makers, training provider, employers and trainees need to consider to produce highly skill workers subsequently completed this skills mismatch issue.

Embodied emissions of buildings - A forgotten factor in green building certificates

The construction and use of buildings consume a significant proportion of global energy and natural resources. Leadership in Energy and Environmental Design (LEED) is arguably the most international green building certification system and attempts to take actions to limit energy use of buildings and construct them sustainably. While there has been a wide range of research mainly focused on energy use and emission production during the operation phase of LEED-certified buildings, research on embodied emissions is rare. The aim of this study is to evaluate the efficiency of LEED regarding initial (pre-use) embodied emissions using life cycle assessment (LCA). The study comprised several steps using a designed model. In the first step, three optional building material scenarios were defined (optimized concrete, hybrid concrete-wood, and wooden buildings) in addition to the base case concrete building located in Iceland. Second, an LCA was conducted for each scenario. Finally, the number of LEED points and the level of LEED certification was assessed for all studied scenarios. In addition, a comparison regarding embodied emissions consideration between LEED and Building Research Establishment Environmental Assessment Method (BREEAM) as mostly used green certificate was conducted in the discussion section. The LCA showed the lowest environmental impact for the wooden building followed by the hybrid concrete-wood building. In the LEED framework, wooden and hybrid scenarios obtained 14 and 8 points that were related to material selection. Among these points, only 3 (out of a total of 110 available points) were directly accredited to embodied emissions. The study recommends that the green building certificates increase the weight of sustainable construction materials since the significance of embodied emissions is substantially growing along with the current carbon neutrality goals. As most of the materials for building construction are imported into Iceland, this study is useful for locations similar to Iceland, while overall it is beneficial for the whole world regarding climate change mitigation.

Carotid web: an under-recognized and misdiagnosed ischemic stroke etiology

BackgroundCarotid web (CaW) constitutes a possible cause of ischemic stroke, particularly large vessel occlusion syndromes. We aim to evaluate misdiagnosis rates and diagnosis trends for CaW.MethodsBased on CT angiography (CTA),...

Обучение языку специальности студентов-музыкантов из Китая: из опыта использования учебного пособия «Поговорим о музыке по-русски»

The study aims to consider possibilities of using in educational process the textbook “Let’s Talk about Music in Russian”, developed by researchers and designed for teaching language for specific purposes to student musicians from China, who are proficient in Russian at the First Certification Level (TORFL-I/B1). The article showcases creative tasks from the textbook “Let’s Talk about Music in Russian”, intended to increase interest in study of the Russian language and to reinforce musical terminology. Scientific novelty of the work lies in developing methodological recommendations for using the textbook “Let’s Talk about Music in Russian” in educational process. As a result, it has been proved that texts and creative tasks from the textbook “Let’s Talk about Music in Russian” possess a didactic potential and allow the Chinese students to develop discussion skills in the field of professional communication.

ASSERTIVENESS AND SELF-ESTEEM AMONG NURSING STUDENTS OF MANIPAL COLLEGE OF MEDICAL SCIENCE OF POKHARA, NEPAL

Background: Assertive behaviour and low self-esteem have been found to major problem in the nursing profession. Nursing students today are the backbone of professional nurses of tomorrow. In order to ensure competent and safe practice, it is necessary for them to be individuals with high assertive skills and self-esteem. This study was conducted to identify assertiveness and self-esteem among nursing students.
 Methods: A descriptive cross sectional survey was conducted among 202 Proficiency Certificate Level and Bachelor of Science in nursing students of Manipal College of Medical Sciences (nursing programme), Pokhara, Nepal during July/August 2015. Data collection was done by purposive sampling. Tools used were demographic proforma, Begley and Glacken Assertiveness behavior questionnaire and Rosenberg self-esteem scale. Data were analyzed using descriptive and inferential sta­tistics chi-square and correlation coefficient.
 Results: The study revealed nursing students had moderate level of as­sertiveness and self-esteem. There is a significant association between assertiveness and level of study and residence. There is a significant as­sociation between level of self-esteem with level of study and residence and There is significant positive correlation (r= 412) among assertive­ness and self-esteem score with p value <0.001.
 Conclusion: It is concluded that majority of nursing students have mod­erate assertiveness and self–esteem. Nurse educators should take ini­tiation to improve high assertiveness and self-esteem of nursing stu­dents.

СОЦИОКУЛЬТУРНЫЕ ЗНАНИЯ КАК СРЕДСТВО АДАПТАЦИИ В ИНОЯЗЫЧНОЙ СРЕДЕ (НА УРОКАХ РУССКОГО ЯЗЫКА КАК ИНОСТРАННОГО)

The article provides a methodological description of a lesson on the discipline "Russian as a foreign language" on socio-cultural topics: "Youth is the future of the planet." This lexical topic is intended for study and discussion by foreign students studying Russian at the basic or first certification level. Depending on the distribution of academic hours for studying the Russian language, this topic can be considered both in the preparatory department and in the 1st or 2nd year. Of course, the topic is fertile enough for discussion at any stage of language learning, however, from the point of view of the socio-cultural adaptation of foreigners, it is advisable to conduct a lesson on such a topic when students acquire sufficient vocabulary, and knowledge of the language reaches a level where the student can ask a question, formulate and argue your point of view. In the methodological development, not only textual material and a system of tasks for the development of speech skills are presented, but also a dictionary of the topic with an optimal set of vocabulary on this topic and a system of grammatical and syntactic exercises. The lexical topic and the entire structure of the lesson allows students not only to exchange opinions, but to look at this problem through the eyes of a Russian-speaking young person, to find common problems for all and ways to solve them.

ЭЛЕКТРОННОЕ УЧЕБНОЕ ПОСОБИЕ ПО РКИ КАК ОБРАЗОВАТЕЛЬНЫЙ РЕСУРС И ФАКТОР ЯЗЫКОВОЙ АДАПТАЦИИ ИНОСТРАНЦЕВ В УСЛОВИЯХ РОССИЙСКОГО ГОРОДА И ВУЗА

The article outlines the principles and methods of presentation of educational material, content features and prospects for using such a resource as an electronic textbook in the practice of teaching foreigners focused on obtaining higher education in Siberian universities. The publication demonstrates the advantages of an electronic textbook that combines the academism of traditional (habitual) ways of organizing content with the efficiency and accessibility of modern information and communication technologies, since the latest methods of presenting material significantly expand the didactic potential of an electronic textbook, making it an effective means of forming the communicative competence of students. The article contains descriptions of the specifics of the materials that formed the basis of the electronic manual, examples of texts and assignments that form individual competencies and the first certification level of language proficiency in general, as well as indications of the prospects for using such educational resources in teaching practice. Despite the fact that the presented manual is aimed at foreigners studying at a specific Tyumen university, the resource can be useful for teachers of RFL in other cities and even abroad, since it introduces the realities of life in Russia from the angle of intercultural dialogue and the idea of comfortable language adaptation using computer technologies.

Discourse Functions of Lexical Bundles in Pakistani Chemistry and Physics Textbooks

Lexical bundles (LBs) are indispensable building blocks and essential constituents of academic discourse. The appropriate utilization of the lexical bundle’s approach can effectively enhance students’ understanding of academic discourse. LBs in various academic genres have extensively been studied concerning written and spoken language. However, less research has been conducted to explore the occurrence, nature, and frequency of LBs in Pakistani academic discourse, especially in textbooks. Therefore, the present study aims to explore four-word common LBs and their functional taxonomies employed in Pakistani Higher Secondary School Certificate (HSSC) level textbooks of Chemistry and Physics. A specialized corpus of these textbooks was built which was run on Antconc software for the identification and extraction of the LBs in the corpus. The classification of the identified LBs was then carried out utilizing Biber functional taxonomies of LBs. The study found 102 LBs occurring in the selected textbooks. In functional categories, there was a dominant use of discourse organizers and referential expressions. The findings related to frequent strings of words which can have significant educational implications for teachers, language material developers, and syllabus designers. The list of LBs with discourse functions provided by this study can significantly be used to enhance students’ academic writing and their ability to comprehend different types of scientific texts.

Role of the National Institute of Library and Information Sciences to Empower Teacher Librarians in Sri Lanka

The National Institute of Library and Information Sciences (NILIS), an Institute affiliated with the University of Colombo, in Sri Lanka, was established in 1999, with the main objective of training Sri Lankan school librarians and other library staff, under the World Bank project. Accordingly, in 2002, NILIS commenced Certificate, Diploma, and Post-graduate courses for teacher librarians. Concurrently the Ministry of Education selected and trained 4000 teacher librarians with the assistance of NILIS. The training consisted of short term and long term programs commencing at the certificate level and leading to the post graduate level . Teacher librarians were mainly trained to manage school libraries; while being empowered to teach the subjects in which they specialized in the university, or Information literacy, in order to give them the same status as the other teachers. To date NILIS has trained around 2000 teacher librarians under the different categories. In this study, the number of training sessions conducted, number of teachers trained, and the outcome of the programs are elaborated and discussed. Finally, the performance of the teacher librarians after the completion of the masters in teacher librarianship course conducted by NILIS is critically discussed, using the data collected by the interview method with the random sampling technique. The results show that most of the teacher librarians trained at NILIS are performing school library organization activities at a more satisfactory level than prior to receiving their training. Nevertheless, the teaching of information literacy by the teacher librarians to the school children is not being fulfilled at a satisfactory level. Most of the teacher librarians who have obtained higher professional qualifications at NILIS are unsatisfied due to problems with regard to their promotional schemes. Since 2005, NILIS and other relevant bodies have been striving to resolve the problems of the teacher librarians, but so far their efforts have not been successful.

Sustainable site selection using system dynamics; case study LEED-certified project

ABSTRACT This study establishes a dynamic modelling for site-related credits. Guidelines of the ‘Leadership in Energy and Environmental Design’ (LEED) system are used for the context and project levels under Location and Transportation (LT) and Sustainable Sites (SS) categories, respectively. The research steps are; determining site-dependent credits based on LEED project checklist and credit-weighting calculator, calculating the dependency coefficient of credits and categories, developing representative causal-effect feedback loops and a stock-and-flow model using VENSIM-PLE and testing two alternative project site locations. Studying these intrinsic relations reveals that proper site selection may earn the project 63% of total available points which qualifies it to LEED Gold certification level. The results show the dominant effect of site selection on the context and site-related credits. It also shows the latent effect on other sustainable categories; the highest impact is seen for energy-related credits (EA), followed by indoor environmental quality (IEQ), materials and resources (MR) and finally for water efficiency (WE). Comparing site-dependent credits for LEED Version 3.0 and 4.0 shows that they are less in WE and EA for the latter and more for the MR and IEQ categories. This shows that the improper selection of a project site may eventually lead to downsizing building performance. Furthermore, the proposed model establishes a dynamic predictive tracing and evaluation mechanism for the rate and pattern of point-scoring scenarios to achieve sustainability targets and level of certification. It also proposes a new datum to assess the sustainability of site locations; both in a comparative and absolute manner.

Influence of musical background on surgical skills acquisition

BackgroundThere is growing interest in identifying trainees with surgical aptitude predictive of eventual technical proficiency. Musical tasks involve complex, cerebral activity, and ambidextrousity, which may have a positive impact on the acquisition of surgical skill sets. The purpose of this study was to investigate the influence of prior musical experience on the performance of basic surgical skills. MethodsThis was a prospective cross-sectional study involving 51 novice undergraduate and medical school trainees with no prior surgical exposure. Musicality was assessed with a detailed survey and objectively with the Mini-Profile of Music Perception Skills test. Dexterity was assessed using the Purdue Pegboard test. Surgical skills were then evaluated by performing 2 timed suturing trials after observing tutorial video, followed by a timed laparoscopic peg transfer test. Outcomes included both speed and quality of performance. ResultsParticipants with prior musical experience performed better than nonmusicians on the Mini-Profile of Music Perception Skills test (P = .015), dominant hand dexterity (P = .05), suture quality (P < .03), and laparoscopic peg transfer speed (P < .01). There was no significant difference in the suturing speed between musicians and nonmusicians. The dexterity and Mini-Profile of Music Perception Skills scores were predictive of suture quality (P < .01). Among musicians, duration of musical training, inactivity, instrument type, and certification levels did not correlate with differences in surgical task performance. ConclusionMusical background is associated with better performance of fundamental surgical skills among surgical novices, particularly technique quality. Although this does not imply superior ultimate surgical ability, musicality may be a marker for basic surgical skill development useful in identifying suitable candidates for surgical training.

Barriers to Physical Activity Among Emergency Medical Services Professionals.

Emergency medical services (EMS) professionals demonstrate low adherence to physical activity guidelines and experience a high prevalence of obesity and incidence of injury. The authors investigate the barriers to participating in physical activity among EMS professionals. The EMS professionals employed by 15 North Carolina EMS agencies were surveyed with validated items. Multivariable logistic regression models were used to estimate the odds (odds ratio, 95% confidence interval) of not meeting physical activity guidelines for each barrier to being active, controlling for age, sex, body mass index category, race/ethnicity, certification and education level, and work hours. A total of 1367 EMS professionals were invited to participate, and 359 complete responses were recorded. Half of the respondents (48.2%) met Centers for Disease Control and Prevention physical activity guidelines. According to standard body mass index categories, 55.9% were obese. There were increased odds of not meeting physical activity guidelines for the following barriers: lack of energy (5.32, 3.12-9.09), lack of willpower (4.31, 2.57-7.22), lack of time (3.55, 2.12-5.94), social influence (3.02, 1.66-5.48), and lack of resources (2.14, 1.12-4.11). The barriers of fear of injury and lack of skill were not associated with meeting physical activity guidelines. Half of EMS professionals did not meet physical activity guidelines, and the majority were obese. Significant associations exist between several modifiable barriers and not meeting physical activity guidelines.

Undergraduate Medical Science Students' Positive Attitude towards Online Classes during COVID-19 Pandemic in a Medical College: A Descriptive Cross-sectional Study.

The outbreak of COVID-19 led to lockdown, which in turn led to the closure of schools and colleges. This situation created an opportunity to transform the conventional learning methods into an online or virtual method using various digital platforms. Nepalese Army Institute of Health Sciences started online classes as an alternative way to resume education during this pandemic. Therefore, this study aims to identify the prevalence of medical science students with a positive attitude towards online classes during the COVID-19 pandemic in a medical college of Kathmandu, Nepal. The study was conducted among 513 students using descriptive cross-sectional study design who were currently studying Bachelor of Medicine, Bachelor of Surgery, Proficiency Certificate Level Nursing, Bachelor of Science in Nursing, and Bachelor of Nursing Science under the Nepalese Army Institute of Health Sciences. Data was collected from June-July 2020 through an online self-administered questionnaire using Google forms. The results were presented through frequency, percentage, mean, and standard deviation. In this study, 112 (87.5%) Bachelor of Science in Nursing, 189 (83.6%) Bachelor of Medicine, Bachelor of Surgery, and 63 (82.9%) Bachelor of Science in Nursing students had a positive attitude towards online classes, while 51 (61.5%) of Proficiency Certificate Level Nursing students had a negative attitude towards it. Most bachelor-level students had a positive attitude towards online classes. With a positive attitude, students' participation and adaptability in online classes will be high, resulting in better academic performance.

Pesticide usage practices as sources of occupational exposure and health impacts on horticultural farmers in Meru County, Kenya

This study assessed pesticide usage practices, knowledge and health effects of pesticides through occupational exposure in randomly selected horticultural farmers in Imenti North, Imenti South and Buuri Sub-counties in Meru, Kenya, where horticultural crops are grown intensively for export and local consumption. The study was done through use of questionnaire distributed to farmers' households, agricultural extension workers and health care workers. The survey established that various classes of pesticides were used in horticultural crop farming and animal production in all the three sub-counties, with the most frequently used (>60 respondents out of 173) being parathion, diazinon, dimethoate, permethrin, pirimiphos methyl, endrin, deltamethrin, dieldrin, propoxur and endosulfan. It was found that there is a gap between the existing government regulations on pesticide use and safe handling and the implementation of these regulations by dealers, farmers and farm workers in the three sub-counties as some of the pesticides that were being used such as parathion, endrin, dieldrin and carbofuran had been banned by the government. Although most farmers had general information on pesticide usage through various social groups and contact with agricultural extension workers, only 32–43 % of the farmers had received training on pesticide handling and use. Most farmers (65%) had knowledge of safe pesticide handling procedures including reading labels on packages and wearing protective clothing; but many farmers (44% in Buuri, 57% in Imenti South and 60% in Imenti North) did not wear the requisite protective clothing when applying pesticides. The agricultural extension workers (52%) and health care workers (59%) were trained in their work and had at least a certificate level qualification from a tertiary institution. Most agricultural extension workers (95%) and health care workers (71%) had experience of dealing with pesticides and knew how to administer 1st AID against pesticide poisoning, respectively. Farmers (26%) reported experiencing health effects after using pesticides, with most effects being felt after using dimethoate, malathion, carbofuran, carbaryl and heptachlor. There was a statistically significant (p < 0.05) association between various factors (availability of protective clothing, hiring of labourers, farm land size, expenditure on pesticides and expenditure on treatment, respectively) on intoxication from pesticide exposure.

Perception of Students and Faculty on Problem Based Learning in Proficiency Certificate Level Nursing Program

Patan Academy of Health Sciences intended to implement problem based learning in proficiency certificate level nursing program who have just completed grade 10. Presently in Nepal, the available literature on use of problem based learning as teaching learning methods is limited to undergraduate medicine who have passed 10+2 or equivalent. It was conducted to measure the perception of students and faculty on problem based learning in nursing program. Nursing faculty who have been involved in teaching learning of nursing curriculum were trained to conduct problem based learning and write problem based learning case. Prior to run problem based learning case, students were also oriented for the problem based learning process. A 44 students and seven faculty returned the filled data collection tool. Both the students and tutors perceived that the problem based learning is an effective teaching learning method. They also found that the attributes of problem based learning such as self-directed learning, collaborative learning, team work and fun learning. Students were eager to have more problem based learning session in their curriculum. Faculty also perceived that problem based learning can be a better teaching learning methods and it can be implemented in proficiency certificate level nursing. This study shows the acceptance of problem based learning as a teaching learning methods in proficiency certificate level nursing program by both the students and faculty.

Methods and Implementation of the 2019 EMS Practice Analysis

Background: The EMS Practice Analysis provides a vision of current prehospital care by defining the work performed by EMS professionals. In this manuscript, we present the National Advanced Life Support (ALS) EMS Practice Analysis for the advanced EMT (AEMT) and paramedic levels of certification. The goal of the 2019 EMS Practice Analysis is to define the work performed by EMS professionals and present a new template for future practice analyses. Methods: The project was executed in three phases. Phase 1 defined the types/frequency of EMS clinical presentations using the 2016 National Emergency Medical Services Information System (NEMSIS) dataset. Phase 2 defined the criticality or potential for harm of these clinical presentations through a survey of a random sample of nationally certified EMS professionals and medical directors. Phase 3 defined the tasks and the associated knowledge, skills, and abilities (KSA) that encompass EMS care through focus groups of subject matter experts. Results: In Phase 1, the most common EMS adult impressions were traumatic injury, abdominal pain/problems, respiratory distress/arrest, behavioral/psychiatric disorder, and syncope/fainting. The most common pediatric impressions were traumatic injury, behavioral/psychiatric disorder, respiratory distress/arrest, seizure, and abdominal pain/problems. Criticality was defined in Phase 2 with the highest risk of harm for adults being airway obstruction, respiratory distress/arrest, cardiac arrest, hypovolemia/shock, allergic reaction, or stroke/CVA. In comparison, pediatric patients presenting with airway obstruction, respiratory distress/arrest, cardiac arrest, hypovolemia/shock, allergic reaction, stroke/CVA, and inhalation injury had the highest potential for harm. Finally, in Phase 3, task statements were generated for both paramedic and AEMT certification levels. A total of 425 tasks and 1,734 KSAs were defined for the paramedic level and 405 tasks and 1,636 KSAs were defined for the AEMT level. Conclusion: The 2019 ALS Practice Analysis describes prehospital practice at the AEMT and paramedic levels. This approach allows for a detailed and robust evaluation of EMS care while focusing on each task conducted at each level of certification in EMS. The data can be leveraged to inform the scope of practice, educational standards, and assist in validating the ALS levels of the certification examination.