Development and psychometric assessment of the basic resuscitation skills self-efficacy scale

Background: Nurses are usually the first responders to an in-hospital cardiac arrest. As bystanders, nurses are expected to master some basic resuscitation skills. Self-efficacy levels are a key component in the acquisition of basic resuscitation skills. Aim: To develop, test and validate a self-efficacy scale that accurately measures nursing students’ confidence levels in their capabilities when responding to a cardiac arrest. Methods: This study enrolled a conveniently recruited sample of 768 nursing students from two different universities in Europe. The Basic Resuscitation Skills Self-Efficacy Scale (BRS-SES) was developed and its psychometrics established. Content validity, criterion validity, discriminant validity, and internal consistency were assessed. Performing item-analysis, principal component analysis and known group analysis evaluated construct validity. Results: Principal component analysis revealed the three-subscale structure of the final 18-item BRS-SES. A Cronbach’s alpha of 0.96 for the overall measure demonstrated the internal consistency of the BRS-SES. Data also evidenced discriminant ability of the BRS-SES and known-group analysis showed its high sensitivity and specificity. Conclusion: The BRS-SES showed good psychometric properties for measuring self-efficacy in basic resuscitation skills that nursing students, as future first responders to an in-hospital cardiac arrest, will be expected to master. Implications for practice: The BRS-SES is a validated tool that could have a positive impact on the training of basic resuscitation skills and, therefore, on patients’ outcomes

Lateral migration of large sedimentary bodies in a deep-marine system offshore of Argentina

Abstract Contourite features are increasingly identified in seismic data, but the mechanisms controlling their evolution remain poorly understood. Using 2D multichannel reflection seismic and well data, this study describes large Oligocene- to middle Miocene-aged sedimentary bodies that show prominent lateral migration along the base of the Argentine slope. These form part of a contourite depositional system with four morphological elements: a plastered drift, a contourite channel, an asymmetric mounded drift, and an erosive surface. The features appear within four seismic units (SU1–SU4) bounded by discontinuities. Their sedimentary stacking patterns indicate three evolutionary stages: an onset stage (I) (~ 34–25 Ma), a growth stage (II) (~ 25–14 Ma), and (III) a burial stage (< 14 Ma). The system reveals that lateral migration of large sedimentary bodies is not only confined to shallow or littoral marine environments and demonstrates how bottom currents and secondary oceanographic processes influence contourite morphologies. Two cores of a single water mass, in this case, the Antarctic Bottom Water and its upper interface, may drive upslope migration of asymmetric mounded drifts. Seismic images also show evidence of recirculating bottom currents which have modulated the system’s evolution. Elucidation of these novel processes will enhance basin analysis and palaeoceanographic reconstructions

Pseudoartrosis de escafoides carpiano tratadas mediante la técnica de Matti-Russe: estudio retrospectivo de 36 casos

Presentamos un estudio retrospectivo de una serie de 36 pacientes con pseudoartrosis de escafoides operados mediante la técnica de Matti-Russe entre 1985 y 1991. Utilizamos injerto córtico esponjoso obtenido del radio (50%), cresta ilíaca (42%) y cúbito (8%) sin diferencias en la incorporación. La tasa de curación fue mayor en las pseudoartrosis medias y distales (80%) que en las de localización proximal (54%). El 80% de los fracasos de curación en la localización media y distal eran pseudoartrosis de más de 30 meses de evolución. Los cambios degenerativos en el carpo de las pseudoartrosis no curadas fueron significativamente mayores (p< 0,001) que en las que se obtuvo la consolidación. La localización y la antiguedad de la pseudoartrosis parecen ser dos importantes factores pronósticos. La técnica de Matti-Russe presenta limitaciones en la pseudoartrosis de localización proximal y en los carpos muy degenerados.We reported a retrospective study of 36 patients with a pseudoarthrosis of the carpal scaphoid bone treated by the Matti-Russe operation from 1985 to 1991. We used radial (50%), iliac (42%) or ulnar (8%) autogenous grafts without any difference in the rate of incorporation. The rate of healing of the pseudoarthrosis was higher in mid and distal location (80%) than in proximal location (54%). In 80% of cases, healing failures in the mid and distal location occurred in old pseudoarthrosis ( >3 0 months evolution). Carpal degenerative changes were significantly higher (p < 0,01) in patients with not healed pseudoarthrosis. The location and the age of the pseudoarthrosis appear to be important prognostic factors. The Matti-Russe technique has limitations when is performed either in proximal pseudoarthrosis or in the presence of advanced radiocarpal osteoarthritis

Design and validation of a three-instrument toolkit for the assessment of competence in electrocardiogram rhythm recognition

Background: Rapid and accurate interpretation of cardiac arrhythmias by nurses has been linked with safe practice and positive patient outcomes. Although training in electrocardiogram (ECG) rhythm recognition is part of most undergraduate nursing programmes, research continues to suggest that nurses and nursing students lack competence in recognising cardiac rhythms. In order to promote patient safety, nursing educators must develop valid and reliable assessment tools that allow the rigorous assessment of this competence before nursing students are allowed to practise without supervision. Aim: To develop and psychometrically evaluate a toolkit to holistically assess competence in ECG rhythm recognition. Methods: Following a convenience sampling technique, 293 nursing students from a nursing faculty in a Spanish university were recruited for the study. The following three instruments were developed and psychometrically tested: a knowledge assessment tool (ECG-KAT), a skills assessment tool (ECG-SAT) and a self-efficacy assessment tool (ECG-SES). Reliability and validity (content, criterion and construct) of these tools were meticulously examined. Results: A high Cronbach’s alpha coefficient demonstrated the excellent reliability of the instruments (ECG-KAT=0.89; ECG-SAT=0.93; ECG-SES=0.98). An excellent context validity index (S-CVI/Ave>0.94) and very good criterion validity were evidenced for all the tools. Regarding construct validity, principal component analysis revealed that all items comprising the instruments contributed to measure knowledge, skills or self-efficacy in ECG rhythm recognition. Moreover, known-groups analysis showed the tools’ ability to detect expected differences in competence between groups with different training experiences. Conclusion: The three-instrument toolkit developed showed excellent psychometric properties for measuring competence in ECG rhythm recognition

Strain balanced quantum posts

Quantum posts are assembled by epitaxial growth of closely spaced quantum dot layers, modulating the composition of a semiconductor alloy, typically InGaAs. In contrast with most self-assembled nanostructures, the height of quantum posts can be controlled with nanometer precision, up to a maximum value limited by the accumulated stress due to the lattice mismatch. Here we present a strain compensation technique based on the controlled incorporation of phosphorous, which substantially increases the maximum attainable quantum post height. The luminescence from the resulting nanostructures presents giant linear polarization anisotropy.Comment: Submitted to Applied Physics Letters (7th March 2011). 4 pages, 4 figure

The diagnosis of hereditary angioedema: family caregivers’ experiences

The aim of this study was to understand the experiences of family caregivers in the process of diagnosing hereditary angioedema. An interpretive and qualitative research methodology based on Gadamer’s philosophical hermeneutics was carried out. Data collection took place between May 2015 and August 2016 and included a focus group and in-depth interviews with 16 family caregivers. Two themes define the experiences of family caregivers: “Family life focuses on identifying the problem” and “Discovering and coping with a complex diagnosis.” The process of diagnosis generates fear, anxiety, uncertainty, and incomprehension. Family caregivers are the main support for patients diagnosed with hereditary angioedema. As they share in the patients’ suffering, they need a diagnosis to be established to be able to cope with the disease and offer support. Family health nurses can contribute to improving the coping process in this phase of the disease